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

IF 3.2 3区医学 Q2 ENDOCRINOLOGY & METABOLISM Diabetic Medicine Pub Date : 2024-11-13 DOI:10.1111/dme.15451

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

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引用次数: 0

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.

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评估针对生活在农村和偏远社区的 1 型糖尿病成人患者的心理健康支持移动应用程序：REACHOUT 试点研究。

目的：采用 "覆盖面、有效性、采用率、干预忠实度、维持"（RE-AIM）框架，对一款为生活在农村和偏远社区的1型糖尿病（T1D）成人患者提供心理健康支持的手机应用进行评估：这项研究招募了 46 名成人参加为期 6 个月的 REACHOUT 干预活动，REACHOUT 是一款提供同伴心理健康支持（一对一、基于群组的短信和面对面虚拟支持）的移动应用程序。基线评估和为期 6 个月的评估测量了糖尿病困扰 (DD)、抑郁症状、感知到的支持（来自家人/朋友、医疗团队和同伴）以及其他 RE-AIM 指标：对覆盖率和采用率的计算发现，3%符合条件的成年人注册了REACHOUT，55%的糖尿病教育中心参与了招募工作。维持指标显示，分别有56%和24%的同伴支持者和参与者成为了REACHOUT后续随机对照试验的同伴支持者。干预后，总体痛苦（p = 0.007）、无力感（p = 0.009）、管理痛苦（p = 0.001）、社会认知痛苦（p = 0.023）、进食痛苦（p = 0.032）和抑郁症状（p = 0.009）均有所减轻；来自家人/朋友和同伴的支持也有所增加。在对性别和年龄进行调整后，只有与支持相关的改善依然存在。在对女性组和男性组进行单独分析时，女性组报告的总体痛苦程度和三个痛苦分量表较低，而男性组报告的家庭/朋友和同伴支持程度较高：虽然覆盖率相对较低，但采用和维持的指标很有希望。在所有样本中都观察到了困扰程度的改善，但在控制性别和年龄后，这些变化有所减弱，只有女性的显著性得以保持。数字健康支持的同伴支持可能有助于向地理位置偏僻的社区提供心理健康支持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetic Medicine 医学-内分泌学与代谢

CiteScore

7.20

自引率

5.70%

发文量

229

审稿时长

3-6 weeks

期刊介绍： Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”