The effectiveness of text messages support for diabetes self-management: protocol of the TEXT4DSM study in the democratic Republic of Congo, Cambodia and the Philippines

Josefien van Olmen, Grace Marie Ku, Maurits van Pelt, Jean Clovis Kalobu, Heang Hen, Christian Darras, Kristien Van Acker, Balthazar Villaraza, Francois Schellevis, Guy Kegels, Josefien van Olmen, Grace Marie Ku, Maurits van Pelt, Jean Clovis Kalobu, Heang Hen, Christian Darras, Kristien Van Acker, Balthazar Villaraza, Francois Schellevis, Guy Kegels

Abstract

Background: People with diabetes find it difficult to sustain adequate self-management behaviour. Self-Management Support strategies, including the use of mobile technology, have shown potential benefit. This study evaluates the effectiveness of a mobile phone support intervention on top of an existing strategy in three countries, DR Congo, Cambodia and the Philippines to improve health outcomes, access to care and enablement of people with diabetes, with 480 people with diabetes in each country who are randomised to either standard support or to the intervention.

Design/methods: The study consists of three sub-studies with a similar design in three countries to be independently implemented and analysed. The design is a two-arm Randomised Controlled Trial, in which a total of 480 adults with diabetes participating in an existing DSME programme will be randomly allocated to either usual care in the existing programme or to usual care plus a mobile phone self-management support intervention. Participants in both arms complete assessments at baseline, one year and two years after inclusion.Glycosylated haemoglobin blood pressure, height, weight, waist circumference will be measured. Individual interviews will be conducted to determine the patients' assessment of chronic illness care, degree of self-enablement, and access to care before implementation of the intervention, at intermediate moments and at the end of the study.Analyses of quantitative data including assessment of differences in changes in outcomes between the intervention and usual care group will be done. A probability of <0.05 is considered statistically significant. Outcome indicators will be plotted over time. All data are analysed for confounding and interaction in multivariate regression analyses taking potential clustering effects into account.Differences in outcome measures will be analysed per country and realistic evaluation to assess processes and context factors that influence implementation in order to understand why it works, for whom, under which circumstances. A costing study will be performed.

Discussion: The intervention addresses the problem that the greater part of diabetes management takes place without external support and that many challenges, unforeseen problems and questions occur at moments in between scheduled contacts with the support system, by exploiting communication technology.

Trial registration: ISRCTN86247213.

Figures

Figure 1
Figure 1
Context, study sites and block randomisation of the TEXTFORDSM study.

References

    1. Funnell M. Peer-based behavioural strategies to improve chronic disease self-management and clinical outcomes: evidence, logistics, evaluation considerations and needs for future research. Family practice, 27 Suppl. 2010;1(June 2009):i17–i22. doi: 10.1093/fampra/cmp027.
    1. Shigaki C, Kruse R, Mehr D, Sheldon K, Bin G, Moore C, Lemaster J. Motivation and diabetes self-management. Chronic Illn. 2010;6(1745–9206 (Electronic)):202–214.
    1. van Olmen J, Ku G, Bermejo R, Kegels G, Hermann K, Van Damme W. The Growing Caseload of Chronic Life-Long Conditions Calls for a Move towards Full Self-Management in Low Income Countries. Glob Heal. 2011;7(1):38. doi: 10.1186/1744-8603-7-38.
    1. Coleman K, Austin BT, Brach C, Wagner EH. Evidence on the Chronic Care Model in the new millennium. Health Aff. 2009;28(1):75–85. doi: 10.1377/hlthaff.28.1.75.
    1. Funnell M, Nwankwo R, Gillard M, Anderson R, Tang T. Implementing an empowerment-based diabetes self-management education program. Diabetes Educ. 2005;31(1):53. doi: 10.1177/0145721704273166. 55–6, 61.
    1. Gary TL, Genkinger JM, Guallar E, Peyrot M, Brancati FL. Meta-analysis of randomized educational and behavioral interventions in type 2 diabetes. Diabetes Educ. 2003;29(3):488–501. doi: 10.1177/014572170302900313.
    1. Glazier RH, Bajcar J, Kennie NR, Willson K. A systematic review of interventions to improve diabetes care in socially disadvantaged populations. Diabetes Care. 2006;29(7):1675–1688. doi: 10.2337/dc05-1942.
    1. Lorig K, Sobel D, Stewart A, Brown B Jr, Bandura A, Ritter P, Gonzalez V. Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial. Medical Care. 1999;37(0025–7079 (Print):5–14.
    1. Krishna S, Boren SA, Balas EA. Healthcare via cell phones: a systematic review. Telemedicine and e-Health. 2009;15(3):231–240. doi: 10.1089/tmj.2008.0099. Retrieved from .
    1. Lester RT, Ritvo P, Mills EJ, Kariri A, Karanja S, Chung MH, Jack W. Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial. Lancet. 2010;376(9755):1838–1845. doi: 10.1016/S0140-6736(10)61997-6.
    1. Trief P, Sandberg J, Izquierdo R, Morin P, Shea S, Brittain R, Feldhousen E. Diabetes management assisted by telemedicine: patient perspectives. Telemedicine and e-Health. 2008;14(1556–3669 (Electronic)):647–655.
    1. Cole-Lewis H, Kershaw T. Text messaging as a tool for behavior change in disease prevention and management. Epidemiol Rev. 2010;32(1):56–69. doi: 10.1093/epirev/mxq004.
    1. Holtz B, Lauckner C. Diabetes management via mobile phones: a systematic review. Telemedicine journal and e-health : the official journal of the American Telemedicine Association. 2012;18(3):175–184. doi: 10.1089/tmj.2011.0119.
    1. Shea S, Weinstock R, Teresi J, Palmas W, Starren J, Cimino J, Lai A. 1067–5027 (Print) A randomized trial comparing telemedicine case management with usual care in older, ethnically diverse, medically underserved patients with diabetes mellitus: 5 year results of the IDEATel study. J Am Med Inform Assoc. 2009;16:446–456. doi: 10.1197/jamia.M3157.
    1. Tomlinson M, Rotheram-Borus MJ, Swartz L, Tsai AC. Scaling Up mHealth: Where Is the Evidence? PLoS Med. 2007;10(2):e1001382.
    1. Free C, Phillips G, Galli L, Watson L, Felix L, Edwards P, Patel V, Haines V. The Effectiveness of Mobile-Health Technology-Based Health Behaviour Change or Disease Management Interventions for Health Care Consumers: A Systematic Review. PLoS Med. 2013;10(1):e1001362. doi: 10.1371/journal.pmed.1001362.
    1. Kahn BJG, Yang JS, Kahn JS. “Mobile” Health Needs And Opportunities In Developing Countries. Health Aff. 2010;2(2):254–260. doi: 10.1377/hlthaff.
    1. Mahmud N, Rodriguez J, Nesbit J. A text message-based intervention to bridge the healthcare communication gap in the rural developing world. Technology and health care : official journal of the European Society for Engineering and Medicine. 2010;18(2):137–144. doi: 10.3233/THC-2010-0576.
    1. Rotheram-Borus MJ, Tomlinson M, Gwegwe M, Comulada WS, Kaufman N, Keim M. Diabetes buddies: peer support through a mobile phone buddy system. Diabetes Educ. 2012;38(3):357–365. doi: 10.1177/0145721712444617.
    1. International Diabetes Federation. Diabetes Atlas. Retrieved February 6, 2013. 2011.
    1. Oum S, Prak P, Khuon E, Mey V, Aim S, Bounchan Y, Cin S. Prevalence of Non Communicable Disease Risk Factors in Cambodia. Steps Survey Country Report. Pnom Penh: University of Health Sciences & Ministry of Health; 2010.
    1. Fisher EB, Earp JA, Maman S, Zolotor A. Cross-cultural and international adaptation of peer support for diabetes management. Fam Pract. 2010;27(Suppl 1):i6–i16. doi: 10.1093/fampra/cmp013.
    1. Van Damme W, Kegels G. Health system strengthening and scaling up antiretroviral therapy: the need for context-specific delivery models: comment on Schneider et al. Reprod Health Matters. 2006;14(27):24–26. doi: 10.1016/S0968-8080(06)27243-4.
    1. De-Graft Aikins A, Boynton P, Atanga LL. Developing effective chronic disease interventions in Africa: insights from Ghana and Cameroon. Glob Heal. 2010;6:6. doi: 10.1186/1744-8603-6-6.
    1. Watkins P, Alemu S. Delivery of diabetes care in rural Ethiopia: an experience from Gondar. Ethiop Med J. 2003;41(0014–1755 (Print)):9–17.
    1. The Global Diabetes Community. HbA1c Units Converter - DCCT to IFCC. UK: ; 2012. Retrieved November 26, 2012, from .
    1. Shojania KG, Ranji SR, McDonald KM, Grimshaw J, Sundaram V, Rushakoff RJ, Owens DK. Effects of quality improvement strategies for type 2 diabetes on glycemic control: a meta-regression analysis. JAMA. 2006;296(4):427–440. doi: 10.1001/jama.296.4.427.
    1. Mbanya JCN, Motala AA, Sobngwi E, Assah FK, Enoru ST. Diabetes in sub-Saharan Africa. Lancet. 2010;375(9733):2254–2266. doi: 10.1016/S0140-6736(10)60550-8.
    1. Ramachandran A, Ma RCW, Snehalatha C. Diabetes in Asia. Lancet. 2010;375(9712):408–418. doi: 10.1016/S0140-6736(09)60937-5.
    1. He X, Wharrad HJ. Diabetes knowledge and glycemic control among Chinese people with type 2 diabetes. Int Nurs Rev. 2007;54(3):280–287. doi: 10.1111/j.1466-7657.2007.00570.x.
    1. American Association of Diabetes Educators. Seven Self-Care Behaviours. AADE . Retrieved September 21, 2012, from .
    1. Funnell M, Brown T, Childs B, Haas L. National standards for diabetes self-management education. Diabetes. 2009;33 doi: 10.2337/dc10-S089.
    1. Glasgow R, Wagner E, Schaefer J, Mahoney L, Reid R, Greene S. Development and validation of the Patient Assessment of Chronic Illness Care (PACIC) Medical care. 2005;43(5):436–44. doi: 10.1097/01.mlr.0000160375.47920.8c. Retrieved from .
    1. Fitzgerald JT, Davis WK, Connell C, Hess GE, Funnell M, Hiss RG. Development and Validation of the Diabetes Care Profile. Eval Health Prof. 1996;19(2):208–230. doi: 10.1177/016327879601900205.
    1. Howie JGR, Heaney D, Maxwell M. Quality, core values and the general practice consultation: issues of definition, measurement and delivery. Fam Pract. 2004;21(4):458–468. doi: 10.1093/fampra/cmh419.
    1. Fitzgerald JT, Anderson RM, Gruppen LD, Davis WK, Aman LC, Jacober SJ, Grunberger G. The reliability of the Diabetes Care Profile for African Americans. Eval Health Prof. 1998;21(1):52–65. doi: 10.1177/016327879802100103. Retrieved from .
    1. Garcia AA, Villagomez ET, Brown SA, Kouzekanani K, Hanis CL. The Starr County diabetes education study. Diabetes Care. 2001;24(1):16. doi: 10.2337/diacare.24.1.16. Retrieved from .
    1. Fitzgerald JT, Funnell MM, Hess GE, Barr PA, Anderson RM, Hiss RG, Davis WK. The reliability and validity of a brief diabetes knowledge test. Diabetes Care. 1998;21(5):706–10. doi: 10.2337/diacare.21.5.706. Retrieved from .
    1. Glasgow RE, Whitesides H, Nelson CC, King DK. Use of the Patient Assessment of Chronic Illness Care (PACIC) with diabetic patients. Diabetes Care. 2005;28(11):2655. doi: 10.2337/diacare.28.11.2655. Retrieved from .
    1. Van Eygen L, Van Lerberghe V, Blaise P, Woelk G, Criel B. The challenge of measuring quality of care at health centre level in Africa: The example of Tsholotsho health district in Matabeleland. Int J Health Plann Manage. 2007;22(1):63–89. doi: 10.1002/hpm.
    1. Marchal B, Dedzo M, Kegels G. A realist evaluation of the management of a well-performing regional hospital in Ghana. BMC Health Serv Res. 2010;10:24. doi: 10.1186/1472-6963-10-24.
    1. Pawson R, Tilley N. Realist Evaluation. Changes . London: SAGE Publications; 1997.
    1. Ridde V, Robert E, Guichard A, Blaise P, van Olmen J. L ’ approche Realist à l ’ épreuve du réel de l ’ évaluation des programmes. Revue. 2012;26(3):1–14.
    1. Byng R. Using Realistic Evaluation to Evaluate a Practice-level Intervention to Improve Primary Healthcare for Patients with Long-term Mental Illness. Evaluation. 2005;11(1):69–93. doi: 10.1177/1356389005053198.
    1. Yin RK. Enhancing the Quality of Case Studies in Health Services Research. Health Serv Res. 1999;34(5):1209–1224.
    1. Creese A, Parker D. Cost analysis in primary health care. Geneva: World Health Organisation; 1994.
    1. Drummond M, O’Brien B, Stoddart G, Torrance G. Methods for the Economic Evaluation of Health Care Programmes. Oxford: Oxford University Press; 1997.
    1. Fjeldsoe BS, Marshall AL, Miller YD. Behavior change interventions delivered by mobile telephone short-message service. Am J Prev Med. 2009;36(2):165–73. doi: 10.1016/j.amepre.2008.09.040.
    1. Ryan P, Lauver D. The efficacy of tailored interventions. J Nurs Scholarsh. 2002;34(1527–6546 (Print)):331–337. Retrieved from .
    1. Abegunde DO, Mathers CD, Adam T, Ortegon M, Strong K. The burden and costs of chronic diseases in low-income and middle-income countries. Lancet. 2007;370(9603):1929–38. doi: 10.1016/S0140-6736(07)61696-1.
    1. Ir P, Men C, Lucas H, Meessen B, Decoster K, Bloom G, Van Damme W. Self-reported serious illnesses in rural Cambodia: a cross-sectional survey. PLoS One. 2010;5(6):e10930. doi: 10.1371/journal.pone.0010930.
    1. van Olmen J, Criel B, Devadasan N, Pariyo G, De Vos P, Van Damme W. Primary Health Care in the 21st century : primary care providers and people’s empowerment. Trop Med Int Health. 2010;00(00):1–5. doi: 10.1111/j.1365-3156.2010.02475.x.
    1. World Health Organization. Prevention and Control of Noncommunicable Diseases: Guidelines for primary health care in low-resource settings. Geneva; 2012.

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