title: Texting Adolescents in Repeat DKA and Their Caregivers.
abstract: Text message interventions are feasible, preferable, and sometimes effective for youth with diabetes. However, few, if any studies, have examined the personalized use of text messages with youth repeatedly hospitalized for diabetic ketoacidosis (DKA) and their caregivers. This study characterizes the use of personalized text messages in Novel Interventions in Children's Healthcare (NICH).
  
  
  
  Approximately 2 months of text messages sent to youth with repeat DKA and their caregivers were logged regarding the following text characteristics: (1) content, (2) intervention type, (3) timing, and (4) recipient characteristics.
  
  
  
  NICH interventionists sent 2.3 and 1.5 texts per day to patients and caregivers, respectively. Approximately 59% of outgoing texts occurred outside of typical business hours, and roughly 68% of texts contained some form of support and/or encouragement. The relation between type of intended intervention and day/time of text was significant, χ(2)(2, N = 5,808) = 266.93, P < .001. Interventionists were more likely to send behavioral intervention text messages outside of business hours, whereas they were more likely to send care coordination and case management text messages during business hours.
  
  
  
  To our knowledge, this is the first study to specifically categorize and describe the personalized use of text messages with youth repeatedly hospitalized for DKA and their caregivers. Findings indicate that a promising treatment program for these youth frequently used text interventions to deliver praise and encouragement to patients and caregivers alike, often outside of typical business hours, and tailored text content based on patient and caregiver characteristics.
authors.affiliation: Oregon Health & Science University, Portland, OR, USA wagnedav@ohsu.edu.
authors.forename: David V
authors.initials: DV
authors.lastname: Wagner
authors.affiliation: Oregon Health & Science University, Portland, OR, USA.
authors.forename: Samantha
authors.initials: S
authors.lastname: Barry
authors.affiliation: Oregon Health & Science University, Portland, OR, USA.
authors.forename: Lena
authors.initials: L
authors.lastname: Teplitsky
authors.affiliation: Oregon Health & Science University, Portland, OR, USA.
authors.forename: Annan
authors.initials: A
authors.lastname: Sheffield
authors.affiliation: Oregon Health & Science University, Portland, OR, USA.
authors.forename: Maggie
authors.initials: M
authors.lastname: Stoeckel
authors.affiliation: Oregon Health & Science University, Portland, OR, USA.
authors.forename: Jimmie D
authors.initials: JD
authors.lastname: Ogden
authors.affiliation: Oregon Health & Science University, Portland, OR, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Karkula
authors.affiliation: Oregon Health & Science University, Portland, OR, USA.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Hartman
authors.affiliation: Oregon Health & Science University, Portland, OR, USA Harold Schnitzer Diabetes Health Center, Portland, OR, USA.
authors.forename: Danny C
authors.initials: DC
authors.lastname: Duke
authors.affiliation: Oregon Health & Science University, Portland, OR, USA.
authors.forename: Kim
authors.initials: K
authors.lastname: Spiro
authors.affiliation: Oregon Health & Science University, Portland, OR, USA Harold Schnitzer Diabetes Health Center, Portland, OR, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Harris
mesh_terms: D000293:Adolescent; D017028:Caregivers; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D016883:Diabetic Ketoacidosis; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D060145:Text Messaging / Q000706:statistics & numerical data*
keywords: NICH; SMS; adolescence; mHealth; text message; type 1 diabetes