Sapre Manali, Elaiho Cordelia R, Brar Prayaga Rena, Prayaga Ram, Constable Jeremy, Vangeepuram Nita
New York University Langone, New York, NY, United States.
Medical College of Wisconsin, Milwaukee, WI, United States.
JMIR Form Res. 2024 May 29;8:e45561. doi: 10.2196/45561.
Approximately 1 in 5 adolescents in the United States has prediabetes, and racially and ethnically minoritized youths are disproportionately impacted. Unfortunately, there are few effective youth diabetes prevention programs, and in-person interventions are challenging because of barriers to access and engagement.
We aimed to develop and assess the preliminary feasibility and acceptability of a youth-informed SMS text messaging platform to provide additional support and motivation to adolescents with prediabetes participating in a diabetes prevention workshop in East Harlem, New York City, New York, United States. We collaborated with our youth action board and a technology partner (mPulse Mobile) to develop and pilot-test the novel interactive platform.
The technology subcommittee of our community action board (comprising youths and young adults) used the results from focus groups that we had previously conducted with youths from our community to develop 5 message types focused on healthy eating and active living: goal setting, behavior tracking, individually tailored guidance, motivational messages, and photo diary. We used an iterative process to develop and pilot the program with our internal study team, including youths from our community action board and mPulse Mobile developers. We then conducted a pilot of the 12-week SMS text messaging program with 13 youths with prediabetes.
Participants (aged 15-21 years; 10/13, 77% female; 3/10, 23% Black and 10/13, 77% Hispanic or Latinx) received an average of 2 automated messages per day. The system correctly sent 84% (2231/2656) of the messages at the time intended; the remaining 16% (425/2656) of the messages were either sent at the incorrect time, or the system did not recognize a participant response to provide the appropriate reply. The level of engagement with the program ranged from 1 (little to no response) to 5 (highly responsive) based on how frequently participants responded to the interactive (2-way) messages. Highly responsive participants (6/13, 46%) responded >75% (1154/1538) of the time to interactive messages sent over 12 weeks, and 69% (9/13) of the participants were still engaged with the program at week 12. During a focus group conducted after program completion, the participants remarked that the message frequency was appropriate, and those who had participated in our in-person workshops reflected that the messages were reminiscent of the workshop content. Participants rated goal setting, behavior tracking, and tailored messages most highly and informed planned adaptations to the platform. Participants described the program as: "interactive, informative, enjoyable, very convenient, reliable, motivational, productive, and reflective."
We partnered with youths in the initial content development and pilot testing of a novel SMS text messaging platform to support diabetes prevention. This study is unique in the triple partnership we formed among researchers, technology experts, and diverse youths to develop a mobile health platform to address diabetes-related disparities.
在美国，约五分之一的青少年患有糖尿病前期，少数族裔青少年受此影响的比例尤其高。遗憾的是，有效的青少年糖尿病预防项目很少，而面对面干预因获取服务和参与方面的障碍而颇具挑战性。
我们旨在开发并评估一个以青少年为导向的短信平台的初步可行性和可接受性，该平台旨在为参与美国纽约市东哈莱姆区糖尿病预防工作坊的糖尿病前期青少年提供额外支持和激励。我们与青少年行动委员会及技术合作伙伴（mPulse Mobile）合作，开发并试点测试了这个新颖的互动平台。
我们社区行动委员会的技术小组委员会（由青少年和青年成年人组成）利用此前与社区青少年进行焦点小组讨论的结果，开发了5种关注健康饮食和积极生活方式的短信类型：目标设定、行为跟踪、个性化指导、激励信息和照片日记。我们通过迭代过程与内部研究团队（包括社区行动委员会的青少年和mPulse Mobile开发者）共同开发并试点该项目。然后，我们对13名患有糖尿病前期的青少年开展了为期12周的短信项目试点。
参与者年龄在15至21岁之间；13人中有10人（77%）为女性；13人中有3人（23%）为黑人，13人中有10人（77%）为西班牙裔或拉丁裔。参与者平均每天收到2条自动发送的信息。系统在预定时间正确发送了84%（2231/2656）的信息；其余16%（425/2656）的信息要么在错误时间发送，要么系统未识别参与者的回复以提供适当回复。根据参与者对互动（双向）信息的回复频率，对该项目的参与程度从1（几乎无回复）到5（高度响应）进行评分。高度响应的参与者（13人中有6人，46%）在12周内对发送的互动信息回复次数超过75%（1154/1538），12周时69%（13人中有9人）的参与者仍在参与该项目。在项目结束后进行的焦点小组讨论中，参与者表示信息频率合适，参加过我们面对面工作坊的人反映这些信息让人想起工作坊内容。参与者对目标设定、行为跟踪和个性化信息评价最高，并为平台的计划调整提供了参考。参与者将该项目描述为：“互动性强、信息丰富、有趣、非常方便、可靠、有激励作用、富有成效且能引发思考。”
我们在一个新颖的短信平台的初始内容开发和试点测试中与青少年合作，以支持糖尿病预防。本研究在研究人员、技术专家和不同青少年之间形成的三方合作关系中具有独特性，旨在开发一个移动健康平台来解决与糖尿病相关的差异问题。
