PMID- 31313657 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20201001 IS - 2371-4379 (Electronic) IS - 2371-4379 (Linking) VI - 4 IP - 3 DP - 2019 Jul 16 TI - An Evaluation of Digital Health Tools for Diabetes Self-Management in Hispanic Adults: Exploratory Study. PG - e12936 LID - 10.2196/12936 [doi] LID - e12936 AB - BACKGROUND: Although multiple self-monitoring technologies for type 2 diabetes mellitus (T2DM) show promise for improving T2DM self-care behaviors and clinical outcomes, they have been understudied in Hispanic adult populations who suffer disproportionately from T2DM. OBJECTIVE: The objective of this study was to evaluate the acceptability, feasibility, and potential integration of wearable sensors for diabetes self-monitoring among Hispanic adults with self-reported T2DM. METHODS: We conducted a pilot study of T2DM self-monitoring technologies among Hispanic adults with self-reported T2DM. Participants (n=21) received a real-time continuous glucose monitor (RT-CGM), a wrist-worn physical activity (PA) tracker, and a tablet-based digital food diary to self-monitor blood glucose, PA, and food intake, respectively, for 1 week. The RT-CGM captured viewable blood glucose concentration (mg/dL) and PA trackers collected accelerometer-based data, viewable on the device or an associated tablet app. After 1 week of use, we conducted a semistructured interview with each participant to understand experiences and thoughts on integration of the data from the devices into a technology-facilitated T2DM self-management intervention. We also conducted a brief written questionnaire to understand participants' self-reported T2DM history and past experience using digital health tools for T2DM self-management. Feasibility was measured by device utilization and objective RT-CGM, PA tracker, and diet logging data. Acceptability and potential integration were evaluated through thematic analysis of verbatim interview transcripts. RESULTS: Participants (n=21, 76% female, 50.4 [SD 11] years) had a mean self-reported hemoglobin A(1c) of 7.4 [SD 1.8] mg/dL and had been diagnosed with T2DM for 7.4 [SD 5.2] years (range: 1-16 years). Most (89%) were treated with oral medications, whereas the others self-managed through diet and exercise. Nearly all participants (n=20) used both the RT-CGM and PA tracker, and 52% (11/21) logged at least one meal, with 33% (7/21) logging meals for 4 or more days. Of the 8 possible days, PA data were recorded for 7.1 [SD 1.8] days (range: 2-8), and participants averaged 7822 [SD 3984] steps per day. Interview transcripts revealed that participants felt most positive about the RT-CGM as it unveiled previously unknown relationships between lifestyle and health and contributed to changes in T2DM-related thoughts and behaviors. Participants felt generally positive about incorporating the wearable sensors and mobile apps into a future intervention if support were provided by a health coach or health care provider, device training were provided, apps were tailored to their language and culture, and content were both actionable and delivered on a single platform. CONCLUSIONS: Sensor-based tools for facilitating T2DM self-monitoring appear to be a feasible and acceptable technology among low-income Hispanic adults. We identified barriers to acceptability and highlighted preferences for wearable sensor integration in a community-based intervention. These findings have implications for the design of T2DM interventions targeting Hispanic adults. CI - (c)Leah Yingling, Nancy A Allen, Michelle L Litchman, Vanessa Colicchio, Bryan S Gibson. Originally published in JMIR Diabetes (http://diabetes.jmir.org), 16.07.2019. FAU - Yingling, Leah AU - Yingling L AUID- ORCID: 0000-0002-7851-690X AD - Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, UT, United States. FAU - Allen, Nancy A AU - Allen NA AUID- ORCID: 0000-0001-7358-2265 AD - College of Nursing, University of Utah School of Medicine, Salt Lake City, UT, United States. FAU - Litchman, Michelle L AU - Litchman ML AUID- ORCID: 0000-0002-8928-5748 AD - College of Nursing, University of Utah School of Medicine, Salt Lake City, UT, United States. FAU - Colicchio, Vanessa AU - Colicchio V AUID- ORCID: 0000-0002-4656-2047 AD - College of Nursing, University of Utah School of Medicine, Salt Lake City, UT, United States. FAU - Gibson, Bryan S AU - Gibson BS AUID- ORCID: 0000-0003-4747-6383 AD - Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, UT, United States. LA - eng PT - Journal Article DEP - 20190716 PL - Canada TA - JMIR Diabetes JT - JMIR diabetes JID - 101719410 PMC - PMC6664655 OTO - NOTNLM OT - Hispanic OT - blood glucose self-monitoring OT - culturally appropriate technology OT - mobile app OT - type 2 diabetes COIS- Conflicts of Interest: None declared. EDAT- 2019/07/18 06:00 MHDA- 2019/07/18 06:01 PMCR- 2019/07/16 CRDT- 2019/07/18 06:00 PHST- 2018/11/26 00:00 [received] PHST- 2019/05/21 00:00 [accepted] PHST- 2019/05/16 00:00 [revised] PHST- 2019/07/18 06:00 [entrez] PHST- 2019/07/18 06:00 [pubmed] PHST- 2019/07/18 06:01 [medline] PHST- 2019/07/16 00:00 [pmc-release] AID - v4i3e12936 [pii] AID - 10.2196/12936 [doi] PST - epublish SO - JMIR Diabetes. 2019 Jul 16;4(3):e12936. doi: 10.2196/12936.