1. MyDiaText A technology-driven approach to diabetes education for today’s connected teens Abstract: MyDiaText is a text message reminder service designed to improve the effectiveness of the current diabetes education programs at the Diabetes Center for Children at the Children’s Hospital of Philadelphia. With the growing population of adolescents with diabetes, this technology-based intervention may prove more effective than traditional classroom diabetes education alone. Using the online portal, www.MyDiaText.com, newly diagnosed patients choose a behavioral goal they wish to modify. These goals range from counting carbohydrates to establishing healthy exercise habits. Patients receive text messages throughout the program as a reminder to follow their chosen goal and are also prompted to rate their progress. As patients respond and receive reminder text messages, all activity is logged to their MyDiaText profile. Patients and their families use the online portal to track progress throughout the one-month program. The website also hosts educational quizzes and trivia to provide further diabetes education. The Diabetes Center for Children will pilot a one month trial of MyDiaText to patients in May 2012. Once the pilot is completed, participants will be asked to complete a patient satisfaction survey. Responses to the survey will help assess if MyDiaText was helpful to patients and the feedback will help improve MyDiaText for future use. The Diabetes Center for Children hopes to officially implement and integrate MyDiaText into its formal diabetes education program later this year. University of Pennsylvania Department of Electrical and Systems Engineering TEAM 16 Authors: Valerie Cerasuolo (SSE) Kara Hollis (SSE) Reid Simon (SSE) John Stuckey (EE) Advisor: Dr. Barry Silverman (ESE) DEMO TIMES: Thursday, April 19 th, 2012 10:30am, 11:30am, 1:30pm, 2:00pm Problem Statement Type 1 Diabetes is the second most prevalent chronic disease of young adolescents (aged 10- 16). The lifestyle and behavior changes necessary for proper diabetes management are a significant challenge for this population. Working with the Children’s Hospital of Philadelphia’s Diabetes Center for Children, the MyDiaText team has integrated popular texting technology to assist newly diagnosed diabetes patients in adapting to managing this lifelong disease. Solution: MyDiaText MyDiaText provides a text message reminder service and interactive web portal designed to improve the effectiveness of the current Behavior Modification Goal program. Objectives Improve the Diabetes Center for Children’s education program by completing the following objectives: 1)Design and implement an interactive online portal where patients create a profile and choose goal 2)Integrate goal selection with a customized text message service with reminders and goal progress tracking 3)Implement interactive quizzes, trivia, and educational material in text messages and the online portal Website Design Target Population Participants are within 3 months of diagnosis with Type 1 diabetes mellitus and between 10 and 16 years of age. Many of the patients are from low income backgrounds. This age group has demonstrated non-adherence to diabetes related management and has proven particularly vulnerable to mismanagement. Incentivizing Participation By participating in online quizzes and showing positive progress toward their goal, patients earn participation points and win customized, printable certificates upon completion of defined modules. Security of Patient Information MyDiaText must keep patient information confidential and secure. Patients’ data are kept confidential via industry standard SSL encryption between server and browser. Only the patient and approved administrators may view profiles. Impact Potential The MyDiaText platform can have a major impact on future approaches to diabetes education. With growing numbers of diabetic adolescents, a technology-based intervention may prove more effective than traditional diabetes education alone. MyDiaText has the potential be nationally adopted by the ADA for use in all certified diabetes care practices. Further, text message-based interventions resonate with youth and can be used to aid behavioral changes needed for many other chronic adolescent diseases. Current Diabetes Education Methods The Diabetes Center for Children holds monthly education classes for newly diagnosed diabetes patients. Approximately thirty patients and their families attend. The classes use the American Diabetes Association’s (ADA) Behavioral Modification Goal Program to help incentivize behavior change. Patients are asked to choose one behavior modification goal during the class. A follow-up letter is sent electronically or by mail, two to three months later to assess the patient’s perception of progress in behavior change. In 2010 there was ~20% response rate to the follow- up letter or email. Due to the lack of response, perceived behavior change cannot be determined. This lack of participation concerns the Diabetes Center for Children as this population is vulnerable to a harmful lack of management of their diabetes. Figure 1: MyDiaText Homepage Conversation Example Figure 3: Text Message Conversation with MyDiaText Text Messaging Process Figure 2: Text Messaging Process Implementation In order to introduce our pilot, the MyDiaText platform needed approval from the Children’s Hospital of Philadelphia’s Institutional Review Board. This long and arduous process involved receiving Non-Traditional Personnel Status for everyone on the MyDiaText team and completing many rounds of proposals for the hospital. MyDiaText was granted Institutional Review Board approval in early April. Now that the functionality testing stage has been completed, the Diabetes Center for Children started to recruit patients who would be willing to participate in the pilot. Once the pilot concludes, participants will be asked to complete a patient satisfaction survey. Responses to the survey will help assess if MyDiaText was helpful to patients and the feedback will help improve MyDiaText for future use. User send message to MyDiaText Twilio send HTTP request to MyDiaText.com MyDiaText algorithms determine response Messages are logged to database User receives response text message Text Message Path Figure 4: Sample Text Message Path