Exp Gerontol. 2026 Jul 27:113252. doi: 10.1016/j.exger.2026.113252. Online ahead of print.
ABSTRACT
BACKGROUND AND OBJECTIVES: Medication nonadherence among older adults with type 2 diabetes is common and contributes to preventable complications, especially in African American communities. MediTeddi is a new cognitive prosthetic in the form of a friendly talking electronic bear that delivers scheduled medication prompts, collects simple confirmations, and provides rolling statistical feedback based on Self-Determination Theory. This study evaluated its pilot efficacy and explored support for a cognitive prosthetic framework.
RESEARCH DESIGN AND METHODS: Two pilot studies were conducted with African American adults with poorly controlled type 2 diabetes. Study 1 was a 24-week randomized controlled trial (N = 16) comparing MediTeddi plus biweekly calls with calls alone. Study 2 was a 26-week repeated-measures trial (N = 50; n = 35 completers) examining within-person change with MediTeddi and biweekly calls. The primary behavioral outcome was medication adherence (MMAS-4), and the primary clinical outcome was hemoglobin A1c (HbA1c); secondary outcomes were depressive symptoms and diabetes-related distress.
RESULTS: In Study 1, the intervention group showed a greater reduction in HbA1c (mean decrease 0.88) than the control group (0.32), with a trend toward significance (p < .10). MMAS-4 adherence also improved more in the intervention group (mean increase 0.67 vs. 0.00). In Study 2, participants demonstrated large and statistically significant gains in adherence (MMAS-4 increase from 1.61 to 3.14), along with a 1.71-point reduction in HbA1c and significant reductions in depressive symptoms and diabetes distress.
DISCUSSION: These pilot trials suggest that a simple, socially engaging cognitive prosthetic can meaningfully improve adherence, glycemic control, and psychosocial outcomes in older African American adults with diabetes and warrant larger, theory-driven trials with objective adherence measures. (272 words).
PMID:42503366 | DOI:10.1016/j.exger.2026.113252
