ABSTRACT
Objectives/Introduction: Insomnia is the most prevalent sleep disorder worldwide and cognitive behavioural therapy is the front-line treatment. Digital health technologies have a role to play in screening and delivering interventions remotely and without the need for human intervention. The KANOPEE app, which provides a screening and behavioural intervention for insomnia symptoms through an interaction with a virtual agent, showed encouraging results in previous studies during and after the COVID-19 lockdown, but has not yet been evaluated in a controlled study. This study aims at comparing the benefits of KANOPEE, a smartphone application proposing repeated interactions with a virtual companion to screen and deliver personalized recommendations to deal with insomnia complaints;with another application proposing an electronic sleep diary and named "My Sleep Diary". The acceptance and potential benefits of these digital solutions are demonstrated in real-life settings (i.e., without soliciting human medical resources) and in the general population. Method(s): Subjects were included if they downloaded one of the apps between December 2020 and October 2021;and were of legal age. Both apps are available on downloading platforms in France and both groups were equivalent in terms of baseline characteristics. Primary outcome was Insomnia Severity Index (ISI) and secondary outcomes were Total Sleep Time (TST) and Sleep Efficiency (SE). Result(s): 535 users completed the 17-day intervention with KANOPEE and 489 users completed My Sleep Diary for 17 days. A differential effect was obtained for KANOPEE users compared to My Sleep Diary users regarding ISI score (interaction Time x Group: F [2,2014] = 16.9, p < 0.001) and TST (KANOPEE users gained 48 min of sleep after intervention, while My Sleep Diary users gained only 16 min of sleep). Patients with the most severe ISI score (>15) benefited the most from KANOPEE (interaction severity x Time: F [4,2014] = 26.3, p < 0.001). Conclusion(s): KANOPEE provides significantly greater benefits than an electronic sleep diary regarding reduction of insomnia complaints in a self-selected sample of the general population.
ABSTRACT
Introduction: In the Covid-19 pandemic context, the measures imposed for more than a year have limited the ability to carry out face-to-face diabetes education group programmes. Initially, the programmes were postponed and then cancelled. Objectives: However, during the second lockdown, it seemed to us essential to maintain them via virtual modality since November2020. Methods: To do this, we reviewed and adapted our programmes at each stage of their construction and implementation: families' needs, educative skills and objectives' prioritisations according to the achievable remotely, targeting digital tools inspired from ICTE (Information and Communication Technologies for Education) and adapted to the diabetes care objectives and finally adaptation of the evaluation methods. Moreover team's training in the use of connection platforms and digital tool was necessary in this adaptation process. Results: To date, 19 workshops have been held for 93 children, 12 adolescents, 30 parents, 14 carers and 22 health professionals. This led us to reflect on the contributions and needs of the practice of group diabetes education in a virtual modality: feasibility, necessary structure, skills and objectives to be prioritised, effective educational strategies according to the target audience and objectives, modalities of animation essential in Visio. Conclusions: In general, the evaluations from families and health professionals in terms of satisfaction and knowledge acquired are positive. Moreover, this experience has allowed a progression in the adaptability of our team. Sharing our experience and learning from it can be useful for other teams. The remote group diabetes education modality enriches our practice by providing new ideas and recommendations for development, organisation and evaluation of diabetes care and education. In the near future, we will include hybrid programmes (face-to-face and remote) to respond to our territorial needs particularly in relation to the geographical distance of families and health teams.