Parent-child interaction using a mobile and wireless system for blood glucose monitoring

Deede Gammon, Eirik Arsand, Ole Anders Walseth, Niklas Andersson, Martin Jenssen, Ted Taylor, Deede Gammon, Eirik Arsand, Ole Anders Walseth, Niklas Andersson, Martin Jenssen, Ted Taylor

Abstract

Background: Children 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.

Objective: A 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.

Methods: During 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.

Results: System 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.

Conclusions: User 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.

Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Blood glucose readings are sent to parent’s mobile phone

References

    1. Wysocki T. Associations among teen-parent relationships, metabolic control, and adjustment to diabetes in adolescents. J Pediatr Psychol. 1993 Aug;18(4):441–452.
    1. Levine B S, Anderson B J, Butler D A, Antisdel J E, Brackett J, Laffel L M. Predictors of glycemic control and short-term adverse outcomes in youth with type 1 diabetes. J Pediatr. 2001 Aug;139(2):197–203. doi: 10.1067/mpd.2001.116283.S002234760175473X
    1. Sullivan-Bolyai S, Deatrick J, Gruppuso P, Tamborlane W, Grey M. Constant vigilance: mothers' work parenting young children with type 1 diabetes. J Pediatr Nurs. 2003 Feb;18(1):21–29. doi: 10.1053/jpdn.2003.4.S088259630243905X
    1. Anderson B J, Brackett J, Ho J, Laffel L M. An office-based intervention to maintain parent-adolescent teamwork in diabetes management. Impact on parent involvement, family conflict, and subsequent glycemic control. Diabetes Care. 1999 May;22(5):713–721. .
    1. Weinger K, O'donnell K A, Ritholz M D. Adolescent views of diabetes-related parent conflict and support: a focus group analysis. J Adolesc Health. 2001 Nov;29(5):330–336. doi: 10.1016/S1054-139X(01)00270-1.S1054139X01002701
    1. Auslander W F, Anderson B J, Bubb J, Jung K C, Santiago J V. Risk factors to health in diabetic children: a prospective study from diagnosis. Health Soc Work. 1990 May;15(2):133–142.
    1. Laffel Lori M B, Connell Alexa, Vangsness Laura, Goebel-Fabbri Ann, Mansfield Abigail, Anderson Barbara J. General quality of life in youth with type 1 diabetes: relationship to patient management and diabetes-specific family conflict. Diabetes Care. 2003 Nov;26(11):3067–3073. .
    1. Cohen Dana M, Lumley Mark A, Naar-King Sylvie, Partridge Ty, Cakan Nedim. Child behavior problems and family functioning as predictors of adherence and glycemic control in economically disadvantaged children with type 1 diabetes: a prospective study. J Pediatr Psychol. 2004 Apr;29(3):171–184. doi: 10.1093/jpepsy/jsh019.
    1. Jadad Alejandro R, Delamothe Tony. What next for electronic communication and health care? BMJ. 2004 May 15;328(7449):1143–1144. doi: 10.1136/bmj.328.7449.1143. .328/7449/1143
    1. Murray E, Burns J, See Tai S, Lai R, Nazareth I. Interactive Health Communication Applications for people with chronic disease. Cochrane Database Syst Rev. 2005 Oct 19;4:CD004274. doi: 10.1002/14651858.CD004274.pub4.
    1. Mckay H G, King D, Eakin E G, Seeley J R, Glasgow R E. The diabetes network internet-based physical activity intervention: a randomized pilot study. Diabetes Care. 2001 Aug;24(8):1328–1334. .
    1. Mckay HG, Glasgow RE, Feil EG, Boles SM, Barrera M Jr. Internet-based diabetes self-management and support: initial outcomes from the diabetes network project. Rehabil Psychol. 2002;47(1):31–48. doi: 10.1037/0090-5550.47.1.31.
    1. Rodgers A, Corbett T, Bramley D, Riddell T, Wills M, Lin R-B, Jones M. Do u smoke after txt? Results of a randomised trial of smoking cessation using mobile phone text messaging. Tob Control. 2005 Aug;14(4):255–261. doi: 10.1136/tc.2005.011577.14/4/255
    1. Franklin Victoria, Waller Annalu, Pagliari Claudia, Greene Stephen. "Sweet Talk": text messaging support for intensive insulin therapy for young people with diabetes. Diabetes Technol Ther. 2003;5(6):991–996. doi: 10.1089/152091503322641042.
    1. Norwegian Post and Telecommunication Authorities (NPT), authors Telestatistics 2004. [2005 Aug 5]. .
    1. Grinter R, Eldridge M. "y do tngrs luv 2 txt msg?". ECSCW '01; 2001; Dordech, Netherlands.
    1. Technology and development: the real digital divide, authors. The Economist. 2005 Mar;374(8417):12–18.
    1. Pagliari C, Gregor P, Mcgillivray S, et al. Literature review and conceptual map of the area of E-health. NHS Service Development and Organisation Programme. [2005 Nov 3]. .
    1. Pope C, Ziebland S, Mays N. Qualitative research in health care. Analysing qualitative data. BMJ. 2000 Jan 8;320(7227):114–116. doi: 10.1136/bmj.320.7227.114. .
    1. Malterud K. Qualitative research: standards, challenges, and guidelines. Lancet. 2001 Aug 11;358(9280):483–488. doi: 10.1016/S0140-6736(01)05627-6.S0140673601056276
    1. Sandelowski M. The use of quotes in qualitative research. Res Nurs Health. 1994 Dec;17(6):479–482.
    1. Taylor T K, Biglan A. Behavioral family interventions for improving child-rearing: a review of the literature for clinicians and policy makers. Clin Child Fam Psychol Rev. 1998 Mar;1(1):41–60. doi: 10.1023/A:1021848315541.
    1. Grey M. Interventions for children with diabetes and their families. Annu Rev Nurs Res. 2000;18:149–170.
    1. Spears R, Lea M. Panacea or Panopticon? The hidden power in computer-mediated communication. Communic Res. 1994;21:427–459.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel