We are scheduled to perform a server upgrade on Thursday, November 30, 2017 between 4 and 6 PM Eastern Time.
Please refrain from submitting support requests related to server downtime during this window.
Emerging Technologies, Medical Devices, Apps, Sensors, and Informatics to Help People with Diabetes.
JMIR Diabetes (JD) is a new sister journal of JMIR (the leading open-access journal in health informatics (Impact Factor 2016: 5.175), focusing on technologies, medical devices, apps, engineering, informatics and patient education for diabetes prevention, self-management, care, and cure, to help people with diabetes. As open access journal we are read by clinicians and patients alike and have (as all JMIR journals) a focus on readable and applied science reporting the design and evaluation of health innovations and emerging technologies, as well as on diabetes epidemiology. We publish original research, viewpoints, and reviews (both literature reviews and medical device/technology/app reviews) covering for example wearable devices and trackers, mobile apps, glucose monitoring (including emerging technologies such as Google contact lens), medical devices for insulin and metabolic peptide delivery, closed loop systems and artificial pancreas, telemedicine, web-based diabetes education and elearning, innovations for patient self-management and "quantified self", diabetes-specific EHR improvements, clinical or consumer-focused software, diabetes epidemiology and surveillance, crowdsourcing and quantified self-based research data, new sensors and actuators to be applied to diabetes.
Right click to copy or hit: ctrl+c (cmd+c on mac)
Background: The burden of obesity is high among U.S. veterans yet many face barriers to engaging in in-person, facility-based treatment programs. To improve access to weight-management services, the V...
Background: The burden of obesity is high among U.S. veterans yet many face barriers to engaging in in-person, facility-based treatment programs. To improve access to weight-management services, the Veterans Health Administration (VHA) developed TeleMOVE®, a home-based 82-day curriculum that utilizes in-home messaging devices to promote weight loss in VHA patients facing barriers to accessing facility-based services. Objective: Our primary aims were to establish preliminary evidence for the program to engage the priority population based on the number of patients enrolled per site as well as the program’s clinical effectiveness as demonstrated by average weight lost per patient. A secondary aim was to understand factors influencing implementation variability across demonstration sites to develop recommendations to inform the national TeleMOVE dissemination. Methods: We employed a formative mixed-methods design to evaluate the phased implementation of TeleMOVE programming at nine demonstration sites and to compare patient- and site-level measures of program uptake. Data was collected between October 1, 2009 and September 30, 2012. Twenty-eight stakeholders were recruited to provide contextual details while patient-level program outcomes were extracted from VHA patient care databases. Program stakeholders were recruited to participate in two rounds of semi-structured interviews about aspects of implementation processes, site-level contextual factors, and daily program delivery. Administrative data was used to evaluate program enrollment rates and clinical outcomes. To assess preliminary clinical effectiveness, weight loss outcomes for veterans who enrolled in TeleMOVE were compared to outcomes for participants enrolled in standard MOVE! at each demonstration site as well as to national averages during the first two years of program implementation. Results: Program uptake was high at two sites, delayed-high at one site, low at three sites, and three late-adopting sites declined interviews. At six months post-enrollment, mean weight loss was comparable for TeleMOVE (n=417) and MOVE! (n=1543) participants at -5.2 lb (SD=14.4) and -5.1 lb (SD=12.2), respectively (p=.91). All sites reported high program complexity because TeleMOVE required more staff time per participant than MOVE! due to logistical and technical assistance issues related to the devices. High-uptake sites overcame implementation challenges by leveraging strong communication networks with stakeholders, adapting the program to patient needs whenever possible, setting programmatic goals and monitoring feedback of results, and taking time to reflect and evaluate on delivery to foster incremental delivery improvements whereas, low-uptake sites reported less leadership support and effective communication among stakeholders. Conclusions: This evaluation of the phased implementation of a new clinical telehealth program demonstrates the value of partnership-based research in which researchers not only provide operational leaders with rapid and responsive feedback regarding the effectiveness of a new clinical program but also relevant feedback into contextual factors related to implementation to enable adaptations for national rollout of the program.
Background: The prevalence of type 2 diabetes is rising, placing increasing strain on healthcare services. Web-based and mobile technologies can be an important source of information and support for p...
Background: The prevalence of type 2 diabetes is rising, placing increasing strain on healthcare services. Web-based and mobile technologies can be an important source of information and support for people with type 2 diabetes and may go some way towards reducing complications due to mismanagement. To date, little research has been carried out to gain an insight into people’s perspectives of using such technologies in their daily management. Objective: The purpose of this study is to understand the impact of using web-based and mobile technologies to support the management of type 2 diabetes. Methods: In-depth interviews were conducted with 15 people with type 2 diabetes to explore experiences of using web-based and mobile technologies to manage their diabetes. Transcripts were analyzed using the Framework method. Results: Technology supported users to maintain individualized and tailored goals when managing their health. Seven themes were identified as important to participants when using technology to support self-management: 1) Information, 2) Understanding individual health and personal data, 3) Reaching and sustaining goals, 4) Minimizing disruption to daily life, 5) Reassurance, 6) Communicating with health professionals; and 7) Co-ordinated care. Conclusions: Patients need to be supported to manage their condition to improve well-being and prevent further diabetes related complications arising. Technologies enabled users to get an in-depth sense of how their body reacted to both lifestyle and medication factors; something much more difficult with the use of traditional ‘standardized’ information alone. It is intended that the results of this study will inform a new questionnaire designed to assess self-management in people using web-based and mobile technology to manage their health.
Background: Depression is twice as common in people with diabetes. This comorbidity worsens the course of both pathologies. Screening and treatment of depression in patients with diabetes are highly r...
Background: Depression is twice as common in people with diabetes. This comorbidity worsens the course of both pathologies. Screening and treatment of depression in patients with diabetes are highly recommended in clinical practice guidelines. However, depression is still both under recognized and undertreated. In response to the need to find ways to enhance reach, psychological treatments have taken advantage of the benefits of Internet and/or technological devices as delivery format, delivering interventions that require considerably less (or even none) interaction time with the therapist. These kinds of treatments hold promise for effective interventions at low costs with positive results. Objective: The aims of this review were to describe web-based interventions for depression in individuals with diabetes, and discuss the procedures and findings of these studies in the light of the evidence brought by a wider range of interventions for depression and/or diabetes. Methods: A comprehensive literature search was conducted in PsycINFO and MEDLINE electronic databases. Studies were included if they met the following selection criteria: (1) the study was published in English or Spanish language peer-reviewed journals, (2) the sample of the study was composed of individuals with diabetes, (3) the intervention targeted depression symptomatology, (4) was accessible via internet, and (5) had little to none clinician support. Results: Five research studies were identified in the review. All studies were RCTs, most studies used waitlist as control. Interventions variate in their characteristics, but most of them were clinical-assisted, had a CBT approach, used diabetes-specific topics, had a weekly modular display, used homework assignments and had some kind of adherence management strategy. These characteristics are consistent with intervention features associated with positive results in the literature. The efficacy of these studies to treat depressive symptoms supports the notion that web-based format is a suitable psychology service delivery option for diabetic individuals with depression. Conclusions: Congruently with previous research on depression treatment, web-based interventions for depression in people with diabetes have positive results. Future research should bring light to the reason why these interventions are effective and for whom, and which aspects can increase patient’s adherence. Some recommendations are: (1) to compare interventions with controls that match with nonspecific factors of the intervention (2) refine depression and diabetes distress inclusion criteria and assessment, (3) study if the need of tailoring with diabetic-specific content is associated with the presence of diabetic distress, (4) include measures of glycemic control, (5) assess other psychological outcomes, moderators, use and perception of the intervention, (6) avoid possible recruitment bias, (7) identify effective adherence management techniques and persuasive features, (8) detect which contents of the interventions are more effective, and (9) study the benefits of including peer support.