评估一款针对生活在农村和偏远社区的1型糖尿病成年人的心理健康支持移动应用程序：REACHOUT试点研究。

Evaluating a mental health support mobile app for adults with type 1 diabetes living in rural and remote communities: The REACHOUT pilot study.

作者信息

Tang Tricia S, Klein Gerri, Görges Matthias, Yip Annie, Fisher Lawrence, Polonsky William H, Hessler Danielle, Taylor Deanne

机构信息

Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.

BC Diabetes, Vancouver, British Columbia, Canada.

出版信息

Diabet Med. 2025 Mar;42(3):e15451. doi: 10.1111/dme.15451. Epub 2024 Nov 13.

DOI:10.1111/dme.15451

PMID:39538423

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11823309/

Abstract

AIMS

To evaluate a mobile app that delivers mental health support to adults with type 1 diabetes (T1D) living in rural and remote communities using the Reach, Effectiveness, Adoption, Intervention fidelity, Maintenance (RE-AIM) framework.

METHODS

This study recruited 46 adults to participate in a 6-month intervention using REACHOUT, a mobile app that delivers peer-led mental health support (one-on-one, group-based texting and face-to-face virtual). Baseline and 6-month assessments measured diabetes distress (DD), depressive symptoms and perceived support (from family/friends, health care team and peers) along with other RE-AIM metrics.

RESULTS

Calculations for reach and adoption found that 3% of eligible adults enrolled in REACHOUT and 55% of diabetes education centres participated in recruitment efforts. Maintenance metrics revealed 56% and 24% of peer supporters and participants, respectively, became peer supporters for a subsequent randomized controlled trial of REACHOUT. Post-intervention reductions were observed for overall distress (p = 0.007), powerlessness (p = 0.009), management distress (p = 0.001), social perception distress (p = 0.023), eating distress (p = 0.032) and depressive symptoms (p = 0.009); and elevations in support from family/friends and peers. After adjusting for sex and age, only support-related improvements persisted. When analysing women and men groups separately, women reported lower levels of overall distress, three distress subscales, and higher levels of family/friends and peer support whereas men did not.

CONCLUSIONS

While reach was relatively low, metrics for adoption and maintenance are promising. Improvements in distress were observed for the total sample, but these changes were reduced when controlling for sex and age, with significance maintained only for women. Digital health-enabled peer support may be instrumental in the delivery of mental health support to geographically isolated communities.

摘要

目的

使用“覆盖范围、有效性、采用率、干预保真度、维持率”（RE-AIM）框架，评估一款为生活在农村和偏远社区的1型糖尿病（T1D）成人提供心理健康支持的移动应用程序。

方法

本研究招募了46名成年人，使用REACHOUT（一款提供同伴主导的心理健康支持的移动应用程序，包括一对一、基于群组的短信交流和面对面虚拟交流）进行为期6个月的干预。基线和6个月评估测量了糖尿病困扰（DD）、抑郁症状以及感知到的支持（来自家人/朋友、医疗团队和同伴），同时还测量了其他RE-AIM指标。

结果

覆盖范围和采用率的计算发现，3%符合条件的成年人注册使用了REACHOUT，55%的糖尿病教育中心参与了招募工作。维持率指标显示，同伴支持者和参与者中分别有56%和24%成为了后续REACHOUT随机对照试验的同伴支持者。干预后，总体困扰（p = 0.007）、无助感（p = 0.009）、管理困扰（p = 0.001）、社会认知困扰（p = 0.023）、饮食困扰（p = 0.032）和抑郁症状（p = 0.009）均有所降低；来自家人/朋友和同伴的支持有所增加。在对性别和年龄进行调整后，只有与支持相关的改善仍然显著。分别分析女性和男性组时，女性报告的总体困扰、三个困扰子量表的水平较低，来自家人/朋友和同伴的支持水平较高，而男性则不然。