iPhone 'rewards' help teens with glucose control

Giving teens iTunes cash in return for taking blood glucose measurements via a smartphone app seems to be working in a new pilot project at the University of Toronto. FierceMobileHealthcare caught up with lead researcher Dr. Joseph Cafazzo to get some early results of what he's calling an "exciting" mHealth trial.

The test is small yet--with only 20 teens between 12 and 16 years old--but Cafazzo says adherence levels among participants are 50 percent higher than they were before the project began. For the study, researchers deliberately chose teens with virtually non-existent testing habits, and have seen those levels rise to at least one or two checks per day, for an average of 10 per week. They're hoping to push that to three to four per day, Cafazzo says.

Teens check their glucose levels through an app called "Bant" in honor of the discoverer of insulin, Frederick Banting. Participants receive points for each check, and once they pass 200 points, receive a $0.99 reward that they can redeem for songs or apps in the iTunes store, he explains.

Cafazzo has given out about 10 rewards per child in the two months since the project started. The idea: The more checking teens do, the more likely they are to adhere to diet and exercise recommendations. "Studies have shown that more frequent checking leads to better adherence. We're hoping that will be the same for these children, he says.

The app also engages the teens when blood sugar levels are off-norm. For example, if the teen's morning readings are low for several days, the app might ask the teen why he or she thinks the results were off. The hope: that participants will recognize bad habits, such as not eating breakfast, and self-correct their behavior.

The pilot will expand to a larger, randomized trial of 160 or so teens in late summer or early fall.

The one segment of the trial that hasn't yielded solid results yet is a micro-blogging, social media component, where teens can chat with each other. Only about five of the 20 are engaging on the site regularly, so the social networking component of the trial may have to be tweaked, Cafazzo admits.

"There is a tendency for the kids to boast about when they've won rewards or gotten apps," he says. "We're counting on the competitive nature of teens," to encourage better testing and reporting.

To learn more:
- check out Cafazzo's talk at the recent ATA meeting
- watch this short video of the Bant system in action

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