Patients’ Engagement With “Sweet Talk” – A Text Messaging Support System for Young People With Diabetes

This article examines the educational efficacy of a learning environment in which children diagnosed with Autism Spectrum Conditions (ASC) engage in social interactions with an artificially intelligent (AI) virtual agent and where a human practitioner acts in support of the interactions. A multi-site intervention study in schools across the UK was conducted with 29 children with ASC and learning difficulties, aged 4--14 years old. For reasons related to data completeness and amount of exposure to the AI environment, data for 15 children was included in the analysis. The analysis revealed a significant increase in the proportion of social responses made by ASC children to human practitioners. The number of initiations made to human practitioners and to the virtual agent by the ASC children also increased numerically over the course of the sessions. However, due to large individual differences within the ASC group, this did not reach significance. Although no evidence of transfer to the real-world post-test was shown, anecdotal evidence of classroom transfer was reported. The work presented in this article offers an important contribution to the growing body of research in the context of AI technology design and use for autism intervention in real school contexts. Specifically, the work highlights key methodological challenges and opportunities in this area by leveraging interdisciplinary insights in a way that (i) bridges between educational interventions and intelligent technology design practices, (ii) considers the design of technology as well as the design of its use (context and procedures) on par with one another, and (iii) includes design contributions from different stakeholders, including children with and without ASC diagnosis, educational practitioners, and researchers.

Optimal diabetes management involves considerable behavioural modification, while nonadherence contributes significantly to poor glycaemia. Extensive research on psychological interventions aiming to improve glycaemia suggests that current strategies are costly and time-consuming and in our experience do not appeal to young people with Type 1 diabetes. Text messaging has rapidly become a socially popular form of communication. It is personal, highly transportable, and widely used, particularly in the adolescent population. However, text messaging coupled with specific behavioural health strategies has yet to be utilised effectively. We have developed a novel support network ("Sweet Talk"), based on a unique text-messaging system designed to deliver individually targeted messages and general diabetes information. Individualised motivation strategies—based on social cognition theory, the health belief model, and goal setting—form the theoretical basis of the message content. Intensifying insulin therapy and increasing contact with the diabetes team can improve control, but are difficult to provide within existing resources. Our support system offers a means of contact and support between clinic visits and aims to increase adherence with intensive insulin regimens and to improve clinical outcome.

To use the University of California Los Angeles Loneliness Scale Version 3 to (a) explore and compare the levels of loneliness experienced between two groups of older adults (aged 40 years and over) with cerebral palsy, a group who use natural speech to communicate and a group who use augmentative and alternative communication (AAC) and (b) to test the reliability of the UCLA Loneliness Scale (Version 3) when used with the older adults with cerebral palsy who use a variety of communication modes. The UCLA Loneliness Scale (Version 3) was administered twice to two groups of older participants with cerebral palsy. Group 1 consisted of 11 participants who used natural speech and Group 2 consisted of nine participants who used augmentative and alternative communication systems. The scores from the second assessment were used to calculate test retest reliability. The mean loneliness scores for the two groups indicated that older people with cerebral palsy experience more loneliness than older adults without disability. There was no significant difference between the scores of Groups 1 and 2. The UCLA Loneliness Scale (Version 3) is a reliable tool for use with people who communicate using a variety of communication modes. The UCLA Loneliness Scale (Version 3) items are pertinent to participants' perceived satisfaction with the quantity and quality of their relationships with others. Policy makers, service providers and the general community have a responsibility to ensure that older people with cerebral palsy are given the support they need to achieve satisfactory relationships and thus facilitate a good quality of life as they age.