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Integrating glucometers and digital photography as experience capture tools to enhance patient understanding and communication of diabetes self-management practices

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Abstract

Glucometers measure the accumulation of glucose in the bloodstream and are essential for avoiding health complications related to diabetes. Despite their value as tools to record and present physiological data, they lack the ability to capture the behaviors that cause fluctuations in blood glucose levels, activities that ultimately need to be understood and managed in order to maintain good health. In this paper, we describe an intervention that introduces digital photography into diabetes self-management routines to augment glucometer data and facilitate the sharing of experiences that affect long-term health. Two studies of the approach are presented to illustrate the ways that diabetics use visualizations of past activities to reflect on their health. We also discuss design suggestions for augmented memory systems based on our findings, focusing on ways to enhance learning with repositories of past experiences collected automatically and/or manually.

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Notes

  1. Normal blood glucose levels for non-diabetics range from 70 to 120 mg/dl.

  2. Food exchange lists/books are used to guide choices about how much and what kinds of foods can be eaten as meals and snacks.

References

  1. Bush V (1945) As we may think. Atl Mon 76(1):101–108

    Google Scholar 

  2. DeVaul RW, Pentland A, Corey VR (2003) The memory glasses: subliminal vs. overt memory support with imperfect information. In: Proceedings of the Seventh IEEE International Symposium on Wearable Computers, Piscataway, NJ, IEEE Press, pp 146–153

  3. Gemmell J, Bell G, Lueder R, Drucker S, Wong C (2002) Mylifebits: fulfilling the memex vision. In: Proceedings of ACM Multimedia 2002, ACM Press, New York, pp 235–238

  4. Hindus D, Schmandt C (1992) Ubiquitous audio: capturing spontaneous collaboration. In: Proceedings of Computer Supported Collaborative Work, ACM Press, New York, pp 210–217

  5. Lamming M, Brown P, Carter K, Eldridge M, Flynn M, Louie G, Robinson P, Sellen A (1994) The design of a human memory prosthesis. Comput J 37(3):153–163

    Article  Google Scholar 

  6. Mase K, Sumi Y, Fels S (eds) (2004) In: Proceedings of pervasive 2004 workshop on memory and sharing of experiences, Vienna, Austria

  7. Rhodes B (1997) The wearable remembrance agent: a system for augmented memory. Pers Technol 1:218–224

    Article  Google Scholar 

  8. Truong KN, Abowd GD, Brotherton JA (2001) Who, what, when, where, how: design issues of capture access applications. In: Proceedings of the International Conference on Ubiquitous Computing, Atlanta, GA, pp 209–224

  9. Vemuri S, Schmandt C, Bender W, Tellex S, Lassey B (2004) An audio-based memory aid. In: Proceedings of the Sixth International Conference on Ubiquitous Computing, pp 400–417

  10. Franciosi M, Pellegrini F, Beradis GD, Belfigio M, Cavaliere D, Nardo BD, Greenfield S, Kaplan SH, Sacco M, Tognoni G, Valentini M, Nicolucci A (2001) The impact of blood glucose self-monitoring on metabolic control and quality of life in type 2 diabetic patients. Diabetes Care 24:1870–1877

    Article  Google Scholar 

  11. Norris SL, Engelgau MM, Narayan KMV (2001) Effectiveness of self-management training in type 2 diabetes: a systematic review of randomized controlled trials. Diabetes Care 24:561–587

    Article  Google Scholar 

  12. Schiffrin A, Belmonte M (1982) Multiple daily self-glucose monitoring: its essential role in long term glucose control in insulin-dependent diabetic patients treated with pump and multiple subcutaneous injections. Diabetes Care 5(5):479–484

    Article  Google Scholar 

  13. Strowig SM, Raskin P (1998) Improved glycemic control in intensively treated type 1 diabetic patients using blood glucose meters with storage capability and computer-assisted analyses. Diabetes Care 21(10):1694–1698

    Article  Google Scholar 

  14. Buchenau M, Sun JF (2000) Experience prototyping. In: Proceedings of Designing Interactive Systems 2000 (DIS ‘00), ACM Press, New York, pp 424–433

  15. Wild S, Roglic G, Green A, Sicref R, King H (2004) Global prevalence of diabetes: estimates for year 2000 and projections for 2030. Diabetes Care 27(4):1047–1053

    Article  Google Scholar 

  16. National Institutes of Diabetes & Digestive & Kidney Diseases (2002) Conquering diabetes: a scientific progress report on the diabetes working group’s strategic plan. National Institutes of Health, Bethesda, MD

  17. Diabetes Prevention Program Research Group (2002) Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 346(6):393–403

    Google Scholar 

  18. Diabetic Control and Complications Research Group (1993) The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 329:977–986

    Google Scholar 

  19. UK Prospective Diabetes Study Group (1998) Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (ukpds33). Lancet 32:837–853

    Google Scholar 

  20. American Diabetes Association (2005) Standards of medical case in diabetes. Diabetes Care 28 (Suppl 1) (1):S4–S36

  21. Jones H, Edwards L, Vallis TM, Ruggiero L, Rossi SR, Rossi JS, Greene G, Prochaska JO, Zinman B (2003) Changes in diabetes self-care behaviors make a difference in glycemic control: the diabetes stages of change (disc) study. Diabetes Care 26(3):732–737

    Article  Google Scholar 

  22. Ary DV, Toohen D, Wilson W, Glasgow R (1986) Patient perspective on factors contributing to nonadherence to diabetes regimen. Diabetes Care 9:168–172

    Article  Google Scholar 

  23. Schlundt DG, Rea MR, Kline SS, Pichert JW (1994) Situational obstacles to dietary adherence for adults with diabetes. J Am Diet Assoc 94:874–876, 879

    Article  Google Scholar 

  24. Mercado-Martinez FJ, Ramos-Herrera IM (2002) Diabetes: the layperson’s theory of causality. Qual Health Res 12(6):792–806

    Google Scholar 

  25. Furnham A (1988) Lay theories: everyday understanding of problems in the social sciences. Whurr Publishers, Ltd, London

    Google Scholar 

  26. Skinner TC, Hampson SE (2001) Personal models of diabetes in relation to self-care, well-being, and glycemic control. Diabetes Care 24:828–833

    Article  Google Scholar 

  27. Glasgow RE, Hiss RG, Anderson RM, Friedman NH, Hayward RA, Marrero DG, Taylor CB, Vinicor F (2001) Report of the health care delivery work group: behavioral research related to the establishment of a chronic disease model for diabetes care. Diabetes Care 24(1):124–130

    Article  Google Scholar 

  28. Schon DA (1983) The reflective practitioner: how professionals think in action. Basic Books, New York

    Google Scholar 

  29. Roschelle J (1992) Learning by collaboration: convergent conceptual change. J Learn Sci 2:235–276

    Article  Google Scholar 

  30. Brinck T, Gomez LM (1992) A collaborative medium for the support of conversational props. In: Turner J, Kraut R (eds) Conference proceedings on computer-supported collaborative work, ACM Press, New York

    Google Scholar 

  31. Dewey J (1910) How we think. DC Heath & Co, Boston

    Google Scholar 

  32. Schank RC (1986) Explanation patterns: understanding mechanically and creatively. Lawrence Erlbaum Associates, Hillsdale

    Google Scholar 

  33. Schank RC (1982) Dynamic memory: a theory of learning in computers and people. Cambridge University Press, New York

    Google Scholar 

  34. Miller C, Warland R, Achterberg C (1997) Food purchase decision-making typologies of women with non-insulin dependent diabetes mellitus. Patient Educ Couns 30:271–281

    Article  Google Scholar 

  35. Nardi BA, Kuchinsky A, Whittaker S, Leichner R, Schwarz H (1996) Video-as-data: technical and social aspects of a collaborative multimedia application. Comput Support Collab Work 4:73–100

    Article  Google Scholar 

  36. Whittaker S (1995) Rethinking video as a technology for interpersonal communications: theory and design implications. Int J Hum Comput Stud 42:501–529

    Article  Google Scholar 

  37. Whittaker S, O’Conaill B (1997) The role of vision in face-to-face and mediated communication. In: Finn KE, Sellen AJ, Wilbur SB (eds) Video-mediated communication, Lawrence Erlbaum Associates, Hillsdale

    Google Scholar 

  38. Smith BK, Blankinship E (2000) Justifying imagery: multimedia support for learning through explanation. IBM Syst J 39(3&4):749–767

    Article  Google Scholar 

  39. Rich M, Lamola S, Amorty C, Schneider L (2000) Asthma in life context: video intervention/prevention assessment (via). Pediatrics 105(3):469–477

    Article  Google Scholar 

  40. Frost J (2001) Visualizing health: Imagery as data for changing personal practice. MS Thesis. Media Arts & Sciences, MIT, Cambridge, MA

  41. Frost J, Smith BK (2003) Visualizing health: Imagery in diabetes education. In: Proceedings of the Designing for User Experiences Conference (DUX 2003), San Francisco, CA, American Institute of Graphic Arts

  42. Kilman DG, Forslund DW (1997) An international collaboratory based on virtual patient records. Commun ACM 40(8):111–117

    Article  Google Scholar 

  43. Plaisant C, Milash B, Rose A, Widoff S, Schneiderman B (1996) Lifelines: visualizing personal histories. In: Proceedings of the CHI 96 Conference on Human Factors in Computing Systems, ACM Press, New York, pp 221–227

  44. Powsner SM, Tufte ER (1994) Graphical summary of patient status. Lancet 344:386–389

    Article  Google Scholar 

  45. Alonso DL, Rose A, Plaisant C, Norman KL (1998) Viewing personal history records: a comparison of tabular format and graphical presentation using lifelines. Behav Inf Technol 17(5):249–262

    Article  Google Scholar 

  46. Hanna KM, Guthrie D (2003) Adolescents’ behavioral autonomy related to diabetes management and adolescent activities/rules. Diabetes Educ 29(2):283–291

    Google Scholar 

  47. Anderson BJ, Wolpert HA (2004) A developmental perspective on the challenges of diabetes education and care during the young adult period. Patient Educ Couns 53:347–352

    Article  Google Scholar 

  48. Dickinson JK, O’Reilly MM (2004) The lived experience of adolescent females with type 1 diabetes. Diabetes Educ 30(1):99–107

    Google Scholar 

  49. Glasgow RE, Fisher EB, Anderson BJ, LaGreca A, Marrero D, Johnson SB, Rubin RR, Cox DJ (1999) Behavioral science in diabetes: contributions and opportunities. Diabetes Care 22:832–843

    Article  Google Scholar 

  50. Charon R (2001) Narrative medicine: a model for emphathy, reflection, profession, and trust. J Am Med Assoc 286(15):1897–1902

    Article  Google Scholar 

  51. Engel GL (1977) The need for a new medical model: a challenge for biomedicine. Science 196:129–136

    Article  Google Scholar 

  52. Laine C, Davidoff F (1996) Patient-centered medicine: a professional evolution. J Am Med Assoc 275:152–156

    Article  Google Scholar 

  53. Klayman J, Ha Y-W (1987) Confirmation, disconfirmation, and information in hypothesis testing. Psychol Rev 94:211–228

    Article  Google Scholar 

  54. Lord CG, Ross L, Lepper MR (1979) Biased assimilation and attitude polarization: the effects of prior theories on subsequently considered evidence. J Pers Soc Psychol 37(11):2098–2109

    Article  Google Scholar 

  55. Wason PC (1960) On the failure to eliminate hypotheses in a conceptual task. Q J Exp Psychol 12(3):129–140

    Article  Google Scholar 

  56. LifeScan Inc. (2001) Onetouch ultra meter communication specifications. LifeScan, Inc., Milpitas

  57. Gemmell J, Williams L, Wood K, Lueder R, Bell G (2004) Passive capture and ensuing issues for a personal lifetime store. In: Gemmell J, Sundaram H (eds) Proceedings of the first acm workshop on continuous archival and retrieval of personal experiences, ACM Press, New York

    Google Scholar 

  58. Healey J, Picard RW (1998) Startlecam: a cybernetic wearable camera. In: Proceedings of the second ieee international symposium on wearable computing, Pittsburgh, PA

  59. Hori T, Aizawa K (2003) Context-based video retrieval system for the life-log applications. In: Sebe N, Lew MS, Djeraba C (eds) Proceedings of the fifth acm sigmm international workshop on multimedia information retrieval, ACM Press, Berkeley

    Google Scholar 

  60. Mann S (1996) “smart clothing”: Wearable multimedia computing and “personal imaging” to restore the technological balance between people and their environments. In: Aigrain P, Hall W, Little TCD, Bove VM Jr (eds) Proceedings of acm multimedia ‘96, ACM Press, New York

    Google Scholar 

  61. Knight JF, Schwirtz A, Psomadelis F, Baber C, Bristow HW, Arvanitis TN (2005) The design of the sensvest. Pers Ubiq Comput 9(1):6–19

    Article  Google Scholar 

  62. Tierney MJ, Tamada JA, Potts RO, Jovanovic L, Garg S, Cygnus Research Team (2001) Clinical evaluation of the glucowatch® biographer: a continual, non-invasive glucose monitor for patients with diabetes. Biosens Bioelectron 16:621–629

    Article  Google Scholar 

  63. Williamson DA, Martin PD, Allen HR, Most MM, Alfonso AJ, Thomas V, Ryan DH (2002) Changes in food intake and body weight associated with basic combat training. Mil Med 167(3):248–253

    Google Scholar 

  64. Williamson DA, Allen HR, Martin PD, Alfonso AJ, Gerald B, Hunt A (2003) Comparison of digital photography to weighted and visual estimation of portion sizes. J Am Diet Assoc 103:1139–1145

    Article  Google Scholar 

  65. Prochaska JO, DiClemente CC (1985) Common processes of self-change in smoking, weight control, and psychological distress. In: Shiffman S, Wills TA (eds) Coping with substance use, Academic, Orlando

    Google Scholar 

  66. Prochaska JO, Norcross JC, DiClemente CC (1994) Changing for good. Avon Books, New York

    Google Scholar 

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Acknowledgments

This work was supported in part by a National Science Foundation grant (REC-0302169) to the first author, MIT Media Laboratory’s information: organized research consortium, and glucometer donations from LifeScan, Inc. We would also like to acknowledge Shelly Leaf, R.N. for allowing us to conduct our initial studies in her diabetes education classroom, Dr. Hector Sobrino for teaching us the intricacies of diabetes, and Omalara Layeni for assisting with interviews in the second study. We also thank our anonymous reviewers for their thoughtful critiques and suggestions.

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Authors and Affiliations

  1. Colleges of Information Sciences & Technology and Education, The Pennsylvania State University, University Park, PA, 16802, USA

    Brian K. Smith

  2. Medical Information Systems Unit, Boston University, Boston, MA, 02118, USA

    Jeana Frost

  3. College of Education, The Pennsylvania State University, University Park, PA, 16802, USA

    Meltem Albayrak

  4. Princeton Consultants, Princeton, NJ, 08540, USA

    Rajneesh Sudhakar

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  1. Brian K. Smith
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Correspondence to Brian K. Smith.

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Smith, B.K., Frost, J., Albayrak, M. et al. Integrating glucometers and digital photography as experience capture tools to enhance patient understanding and communication of diabetes self-management practices. Pers Ubiquit Comput 11, 273–286 (2007). https://doi.org/10.1007/s00779-006-0087-2

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