Islam Sheikh Mohammed Shariful, George Elena S, Maddison Ralph
Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
Mhealth. 2021 Jan 20;7:10. doi: 10.21037/mhealth-2020-3. eCollection 2021.
Evidence suggests that mobile phone health (mHealth) programs may improve healthy behaviours and clinical outcomes in patients with type 2 diabetes mellitus (T2DM). However, data on mHealth dietary behaviour is scarce in low-and-middle-income countries. This study aims to determine the effectiveness of a text messaging program on dietary habits in patients with T2DM.
We performed a post-hoc analysis of a randomised controlled trial of text messaging intervention in 236 patients with T2DM recruited from a tertiary hospital. Data were collected on socio-demographics, mobile phone use, family and medical history, self-reported diseases, medication use, health-seeking behaviour, diet and physical activity. Dietary behaviour was assessed using a modified version of WHO STEPS and the Indian Migration Study Food Frequency Questionnaire. Intervention participants received one message/day over six months focusing on lifestyle modification. Dietary intake of fruits, vegetables, sugar beverages and teaspoons of sugar in tea/coffee were determined in serves-per-week and were analysed using Chi-square tests. Poisson regression models, adjusted for age, sex and baseline values following an intention-to-treat approach were performed and expressed as an estimate of effect size.
At 6 months, the adjusted difference in vegetable consumption was -0.02 serves/week [95% confidence interval (CI): -0.11-0.06, P>0.05] and fruit intake was 0.02 serves/week (95% CI: -0.15-0.21, P>0.05). Consumption of sugar beverages reduced in both groups at 6 months with an adjusted difference of -0.34 serves/week (95% CI: -1.10-0.42, P>0.05). Teaspoons of sugar in tea reduced to 0.1±0.3 teaspoons/week in the control group, however, remained the same at 0.2±0.6 teaspoons/week in the intervention group with an adjusted difference of 0.94 teaspoons/week (95% CI: 0.04-1.84, P<0.05).
Our results suggest that a text messaging program did not significantly improve dietary behaviour in patients with T2DM. Further studies are warranted to explore the effectiveness of text messaging on dietary behaviour in adults with T2DM.
German Clinical Trials Register DRKS00005188, http://www.drks.de.
有证据表明，移动电话健康（mHealth）项目可能改善2型糖尿病（T2DM）患者的健康行为和临床结局。然而，在低收入和中等收入国家，关于mHealth饮食行为的数据很少。本研究旨在确定短信项目对T2DM患者饮食习惯的有效性。
我们对一项在一家三级医院招募的236例T2DM患者中进行的短信干预随机对照试验进行了事后分析。收集了社会人口统计学、手机使用情况、家族和病史、自我报告的疾病、用药情况、求医行为、饮食和身体活动等方面的数据。使用世界卫生组织（WHO）的“综合慢性病防控项目”（STEPS）的修订版和印度移民研究食物频率问卷评估饮食行为。干预组参与者在六个月内每天收到一条关注生活方式改变的短信。以每周份数确定水果、蔬菜、含糖饮料的摄入量以及茶/咖啡中的糖勺数，并使用卡方检验进行分析。采用意向性分析方法，对年龄、性别和基线值进行校正后，进行泊松回归模型分析，并以效应大小估计值表示结果。
在6个月时，蔬菜摄入量的校正差异为-0.02份/周[95%置信区间（CI）：-0.11 - 0.06，P>0.05]，水果摄入量为0.02份/周（95% CI：-0.15 - 0.21，P>0.05）。两组在6个月时含糖饮料的摄入量均有所减少，校正差异为-0.34份/周（95% CI：-1.10 - 0.42，P>0.05）。对照组茶中的糖勺数减少至0.1±0.3勺/周，然而，干预组保持在0.2±0.6勺/周，校正差异为0.94勺/周（95% CI：0.04 - 1.84，P<0.05）。
我们的结果表明，短信项目并未显著改善T2DM患者的饮食行为。有必要进一步研究以探索短信对成年T2DM患者饮食行为的有效性。
德国临床试验注册中心DRKS00005188，http://www.drks.de 。
