Disparities in the use of a mHealth medication adherence promotion intervention for low-income adults with type 2 diabetes

Nelson, Lyndsay A.; Mulvaney, Shelagh A.; Gebretsadik, Tebeb; Ho, Yun-Xian; Johnson, Kevin B.; Osborn, Chandra Y.

doi:10.1093/jamia/ocv082

Cited by 83 publications

(118 citation statements)

References 35 publications

Supporting

Mentioning

110

Contrasting

Order By: Relevance

“…19 Table 2 reports these characteristics by participants who did and did not complete a follow-up interview. Of the 60 participants who completed the interview, the average age was 50.0 -10.1 years old; 65% were female and 62% were non-white (95% African-American); 15% had less than a high school degree or equivalent; 70% had annual household incomes less than $20K; and 83% were either uninsured or had public insurance.…”

Section: Resultsmentioning

confidence: 99%

“…17,19 Users receive a daily tailored text message at a random time each day addressing 1 of their 3 highest ranked barriers to adherence (out of 17 assessed). Barriers are reassessed monthly to update the user experience.…”

Section: Med Interventionmentioning

confidence: 99%

“…19 We used a combination of advertisements, and worked with clinic staff to identify eligible persons who were at least 18 years of age, were English speaking, were prescribed diabetes medication(s), and had a cell phone with text message capabilities. Exclusion criteria included a preexisting diagnosis of dementia, auditory limitations, and the inability to see and respond to text messages.…”

Section: Med Interventionmentioning

confidence: 99%

See 2 more Smart Citations

mHealth Intervention Elements and User Characteristics Determine Utility: A Mixed-Methods Analysis

Nelson

Mulvaney

Johnson

et al. 2017

Diabetes Technology & Therapeutics

View full text Add to dashboard Cite

Background: Mobile health (mHealth) interventions are improving the medication adherence of adults with type 2 diabetes mellitus (T2DM), but few studies examine how users experience these interventions. Therefore, we used a mixed-methods approach to understand how T2DM users experience a text messaging and interactive voice response (IVR)-delivered medication adherence intervention called MEssaging for Diabetes (MED). Methods: Adults with T2DM used MED as part of a 3-month pilot study. MED sends daily tailored text messages addressing adherence barriers, daily assessment text messages asking about adherence, and weekly tailored IVR calls providing adherence feedback, encouragement, and questions to facilitate problem solving. Sixty participants completed feedback interviews. We used a mixed-methods approach to understand their experience, examining associations between participants' characteristics and their feedback. Results: Participants who completed feedback interviews were on average 50.0 -10.1 years old; 65% female, 62% non-white; 15% had less than a high school education, 70% had annual incomes less than $20K; and average hemoglobin A1c was 8.0% -1.9%. Participants rated each intervention element favorably; common reasons for MED's helpfulness included receiving novel information about diabetes medications, emotional support, and reminders to take medication. People who were younger and more recently diagnosed with T2DM had more favorable experiences using MED. In general, users valued text messages more than IVR calls. Conclusions: Consideration of the user experience is critical for developing engaging mHealth interventions.User feedback reveals what mHealth elements have the most value and why, which users to target, and how to optimize an intervention's utility and appeal.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Med Interventionmentioning

confidence: 99%

Section: Med Interventionmentioning

confidence: 99%

See 1 more Smart Citation

mHealth Intervention Elements and User Characteristics Determine Utility: A Mixed-Methods Analysis

Nelson

Mulvaney

Johnson

et al. 2017

Diabetes Technology & Therapeutics

View full text Add to dashboard Cite

show abstract

“…Although minorities are disproportionately likely to own a smartphone [14] and to have chronic conditions requiring care coordination [24,25], past research has found that racial/ethnic minorities had lower uptake of technologies such as patient portals [26,27] or a longitudinal mHealth intervention with daily text messaging [28]. In contrast, high-risk FQHC patients in this study expressed a willingness to use the proposed app, which leverages automated location tracking technologies in a way that could enhance information transfer to PCPs, while requiring minimal human effort from app users.…”

Section: Discussionmentioning

confidence: 99%

�The Doctor Needs to Know�: Acceptability of Smartphone Location Tracking for Care Coordination (Preprint)

Liss¹,

Serrano²,

Wakeman³

et al. 2017

Preprint

View full text Add to dashboard Cite

show abstract

“…The MED intervention uses the SuperEgo mobile communications platform (Mulvaney et al, 2012) to deliver and tailor text messages and voice communications to promote medication adherence (Nelson et al, 2015; Osborn & Mulvaney, 2013). MED addresses users’ unique barriers to adherence.…”

Section: Methodsmentioning

confidence: 99%

The MEssaging for Diabetes (MED) intervention improves short-term medication adherence among low-income adults with type 2 diabetes

et al. 2016

Self Cite

View full text Add to dashboard Cite

Adults with type 2 diabetes (T2DM) and low socioeconomic status (SES) have high rates of medication nonadherence, and, in turn, suboptimal glycemic control (hemoglobin A1c [HbA1c]). We tested the initial efficacy of a short message service (SMS) text messaging and interactive voice response (IVR) intervention to promote adherence among this high-risk group. Eighty low SES, diverse adults with T2DM used the MEssaging for Diabetes (MED) SMS/IVR intervention for three months. We used a pre-post single group design to explore adherence changes over three months, and a quasi-experimental design to test the impact of MED on HbA1c among the intervention group relative to a matched, archival control group. Compared to baseline, adherence improved at one (AOR: 3.88, 95% CI: 1.79, 10.86) and at two months (AOR: 3.76, 95% CI: 1.75, 17.44), but not at three months. HbA1c remained stable, with no differences at three months between the intervention group and the control group. MED had a positive, short-term impact on adherence, which did not translate to improvements in HbA1c. Future research should explore the longer-term impact of SMS/IVR interventions on the medication adherence of high risk adults with T2DM.

show abstract

Disparities in the use of a mHealth medication adherence promotion intervention for low-income adults with type 2 diabetes

Cited by 83 publications

References 35 publications

mHealth Intervention Elements and User Characteristics Determine Utility: A Mixed-Methods Analysis

mHealth Intervention Elements and User Characteristics Determine Utility: A Mixed-Methods Analysis

�The Doctor Needs to Know�: Acceptability of Smartphone Location Tracking for Care Coordination (Preprint)

The MEssaging for Diabetes (MED) intervention improves short-term medication adherence among low-income adults with type 2 diabetes

Contact Info

Product

Resources

About