mDiabetes programme using text messages helps improve lifestyle, behaviour
The mDiabetes intervention is both feasible and acceptable in disseminating knowledge to a large population regarding diabetes and healthy lifestyle, as well as in improving health-seeking behaviour, according to a study in India.
“The use of text messages through mobile phones was a feasible approach to reach a large population. The text messages were sent through predefined algorithm-based platform, and it does not require regular engagement of the professional staff. The feedback from the participants has helped to identify limitations in the design of the programme,” researchers said.
A total of 31,725 registered respondents were grouped into six categories, of which 21.4 percent had diabetes and 5.3 percent had multiple risk factors. Responses to feedback messages were given by 15.6 percent of the respondents. Of these, 57.2 percent followed a healthy diet, 72.3 percent heeded the advice on physical activity, 51.9 percent screened for diabetes and 67.3 percent checked their glycaemic status. [BMJ Innovations 2018;4:155-162]
Based on telephone interviews, the programme was found to be feasible and acceptable. The use of an interactive voice response system (IVRS) for registration and motivation was suggested by participants.
“The study shows that lifestyle changes can be promoted at the population level through mHealth interventions. However, some improvements in the programme can enhance the reach among population,” researchers said.
“Text messages can be supplemented with different interactive methods such as IVRS or outbound call to encourage proper responses. Filling the gaps and implementation of improved strategies can help to scale up and improve the performance of mDiabetes interventions in India,” they added.
A randomized controlled diabetes prevention trial by Ramachandran and colleagues used text messages to motivate persons with impaired glucose tolerance to follow lifestyle modification. In another study, Pfammetter and colleagues also used mHealth procedure to motivate the participants to follow a healthy lifestyle. [Lancet Diabetes Endocrinol 2013;1:191-198; J Med Internet Res 2016;18:e207]
“In both the studies, participants were also contacted through personal reviews or through telephonic interview,” researchers said. “In the mDiabetes programme, participants were contacted only through text messages except during the final feedback assessment, which was done in a subset of selected participants through telephonic interviews.”
The present observational study for mDiabetes was conducted in India between 2016 and 2017. Text messages inviting registrations were sent to 130 million people in the country, most of them belonging to the working class. Respondents (n=105,548) registered by dialling a given phone number (missed phone call) or through a website.
Responses were used to group participants into six categories: persons with diabetes, pregnant/lactating women, high-risk individuals, healthcare professionals, elderly and normal population. They received 90 messages on healthy living during the 6 months.
Researchers evaluated the impact of intervention by feedback messages at months 3 and 6. They conducted telephone interviews at 1 year in a subpopulation (n=855).