University of Missouri Institute for Data Science and Informatics, University of Missouri, Columbia, MO, USA.
Department of Health Management and Informatics, University of Missouri, Columbia, MO, USA.
J Diabetes Sci Technol. 2023 Jan;17(1):152-162. doi: 10.1177/19322968211043534. Epub 2021 Sep 16.
In this study, we focused on Healthy Coping, a key principle of ADCES7 Self-Care Behaviors (ADCES7) that enables people with diabetes to achieve health goals for self-care. We aimed to validate Healthy Coping-related feedback messages from diabetes mobile apps against the framework based on behavioral change theories.
We searched apps using the search terms: "diabetes," "blood sugar," "glucose," and "mood" from iTunes and Google Play stores. We entered a range of values on 3 Healthy Coping domains: (1) diabetes-related measures including blood glucose, blood pressure, HbA1c, weight, (2) physical exercise/activity, and (3) mood to generate feedback messages. We used a framework by adopting validated behavioral change theory-based models to evaluate the feedback messages against 3 dimensions of timing, intention, and content (feedback purpose and feedback response). The feedback purposes in this study were categorized into 7 purposes; warning, suggestion, self-monitoring, acknowledging, reinforcement, goal setting, and behavior contract.
We identified 1,749 apps from which 156 diabetes mobile apps were eligible and generated 473 feedback messages. The majority of generated feedback messages were related to blood sugar measurement. Only feedback messages on blood sugar under diabetes-related measures and mood domains encompassed all 7 feedback purposes under the content dimension.
Many feedback messages neither supported Healthy Coping domains nor followed the behavioral theory-based framework. It is important that feedback messages be structured around the dimensions of the behavioral theory-based framework to promote behavior change. Furthermore, our framework had the generalizability that can be used in other clinical areas.
在本研究中，我们专注于健康应对，这是 ADCES7 自我护理行为（ADCES7）的一个关键原则，使糖尿病患者能够实现自我护理的健康目标。我们旨在根据行为改变理论框架验证来自糖尿病移动应用程序的与健康应对相关的反馈信息。
我们使用搜索词“糖尿病”、“血糖”、“葡萄糖”和“情绪”从 iTunes 和 Google Play 商店中搜索应用程序。我们在 3 个健康应对领域输入了一系列值：（1）与糖尿病相关的指标，包括血糖、血压、HbA1c、体重，（2）体育锻炼/活动，和（3）情绪，以生成反馈信息。我们采用经过验证的基于行为改变理论的模型框架，根据时间、意图和内容（反馈目的和反馈响应）这 3 个维度评估反馈信息。本研究中的反馈目的分为 7 种：警告、建议、自我监测、确认、强化、目标设定和行为契约。
我们从 1,749 个应用程序中确定了 156 个符合条件的糖尿病移动应用程序，并生成了 473 条反馈信息。生成的反馈信息大多数与血糖测量有关。只有在糖尿病相关措施和情绪领域的血糖反馈信息涵盖了内容维度下的所有 7 种反馈目的。
许多反馈信息既不支持健康应对领域，也不符合基于行为理论的框架。重要的是，反馈信息应围绕行为理论框架的维度构建，以促进行为改变。此外，我们的框架具有通用性，可以在其他临床领域使用。
