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Using Technology to Engage Adolescents in Chronic Disease Care

Often times, adolescents with chronic disease don’t have control over their health care choices. They rely on parents or other family members to communicate for them and make decisions during appointments. Researchers at the University of California (UC), San Diego recently found that incorporating a dedicated website and text messaging into adolescent chronic disease care improved disease management and self-efficacy, and helped patients take control of their own health care.

“There are a lot of papers saying ‘You need to help adolescents,’ but no one is doing work in the area,” Jeannie Huang, MD, MPH, a pediatric gastroenterologist at UC San Diego said.

To engage this hard-to-reach, at-risk population, researchers conducted an eight-month study of 81 patients ages 12 to 20 years old with inflammatory bowel disease, cystic fibrosis, and type 1 diabetes.

For the first two months of the study, patients in an intervention group logged into a secure website weekly to access materials with lifestyle and communication tips, such as how to tell a friend that they have a chronic disease, and information about disease management. Patients also received automated text messages three to five times a week with advice on how to manage their own care, including monitoring symptoms, keeping appointments, and interpreting medical bills

After the initial two months, the communication became more specialized. The website included disease management  information, and weekly text messages reinforced communicated concepts and skills. Participants were also then able to communicate their own urgent and nonurgent concerns to health care providers using a texting algorithm that determined the level of severity of the issue, provided relevant feedback, and notified the relevant health care provider.

Patients in a control group received monthly messages via mail or email addressing general health care issues and received disease-specific information as appropriate.

The study found that intervention group participants demonstrated significant improvement in the performance of disease management tasks, developed greater health-related self-efficacy, and made more contacts with their health care provider than participants in the control group.

“Clinicians really need to see the advantage of technology and how that can reach populations in a way that we couldn’t before,” Huang said. “They need to know we can have an impact if we invest our time.”

Results were published in the June issue of Pediatrics.

How does your hospital reach patients who are typically difficult to reach? Share with us in the comments below.



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