Burner Elizabeth, Menchine Michael, Taylor Elena, Arora Sanjay
Department of Emergency Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA.
J Diabetes Sci Technol. 2013 Jan 1;7(1):111-8. doi: 10.1177/193229681300700113.
The benefit of mobile health (mHealth) on diabetes management among low-income, inner-city patients is largely unknown, particularly for Latino patients. TExT-MED (Trial to Examine Text Message for Emergency Department Patients with Diabetes) is a text message-based program designed to improve disease knowledge, self-efficacy, and glycemic control among low-income, inner-city Latinos. In phase I, 23 patients participated in an acceptability and feasibility study. Contrary to our model, there was no increase in knowledge despite increases in self-efficacy and healthy behaviors. In phase II, we performed a mixed-methods analysis to understand how TExT-MED achieved these seemingly contradictory findings.
We performed a qualitative analysis of focus groups with patients from phase I. We explored patients' receipt of health information from TExT-MED and other information sources. We used these qualitative findings to perform a mixed-methods analysis of the outcomes from phase I, reanalyzing the quantitative measures of self-efficacy, diabetes knowledge, and healthy behaviors.
We conducted two focus groups, one in English and one in Spanish. Through qualitative analysis, we found gender differences in information sources, dietary self-efficacy, and desired educational content. Applying this knowledge, we re-stratified phase I outcomes by gender and found differential changes in diabetes knowledge, self-efficacy, and behaviors. Men had increased self-efficacy while women showed increased knowledge.
The efficacy of mHealth on diabetes management was affected by gender. Specifically, men and women differ in their dietary self-efficacy, information sources, and desired topics in future mHealth interventions. To achieve maximal impact, future mHealth interventions should be mindful of this gender difference.
移动健康（mHealth）对低收入市中心患者糖尿病管理的益处很大程度上尚不清楚，尤其是对拉丁裔患者。TExT-MED（急诊科糖尿病患者短信试验）是一个基于短信的项目，旨在提高低收入市中心拉丁裔患者的疾病知识、自我效能感和血糖控制水平。在第一阶段，23名患者参与了一项可接受性和可行性研究。与我们的模型相反，尽管自我效能感和健康行为有所增加，但知识水平并未提高。在第二阶段，我们进行了一项混合方法分析，以了解TExT-MED如何得出这些看似矛盾的结果。
我们对第一阶段患者的焦点小组进行了定性分析。我们探讨了患者从TExT-MED和其他信息来源获取健康信息的情况。我们利用这些定性结果对第一阶段的结果进行了混合方法分析，重新分析了自我效能感、糖尿病知识和健康行为的定量指标。
我们进行了两个焦点小组讨论，一个用英语，一个用西班牙语。通过定性分析，我们发现了信息来源、饮食自我效能感和期望的教育内容方面的性别差异。应用这些知识，我们按性别对第一阶段的结果进行了重新分层，发现糖尿病知识、自我效能感和行为存在差异变化。男性的自我效能感有所提高，而女性的知识水平有所提高。
mHealth对糖尿病管理的疗效受性别影响。具体而言，男性和女性在饮食自我效能感、信息来源以及未来mHealth干预中期望的主题方面存在差异。为了实现最大影响，未来的mHealth干预应注意这种性别差异。
