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Developing a Customizable Texting Intervention for Diabetes Self-Management: Participatory Design Approach.

Stephanie A Robinson1,2, Popy Shell3, Linda Am1

  • 1Center for Health Optimization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, United States.

JMIR Formative Research
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PubMed
Summary
This summary is machine-generated.

Researchers developed two automated texting systems for diabetes self-management support in veterans. One version offers standard education, while the other provides interactive, customizable messages to improve patient engagement.

Keywords:
mobile phoneself-managementtext messagingtype 2 diabetesveterans

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Area of Science:

  • Digital health interventions
  • Mobile health (mHealth)
  • Chronic disease management

Background:

  • Uncontrolled diabetes leads to severe complications and mortality.
  • Effective diabetes self-management is crucial but often hindered by limited education and support.
  • Automated texting systems offer a scalable solution for delivering diabetes self-management education.

Purpose of the Study:

  • To develop two versions of an automated texting system for diabetes self-management.
  • To create a standard, education-only intervention (Diabetes Self-Management Support; DSMS).
  • To create an interactive, customizable intervention (DSMS+).

Main Methods:

  • Participatory design approach involving veterans and clinicians.
  • Iterative refinement of message content through surveys, interviews, and expert review.
  • Beta testing to ensure feasibility and inform final adjustments.

Main Results:

  • Two interventions, DSMS and DSMS+, were developed using the VA's Annie texting system.
  • Surveys indicated messages were relevant and confidence-enhancing; interviews guided preferences for content and frequency.
  • Expert review and beta testing refined message safety, appropriateness, clarity, and timing.

Conclusions:

  • Two distinct text messaging interventions were successfully developed for US veterans with diabetes.
  • DSMS provides standard content, while DSMS+ offers personalized, interactive support.
  • Future trials will evaluate if customization improves engagement and health outcomes in mobile health interventions.