Interactive Virtual Assistance for Self-Care Management and Mental Health Promotion in Type 2 Diabetes

Interactive Virtual Assistance for Self-Care Management and Mental Health Promotion in Type 2 Diabetes

Interactive Virtual Assistance for Self-Care Management and Mental Health Promotion in Type 2 Diabetes

BACKGROUD: Health technology is an important tool in the aging process, which may improve the health condition and self-esteem of the elderly, in addition to offering new opportunities and challenges. In this scenario, the use of virtual interaction systems emerge as promising alternatives for the old adults, which often deals with the lack of social interaction, cognitive decline and decline in functional capacity, making the control of chronic diseases, such as diabetes, a challenge. OBJECTIVES: This project aims to evaluate the effectiveness of using an interactive virtual assistance system in mental health parameters, glycemic profile and diabetes selfcare behavior in elderly people with diabetes. METHODS: A randomized clinical trial is proposed, for an intervention that includes 3 months of use of the Smart Speaker Echo Dot system, programmed to provide reminders, stimulate treatment records and maintain healthy habits. Outcomes assessed will include parameters of mental health and diabetes control.

Participants will receive the Smart Speaker EchoDot (3rd Generation) system in a timely manner based on the day of study enrollment. In addition to the usual functionality of the system, all participants will receive the following interventions through voice commands: 1. Reminders of administration of antidiabetics at the time or period of the day informed in the medical prescription; 2. Check for confirmation of antidiabetic administration 1 hour after the moment of administration; 3. Capillary blood glucose monitoring reminder,when indicated by the attending physician and appropriate; 4. Invitation to perform balance and breathing exercises daily, at a time compatible with the daily schedule provided by the patient at the time of inclusion; 5. Reminder to maintain healthy food choices at times typically associated with meals; 6. Invitation to play activities (eg listening tomusic, dancing, meditating, etc.) daily,according to the daily schedule provided by the patient;

For mental health screening, the Self Report Questionnaire (SRQ 20) will be used, translated into Portuguese and validated for the Brazilian population. This scale was specially developed for the screening of depression, anxiety em commom mental health disorders in the elderly

To assess glycemic control, the dosage of glycated hemoglobin (HbA1c) will be performed by high performance liquid chromatography, a measure that estimates the average glycemic control of the three months before the exam.

To assess adherence and self-care related to diabetes, the Self-Care Inventory Revised (SCI-R) questionnaire will be used, a version translated into Portuguese and validated for the Brazilian population. It is a questionnaire with 15 questionsand answer options based on the 5-point Likert scale and which reflects the follow-up of treatment recommendations and lifestyle habits related to diabetes care in the2 months prior to the application. Higher scores reflect greater adherence and self-care.

Quality of Life will be assessed at baseline and after 12 weeks using the World Health Organization Quality of Life Group - Bred (WHOQOLbref) questionnaire.

: Katz Activities of Daily Living Index (basic) and Lawton Instrumental Activities of Daily Living Scale (instrumental), baseline and 12w

Inclusion Criteria: Being 65 years of age or older; Having a diagnosis of type 2 diabetes mellitus; Presenting availability of wifi connection at home, availability to participate in theproposed face-to-face evaluations and present autonomy for the administration ofmedicines and basic health self-care; Be willing to interact with the artificial intelligence system for the appropriate evaluation of the proposed intervention Exclusion Criteria: Type 1 diabetes mellitus Latent autoimmune diabetes of adults (LADA), or early-onset diabetes (MODY) Being hospitalized at the time of enrollment Having an interactive virtual home assistance device at the time of enrollment Having cognitive impairments or severe hearing impairments that prevent adequate interaction with researchers and the application of inclusion and follow-upquestionnaires Residing in regions of difficult access and outside the metropolitan region of Porto Alegre. Recruitment: Study subjects will be recruited through two different strategies: Screening of records of the outpatients clinics of Hospital São Lucas (HSL) Social media advertising, specially in Instagram®