Improving the habits of adolescents and young adults

Partnership with Dexcom and regional NHS Trusts

Improving the habits of adolescents and young adults with type 1 diabetes

For two years now we have been working with the NHS and Dexcom to measure the impact of the Nudg platform on adolescents and young adults with type 1 diabetes.  Although Covid-19 affected our clinical trials in 2020, we have still been able to show adoption and efficacy in our non clinical remote testing.

Case highlights:

  • Developed unique behavioural and clinical framework
  • Data ingestion from Dexcom CGM and Apple Health
  • Enhanced channel experience with WhatsApp integration
  • Evidence – Improved ‘Time in Range’ and reduction in Hyperglycemia

Challenge

Improve short and long term health outcomes for adolescents and young adults with type 1 diabetes

During the transitional phase from paediatric health to adult health; engagement, and adherence in adolescents drops significantly. As they become more independent and seek autonomy, this audience tends to focus on near term health challenges, rather than the longer term risks.

This development phase, over about four years, becomes the health blueprint for the rest of their adult life. So adopting positive habits, and proactive health is critical at this time.

How can we use technology, behavioural and data science, to personalise and contextualise high levels of engagement and adoption within this community.

Approach

Using the Nudg platform to send regular, personalised and contextual short-form reminders and prompts

We partnered with Dexcom and the NHS to develop a new approach to engagement and adoption within the T1 adolescent community.

After the development of clinical and behavioural rules, we established a unique number of habit scenarios which would be used as the bases of our nudges.. We then configured our ingestion engine to pull glucose data from Dexcom’s CGM, and other biomarkers from Apple Health to personalise each notification.

We created over 1,200 clinically validated pieces of content covering, gender and age before adding them into the Nudg platform. Finally, we recruited adolescent and young adult cohorts to take part on the clinical studies.

Dexcom

Dexcom are the world’s leading Continual Glucose Monitoring company for T1 & T2 diabetes

Working with Dexcom’s data science team has given us a unique and validated view of our target audience.  We analysed the glucose data from over 51,000 patients within the 12-25 year age bracket, and were able to use this data to fine tune our rules engine and logic.

It means that we have been able to greatly enhance our pioneering behavioural framework, which is now hyper personalised, and sensitive to the needs of the intended audience.

We continue to work with Dexcom to roll out the platform in the US through 2021/22.


Clinical trials and
content prototyping

Combining our leading behavioural platform, Nudg, with engaging content for the target audience

Over the last two years we continued to evolve our content following each round of audience feedback and evidence. This content prototyping enabled our teams to validate our behavioural framework across our diverse age groups.

Facts about the prototype:

  • Early content was created by repurposing NHS language and scenarios
  • Utilised data from Dexcom’s 51,000 adolescents and young adults
  • Most effective content is lived experience and role models
  • Over 50 content partners/creators around the world
  • Testing in multiple languages

Impact & evidence

Increased adoption and engagement while providing validated clinical evidence

Our trials have measured clinical impact on a T1 diabetics HbA1c level, time in range, and frequency of hypo and hyperglycemia events. We also measured softer user metrics like consumption of content and user experience user feedback.

Highlights

  • 10%

    Improved time in range metrics after a usage period of three months

  • 16%

    Reduction in hyperglycaemic events over a six month period

  • 0.3%

    A significant reduction in HbA1c over the trial period

  • 24

    Average nudges consumed on the platform every month

  • 100%

    All users in trial said the content was relevant and engaging for their age group and gender

  • 51,000

    A 51,000-strong cohort, working with Dexcom, to inform our base glucose data parameters

“Nudg has proven that digital interventions do work with our younger patients compared to more traditional means. We have seen high levels of adoption, efficacy and continual engagement, which is clearly having an impact on their health.”

Dr Hood Thabit

Consultant Diabetologist & Honorary Senior Lecturer, NHS