gms | German Medical Science

Introduction: Adolescents diagnosed with type 1 diabetes mellitus (T1DM) face unique challenges in managing their disease. Health literacy (HL), or the ability to obtain, understand, and use health information to make informed decisions, is crucial in preventing and mitigating debilitating complications. Despite the widespread use of digital health interventions, there is limited knowledge regarding the association between the use of distal technologies (such as social media) and HL in adolescents with T1DM.

Research questions: This systematic review aims to provide an overview of the impact of digital health interventions on HL in adolescents with T1DM and seeks to answer the following two questions:

1.

Which categories and dimensions of HL, as proposed by Bröder and colleagues (2017), are most relevant in the context of adolescents with T1DM?

2.

What distal digital health tools (as defined by Duke, 2018) are currently being used for T1DM adolescents in relation to these HL categories and dimensions, and how are they interconnected?

Methods: Electronic searches were conducted in five electronic databases, including Medline (Medline, PubMed+ via PubMed), The Cochrane Library, EMBASE (via Ovid), Web of Science, and PsycINFO, covering the period from 2011 to 2021. Grey literature searches were also performed in Google Scholar, OAlster, and Trip. In addition, reference lists of included studies were manually searched to identify any missed relevant studies. The review adhered to the PRISMA guidelines. Abstracts were independently screened by two researchers for initial eligibility, and the inclusion and exclusion criteria were applied to relevant full-text articles. The quality of primary studies was assessed using tools such as RoB2 Cochrane, ROBINS I, NOS (Newcastle-Ottawa Scale), and CASP (Critical Appraisal Skills Programme), while secondary studies were evaluated using Amstar-2.

Results: Out of 981 studies initially identified, 22 studies were included in the final review. The majority of primary studies were assessed to have moderate overall risk of bias or some concerns, while most of the secondary studies were rated as critically low quality reviews. The findings of this review suggest that the interplay between health care providers (HCPs) and patients through social media can contribute to improved disease management, which aligns with Bröder et al.'s (2017) dimension of 'communication and interactions' in their concept of HL.

Discussion: The use of social media may be a specific and beneficial intervention for improving communication and interaction between adolescents with T1DM and their health care providers. However, further research is needed to determine the specific forms of social media that are most effective for different groups of adolescents with T1DM.

Implications for care: Based on the findings of this systematic review, digital health interventions, particularly those involving social media, have the potential to positively impact HL among adolescents with T1DM by enhancing communication and interactions with their health care providers. Future research and tailored interventions are warranted to better understand and optimize the use of digital health tools in this population.