期刊
JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION
卷 26, 期 12, 页码 1627-1631出版社
OXFORD UNIV PRESS
DOI: 10.1093/jamia/ocz147
关键词
diabetes; pediatric; ecological momentary assessment; precision medicine; self-management; context
类别
资金
- National Institutes of Health
- National Institute for Diabetes and Digestive and Kidney Diseases [DP3 DK097706]
- Vanderbilt University from the National Center for Advancing Translational Sciences [UL1 TR000445]
Effective diabetes problem solving requires identification of risk factors for inadequate mealtime self-management. Ecological momentary assessment was used to enhance identification of factors hypothesized to impact self-management. Adolescents with type 1 diabetes participated in a feasibility trial for a mobile app called MyDay. Meals, mealtime insulin, self-monitored blood glucose, and psychosocial and contextual data were obtained for 30 days. Using 1472 assessments, mixed-effects between-subjects analyses showed that social context, location, and mealtime were associated with missed self-monitored blood glucose. Stress, energy, mood, and fatigue were associated with missed insulin. Within-subjects analyses indicated that all factors were associated with both self-management tasks. Intraclass correlations showed within-subjects accounted for the majority of variance. The ecological momentary assessment method provided specific targets for improving self-management problem solving, phenotyping, or integration within just-in-time adaptive interventions.
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