DoD-Public Health Sciences-Diabetes

Jennie Moss (left), a senior research associate at Nellis Air Force Base in Las Vegas, takes a blood pressure reading on a patient prior to the diabetes self-management research project’s first phase.
Image Credit: Clemson University

CLEMSON — The Clemson University public health sciences department was awarded a contract of up to $1.2 million from the Department of Defense to study the use of mobile technology and tailored health messaging to educate, assist and motivate patients to become more active in management of their type 2 diabetes. Researchers are collaborating with the U.S. Army Medical Research and Material Command’s Telemedicine and Advanced Technology Research Center on the project.

Jeanette Little, Mobile Health Innovation Center Laboratory leader at the U.S. Army’s research center, said the project should reveal impacts on “patient activation,” the patient’s knowledge, skills, ability and willingness to manage their own health and care. The technology links smart phones and tablets with Bluetooth-enabled devices like glucometers and commercially available fitness tracking devices like the Fitbit. The clinical team will monitor patients’ progress through a secure mobile communication system, with key encryption components for patient privacy.

“This project will allow us to learn more about the potential impact of connected health technologies with respect to patient activation,” Little said.

Clemson’s public health sciences department aims to develop technology that will send tailored health messages to participants that will include information, motivation and guidance on a wide range of topics, including nutrition, exercise, blood pressure maintenance, smoking cessation, blood sugar testing, medication maintenance, foot care and stress management. While a patient might be aware they need to monitor these issues, keeping up with all of them is easier said than done, according to Cheryl Dye, public health sciences professor.

Dye stresses that people managing a complex disease like diabetes need the right information at the right time. She uses the examples of a patient in the beginning stages of self-management who feels overwhelmed with information and a patient who only requires information on a specific aspect of care, such as self-management in stressful situations. In both cases, when the patients receive useful information specific to them on their own smartphones, this process becomes much easier.

“Too often in health care settings patients get too much information at once and they are not able to process and use it effectively,” said Dye. “Our study will provide messages tailored to the patient’s level of activation and the behaviors that are particularly challenging to them.”

Karen Edwards, research associate in Clemson’s public health sciences department, said she looks forward to being a part of research that can potentially provide a highly effective, modern way to satisfy monitoring needs. Researchers expect their work will improve understanding of methods to advance coordination of care and access to care while improving quality and safety through the use of mobile technology. They have tested the technology at Mike O’Callaghan Federal Medical Center at Nellis Air Force Base in Las Vegas, Nevada, and Madigan Army Medical Center in Tacoma, Washington.

The first phase of research began in fall 2016, with user-centered design research using this methodology with type 2 diabetes patients. The Clemson University team visited the bases and conducted in depth research on system implementation and effectiveness. Phase two begins in March and April 2017, when 120 patients will begin the 12-month study. Researchers expect that the study will end in summer 2018. Study wrap-up, data analysis and numerous manuscript submissions will include specific design and investment recommendations grounded in evidence collected during both phases of the study.

“This is an innovative, lengthy study involving a diverse patient population spread across the country,” said Edwards, “but our team is committed to providing quality research that we hope will provide a lasting benefit to people living with type 2 diabetes.”

The Clemson team includes nine faculty members and a research support team from the public health sciences department.

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This material is based upon work supported by the U.S. Army Medical Research Acquisition Activity under Contract No. W81XWH-15-C-0070.  Any opinions, findings and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the U.S. Army Medical Research Acquisition Activity. In the conduct of research where humans are the subjects, the investigator(s) adhered to the policies regarding the protection of human subjects as prescribed by Code of Federal Regulations (CFR) Title 45, Volume 1, Part 46; Title 32, Chapter 1, Part 219; and Title 21, Chapter 1, Part 50 (Protection of Human Subjects).