MyDiaText™: Feasibililty and Functionality of a Text Messaging System for Youth With Type 1 Diabetes.

PURPOSE: The purpose of this study was to determine the feasibility and functionality of MyDiaText™, a website and text messaging platform created to support behavior change in adolescents with type 1 diabetes (T1DM) and to evaluate user satisfaction of the application. METHODS: This study was a nonrandomized, prospective, pilot trial to test the feasibility and user interface with MyDiaText, a text message system for 10- to 17-year-old youths with newly diagnosed T1DM. Feasibility was evaluated by assessing for the user's ability to create a profile on the website. Functionality was defined by assessing whether a subject responded to at least 2 text messages per week and by their accumulating points on the website. User satisfaction of the text messaging system was assessed using an electronic survey. The 4 phases of this study were community engagement-advisory sessions, screening and enrollment, intervention, and follow-up. RESULTS: Twenty subjects (14 male, 6 female) were enrolled. All subjects were able to create a profile, and of these, 86% responded to at least 2 text messages per week. A survey administered during follow-up showed that users enjoyed reading text messages, found them useful, and thought the frequency of messages was appropriate. CONCLUSION: MyDiaText is a feasible, functional behavioral support tool for youth with T1DM. Users of the application reported high satisfaction with text messages and the reward system.

Telemedicine for adolescents with type 1 diabetes.

Diabetes is the third most common chronic disease in the pediatric population and diabetes management in adolescents presents a unique challenge for health care providers. The purpose of this article is to define telemedicine, review a variety of telemedicine intervention studies in the adolescent population, and interpret those results in the context of the current health care climate. Clinicians and researchers will be provided with education related to adolescent needs and telemedicine interventions so that telemedicine can be used effectively to promote the health of adolescents with diabetes. Because telemedicine has yet to demonstrate consistent and significant positive outcomes in this population, further research and continued development of technology are essential to improve diabetes control in adolescents and prevent the long-term complications of this disease.

Implementation of a clinical practice guideline for identification of microalbuminuria in the pediatric patient with type 1 diabetes.

Evidence-based practice is a shift in the health care culture from basing decisions on consensus opinion, past practice, and precedent toward the use of rigorous analysis of scientific evidence using outcomes research and clinical evidence to guide clinical decision making. The development of evidence-based clinical practice guidelines (CPG) is critical to guide the assessment and management of children with diabetes. This article provides an overview of the infrastructure and processes that are crucial to providing evidence-based care in a large urban pediatric diabetes center. Development of a CPG to identify microalbuminuria in children with type 1 diabetes is discussed.

Narrowing the possibilities: using quality improvement tools to decrease competence assessment overload.

In many institutions, competence assessment tools are seen as the way to address all clinical practice issues. In the absence of a systematic approach to development, these tools are produced en masse with little sharing of information among educators, managers, and clinical leaders. In an effort to harness "competence assessment overload," the authors propose a system that will assist staff in prioritizing the use and development of outcome-driven competence assessment tools.