Abstract

Objective

We evaluated the extent to which studies that tested short message service (SMS)– and application (app)-based interventions for diabetes self-management education and support (DSMES) report on factors that inform both internal and external validity as measured by the RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance) framework.

Materials and Methods

We systematically searched PubMed, Embase, Web of Science, CINAHL (Cumulative Index of Nursing and Allied Health Literature), and IEEE Xplore Digital Library for articles from January 1, 2009, to February 28, 2019. We carried out a multistage screening process followed by email communications with study authors for missing or discrepant information. Two independent coders coded eligible articles using a 23-item validated data extraction tool based on the RE-AIM framework.

Results

Twenty studies (21 articles) were included in the analysis. The comprehensiveness of reporting on the RE-AIM criteria across the SMS- and app-based DSMES studies was low. With respect to internal validity, most interventions were well described and primary clinical or behavioral outcomes were measured and reported. However, gaps exist in areas of attrition, measures of potential negative outcomes, the extent to which the protocol was delivered as intended, and description on delivery agents. Likewise, we found limited information on external validity indicators across adoption, implementation, and maintenance domains.

Conclusions

Reporting gaps were found in internal validity but more so in external validity in the current SMS- and app-based DSMES literature. Because most studies in this review were efficacy studies, the generalizability of these interventions cannot be determined. Future research should adopt the RE-AIM dimensions to improve the quality of reporting and enhance the likelihood of translating research to practice.

中文翻译：

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使用 RE-AIM 框架评估基于手机的糖尿病自我管理教育和支持干预的内部和外部有效性。

摘要

客观的

我们评估了测试短消息服务 (SMS) 和基于应用程序 (app) 的糖尿病自我管理教育和支持 (DSMES) 干预措施的研究报告了 RE 衡量的内部和外部有效性因素的报告程度-AIM（范围、功效/效果、采用、实施和维护）框架。

材料和方法

我们系统地搜索了 PubMed、Embase、Web of Science、CINAHL（护理和联合健康文献累积索引）和 IEEE Xplore 数字图书馆，以查找 2009 年 1 月 1 日至 2019 年 2 月 28 日期间的文章。我们随后进行了多阶段筛选过程通过电子邮件与研究作者沟通缺失或不一致的信息。两名独立编码员使用基于 RE-AIM 框架的 23 项验证数据提取工具对符合条件的文章进行编码。

结果

分析中包括 20 项研究（21 篇文章）。基于 SMS 和基于应用程序的 DSMES 研究的 RE-AIM 标准报告的全面性很低。关于内部有效性，大多数干预措施都得到了很好的描述，主要的临床或行为结果被测量和报告。然而，在减员、潜在负面结果的衡量、方案按预期交付的程度以及对交付代理的描述方面存在差距。同样，我们发现关于采用、实施和维护领域的外部有效性指标的信息有限。

结论

在当前基于 SMS 和应用程序的 DSMES 文献中，内部效度存在报告差距，但外部效度更是如此。由于本综述中的大多数研究都是功效研究，因此无法确定这些干预措施的普遍性。未来的研究应采用 RE-AIM 维度来提高报告质量并提高将研究转化为实践的可能性。