Early findings from three U.S. communities that received federal funding through the Beacon Community Cooperative Agreement Program suggest a "promising impact of mHealth on behavior change" for people with type 2 diabetes, according to an article in the Journal of Medical Internet Research.
Three Beacon Communities launched community-based mHealth programs as part of their health IT-enabled quality improvement efforts. New Orleans' Crescent City and Detroit's Southeast Michigan Beacon Communities as well as the Greater Cincinnati Beacon Community participated in pilots of txt4health, a text message-based health information service from Voxiva aimed at helping adults ages 18 and up to understand their risk of developing type 2 diabetes and steps they can take to reduce that risk.
Participants in the pilots received 4-7 messages per week, including general educational messages, diet and exercise tips, health reminders, and information about local health care providers and resources. They could also set and track progress toward weight loss and exercise goals by responding to text message prompts.
Despite their success, "these community-based pilots encountered a number of challenges in the design (e.g., developing content; conducting outreach), execution (e.g., engaging patients and providers), evaluation, and sustainability of their mHealth programs," the article is quick to point out. "Beacon Communities encountered a number of barriers at each stage, including issues related to developing tailored, culturally competent messages; designing comprehensive outreach strategies; enrolling participants; engaging providers in mHealth programs; evaluating mHealth programs; and sustaining and scaling pilots."
Among the lessons learned from these pilots for those community-based mHealth programs looking to implement their own initiatives:
- Identify community partners that are willing to engage with and support the program, and leverage their resources and community presence to design the program strategy and reach the target audience
- To the extent possible, design outreach, enrollment, and message content around the needs and perspectives of end users to increase program enrollment and engagement
- Anticipate that traditional marketing tactics may be insufficient to drive enrollment, and plan and budget additional staff time and resources for in-person engagement with the target audience to help drive enrollment
- To the extent feasible, bring care providers into the process--even if it means developing work-around solutions--to help them understand and promote mHealth as a tool to enhance patient care
- When planning the evaluation strategy, decide at the outset which aspects of the program will be critical to measure and which will not, to determine what stakeholders "need to know" versus what would be "nice to know"
- Last, share lessons learned with others to allow them to benefit from your experience
The Utah Beacon Community, located in and around Salt Lake City, Utah, launched Care4Life, Voxiva's two-way text messaging program designed to enhance self-management among adults aged 18 and up with type 2 diabetes. Care4Life participants received 1-7 messages per day over a period of 6 months. Like txt4health, Care4Life messages included general diabetes education, health improvement suggestions, and encouragement toward self-entered weight loss and exercise goals.
A "primary take-away" from the Beacon Community experiences with txt4health and Care4Life, is that "mHealth technology itself is not a 'silver bullet,'" concludes the JMIR article. "As is increasingly evident in the adoption of many other health IT tools, the full value of mHealth will be realized only when attitudes, behaviors, and health care delivery also change."
Last October, Voxiva announced Care4life, its mobile app and personalized online web portal that provides participants with daily education, encouragement and support via text messages. Available in both English and Spanish, Care4life is personalized to a patient's profile and focuses on education and adherence to their treatment protocol. It also allows participants to build an electronic record of blood glucose readings, blood pressure, weight and exercise that they can view online and share with their providers.
Voxiva's Care4life diabetes self-management program is now available as part of the American Diabetes Association's Living With Type 2 Diabetes Program, which uses text messages, a personal online portal and a mobile website to engage and support users as they learn about diabetes and form healthy habits.
To learn more:
- read the study in JMIR