Stuckey Melanie, Fulkerson Robyn, Read Emily, Russell-Minda Elizabeth, Munoz Claudio, Kleinstiver Peter, Petrella Robert
School of Kinesiology, University of Western Ontario, London, Ontario, Canada.
J Diabetes Sci Technol. 2011 Jul 1;5(4):936-44. doi: 10.1177/193229681100500417.
Remote monitoring technologies are ideally suited for rural communities with limited access to health care. In an 8-week pilot study, we examined the feasibility of implementing and conducting a technology-intensive intervention in an underserviced rural setting. Our goal was to test the utility of self-monitoring technologies, physical activity, and education as tools to manage health indicators for the development of the cardiovascular complications (CVCs) of type 2 diabetes.
The Diabetes and Technology for Increased Activity study was an open single-center study conducted in a community-based research setting. All 24 participants were provided with a Blackberry™ Smartphone, blood pressure monitor, glucometer, and pedometer. Smartphones transmitted measurements and survey results to the database, interfaced participants with the clinical team, and allowed for self-monitoring.
Outcomes were improved body composition, improved markers of CVC risk factors, increased daily exercise, and interest in or awareness of lifestyle changes that impact health outcomes. Participants had excellent compliance for measurements, as self-monitoring provided a sense of security that improved from week 4 to week 8.
Our team gained substantial insight into the operational requirements of technology-facilitated health care, including redefined hours of service; data reporting, management, and access protocols; and the utility of real-time clinical measures by remote monitoring. We developed an understanding of knowledge translation strategies as well as successful motivational and educational tools. Importantly, remote monitoring technology was found to be feasible and accepted in a rural setting.
远程监测技术非常适合医疗服务获取有限的农村社区。在一项为期8周的试点研究中，我们检验了在服务不足的农村地区实施和开展一项技术密集型干预措施的可行性。我们的目标是测试自我监测技术、体育活动和教育作为管理2型糖尿病心血管并发症（CVC）健康指标工具的效用。
“增加活动量的糖尿病与技术”研究是在社区研究环境中进行的一项开放性单中心研究。为所有24名参与者提供了一部黑莓智能手机、血压计、血糖仪和计步器。智能手机将测量结果和调查结果传输到数据库，使参与者与临床团队建立联系，并实现自我监测。
结果包括身体成分改善、CVC危险因素标志物改善、日常锻炼增加以及对影响健康结果的生活方式改变的兴趣或认识提高。参与者对测量的依从性极佳，因为自我监测提供了一种安全感，这种安全感从第4周到第8周有所增强。
我们的团队对技术辅助医疗保健的操作要求有了深入了解，包括重新定义的服务时间；数据报告、管理和访问协议；以及远程监测实时临床测量的效用。我们对知识转化策略以及成功的激励和教育工具形成了认识。重要的是，发现远程监测技术在农村环境中是可行的且被接受的。
