To obtain data on HPs’ knowledge and recommendation of apps to people with diabetes, a second survey was conducted of the HPs attending the annual scientific meeting of the New Zealand Society for the Study of Diabetes (NZSSD) in May 2016. Immediately prior to the meeting all registered attendees (n=286) were invited to participate in the online survey via email. The data from the patient survey was presented at the conference in a 15-min oral presentation and attendees were encouraged to complete the survey. Paper copies of the survey were also available at the meeting. This survey remained open for 2 weeks, with a reminder sent at 1 week.
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Eligible participants were randomised to either an intervention or control group in a 1:1 ratio. Randomisation was stratified by health district category (high urban or high rural/remote), diabetes type (1 or 2), and ethnicity (Māori and Pacific, or non-Māori/non-Pacific). The randomisation sequence was generated by computer programme using variable block sizes of two or four, and overseen by the study statistician. Following participant consent and completion of the baseline interview, the research assistant then randomised the participant to intervention or control, using the REDCap randomisation module. The REDCap randomisation module ensured that treatment allocation was concealed until the point of randomisation. Due to the nature of the intervention, participants were aware of their treatment allocation. Research assistants conducting the phone interviews were also aware of the treatment allocation. However, the objective primary outcome was measured by blinded assessors throughout the study period.
Statistical analyses were performed by SAS version 9.4 (SAS Institute). All statistical tests were two sided at a 5% significance level. Analyses were performed on the principle of intention to treat, including all randomised participants who provided at least one valid measure on the primary outcome after randomisation. Demographics and baseline characteristics of all participants were first summarised by treatment group with descriptive statistics. No formal statistical tests were conducted at baseline, because any baseline imbalance observed between two groups could have occurred by chance with randomisation.
Cost effectiveness as well as healthcare use was assessed during the study period compared with the nine months before randomisation (presented separately). We measured patient engagement and satisfaction with the intervention using semistructured interviews and data from the content management system. The secondary outcomes health related quality of life and perceived social support were not included in the initial trial registration but added before commencing the trial.

The Endocrinology Service at Starship Children's Health provides specialist care for all children diagnosed with type 1 diabetes in the Auckland region (New Zealand). Its Paediatric Diabetes Service provides centralised medical care for all diabetic children up to 15 yr who reside in the Auckland region, drawing from the regional population of approximately 1.5 million [12]. All children or adolescents diagnosed with type 1 diabetes who attended the Paediatric Service between 1 January 1990 and 31 December 2009 were eligible for this study. Subjects were captured from a comprehensive database (Starbase) that gathers data on all children with type 1 diabetes in the Auckland region. This information was cross-referenced with hospital admission data and subsequent clinical follow up, leading to a case ascertainment >95% for children with type 1 diabetes [13].


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