Parent-Child Interaction Using a Mobile and Wireless System for Blood Glucose Monitoring

Abstract

BackgroundChildren with type 1 diabetes and their parents face rigorous procedures for blood glucose monitoring and regulation. Mobile telecommunication systems show potential as an aid for families’ self-management of diabetes.ObjectiveA prototype designed to automatically transfer readings from a child’s blood glucose monitor to their parent’s mobile phone was tested. In this formative stage of development, we sought insights into the appropriateness of the concept, feasibility of use, and ideas for further development and research.MethodsDuring four months, a self-selected sample of 15 children (aged 9 to 15 years) with type 1 diabetes and their parents (n = 30) used the prototype approximately three times daily. Parent and child experiences were collected through questionnaires and through interviews with 9 of the parents.ResultsSystem use was easily integrated into everyday life, and parents valued the sense of reassurance offered by the system. Parents’ ongoing struggle to balance control of their children with allowing independence was evident. For children who measured regularly, use appeared to reduce parental intrusions. For those who measured irregularly, however, parental reminders (eg, “nagging”) appeared to increase. Although increased reminders could be considered a positive outcome, they can potentially increase parent-child conflict and thus also undermine proper metabolic control. Parents felt that system appropriateness tapered off with the onset of adolescence, partly due to a potential sense of surveillance from the child’s perspective that could fuel oppositional behavior. Parental suggestions for further developments included similar alerts of irregular insulin dosages and automatically generated dietary and insulin dosage advice.ConclusionsUser enthusiasm suggests that such systems might find a consumer market regardless of whether or not they ultimately improve health outcomes. Thus, more rigorous studies are warranted to inform guidelines for appropriate use. Potentially fruitful approaches include integrating such systems with theory-based parenting interventions and approaches that can aid in interpreting and responding to experiences of surveillance, virtual presence, and balances of power in e-mediated relationships.

Computerized Automated Reminder Diabetes System (CARDS): E-Mail and SMS Cell Phone Text Messaging Reminders to Support Diabetes Management

“…24 SMS messaging appears ideal for sending and receiving small snippets of data, such as BG values. SMS messages have provided reminders for clinic visits, 25,26 tuberculosis medication compliance, 27 and asthma control, 28,29 as well as diabetes monitoring [30][31][32][33][34][35][36][37][38] in adults. Few studies have focused on teens.…”

Mobile Phone Technology for Children with Type 1 and Type 2 Diabetes: A Parent Survey

“…25 A study by Gammon and associates provided children (ages 9-15) with cellular phone glucometers that sent text message glucose readings to their parents. 26 Parents in this study reported mixed feelings about the prototype, as some felt such a device would increase the responsibility of parents. The prototype described by Gammon and associates did not provide the child's health care provider with access to their glucose data and may be why parents did not respond as positively as they did in our survey.…”

Mobile phone technology in chronic disease management

“…However, the technology is highly topical and the literature reports rapid advancement in the field, for example in the management of cancer (Bielli et al 2004, Maguire et al 2008, asthma (Anhøj and Møldrup 2004), diabetes (Giménez-Pérez et al 2002, Farmer et al 2005, Gammon et al 2005, Carroll et al 2007, Kim and Jeong 2007, and the care of older people (Miskelly 2005). A review identified that studies have been conducted predominantly in Europe (Italy, Denmark, Norway, Spain and the UK), Korea and the United States (US) (Blake 2008b).…”

“…As well as improving communication between patients and healthcare professionals, there is potential for this form of technology to improve communication between parents and their children. A Norwegian study (Gammon et al 2005) reported the findings of a mobile and wireless system, which was used in the self-management of children with type 1 diabetes to improve communication with parents. The system automatically transferred readings from the child's blood glucose monitor directly to the parent's mobile phone.…”