¶ … Telehealth Strategies to Support Adolescents with Diabetes and CKD Children and youth who must undergo dialysis because of chronic kidney disease (CKD) are typically provided age appropriate educational materials for self-care. Key objectives of efforts to strengthen self-care education are the maintenance of optimally beneficial diet and, although direct evidence has not yet been shown for children, maintenance of blood pressure that is below the 90th percentile for height, age, and gender ("NIH," 2014). Longitudinal studies may point to strategies that result in earlier detection, and perhaps even enable diabetic kidney disease to be prevented (Lane, 2005). In the interim period, research that identifies enhanced methods for assisting and encouraging children and youth to adhere to their dietary regimens are an important support to utilize ("NIH," 2014).

Guidelines for optimizing the benefits of a customized diet for children and youth with chronic kidney disease have been provided by the National Institute of Diabetes and Digestive and Kidney Disease (HIDDKD), and other organization devoted to the care and support of patients dealing with CKD ("NIH," 2014). However, nonadherence is a common problem, and one that may grow worse as youngsters with CKD become adolescents. In recent years, a considerable corpus of the research literature has focused on telehealth or telemedicine,...

The use of text messaging for health care has predominantly been directed toward adults, and particularly adults in rural settings that do not have ready access to clinics, healthcare facilities, and physicians (Purcell, 2011). There is opportunity to support adolescent patients with CKD through moderated text messages and diet tracking programs, such as Sparkspeople (http://www.sparkpeople.com/) that are designed to be engaging to this age group (Ammenwerth, 2006; Brown, 2013; Schnall, et al., 2013; Sheehan, et al., 2012).
PICOT

The theory driving this PICOT is that adolescent patients with CKD will find applications designed to track dietary regimens in adolescents both attractive and reinforcing. The therapy / prevention PICOT is based on the belief that a limited degree of monitoring of adherence and interaction through emails by nurses will greatly strengthen the use of the tracking and motivational application by adolescents with CKD.

The acronym PICOT represents the following concepts:

P = Population / Patient Problem

I = Intervention

C = Comparison

O = Outcome

T = Time

The PICOT states, "Do (P) adolescent patients with CKD who (I) access…