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Insights Into How Digital Health Interventions Shape Outcomes for Emerging Adults Living With Type 1 Diabetes:
Ruoxi Wang1, Balpreet Panesar1, Mikayla Sonnenberg2,3
1Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.
Journal of Medical Internet Research
|September 5, 2025
Summary
Emerging adults with type 1 diabetes (T1D) benefit from a text message intervention (KiT) that enhances self-management knowledge and motivation. Different individuals respond to various components, indicating personalized digital health approaches are needed for T1D transition support.
Area of Science:
- Digital Health Interventions
- Type 1 Diabetes Management
- Adolescent and Young Adult Health
Background:
- Emerging adults with type 1 diabetes (T1D) require tailored support for self-management during the critical transition from pediatric to adult care.
- Existing digital health interventions offer promise but lack insight into specific component effectiveness and target populations.
- Understanding which components of digital interventions work, for whom, and how is crucial for optimizing care.
Purpose of the Study:
- To explore the implementation and impact of a text message-based intervention (Keeping in Touch; KiT) on emerging adults with T1D during their care transition.
- To identify specific KiT components that influence participants' transition experiences and understand the underlying mechanisms.
- To determine which subgroups of emerging adults with T1D may benefit most from the intervention's components.
Main Methods:
- A qualitative realist evaluation using semistructured interviews with 16 participants in the KiT intervention arm of a randomized controlled trial.
- Interviews were conducted to test an initial program theory regarding the pathways through which KiT components influence outcomes.
- Data analysis focused on understanding how intervention components (information, support, strategies, reminders) affected transition experiences and motivation.
Main Results:
- All five KiT intervention components positively impacted participants' transition experiences, with varying degrees of effect.
- T1D self-management information and suggestions had a universal positive effect; problem-solving and stress management effectiveness varied by individual characteristics.
- The intervention fostered improvements in diabetes knowledge and self-efficacy, demonstrating interconnected mechanisms influencing motivation.
Conclusions:
- A multicomponent, text message-based intervention like KiT can effectively support emerging adults with T1D in self-management during care transitions.
- Recognizing subgroup-specific responses to intervention components underscores the inadequacy of one-size-fits-all digital health approaches.
- Future digital interventions should be tailored and studied across diverse subgroups and contexts, potentially targeting individuals with lower baseline knowledge/self-efficacy or higher distress.
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