Enhancing Patient Activation and Self-Management Activities in Patients With Type 2 Diabetes Using the US Department of Defense Mobile Health Care Environment: Feasibility Study.
diabetes mellitus
eHealth
mHealth
patient activation
patient-centered care
Journal
Journal of medical Internet research
ISSN: 1438-8871
Titre abrégé: J Med Internet Res
Pays: Canada
ID NLM: 100959882
Informations de publication
Date de publication:
26 05 2020
26 05 2020
Historique:
received:
24
01
2020
accepted:
12
04
2020
revised:
21
03
2020
pubmed:
25
4
2020
medline:
4
11
2020
entrez:
25
4
2020
Statut:
epublish
Résumé
Past mobile health (mHealth) efforts to empower type 2 diabetes (T2D) self-management include portals, text messaging, collection of biometric data, electronic coaching, email, and collection of lifestyle information. The primary objective was to enhance patient activation and self-management of T2D using the US Department of Defense's Mobile Health Care Environment (MHCE) in a patient-centered medical home setting. A multisite study, including a user-centered design and a controlled trial, was conducted within the US Military Health System. Phase I assessed preferences regarding the enhancement of the enabling technology. Phase II was a single-blinded 12-month feasibility study that randomly assigned 240 patients to either the intervention (n=123, received mHealth technology and behavioral messages tailored to Patient Activation Measure [PAM] level at baseline) or the control group (n=117, received equipment but not messaging. The primary outcome measure was PAM scores. Secondary outcome measures included Summary of Diabetes Self-Care Activities (SDSCA) scores and cardiometabolic outcomes. We used generalized estimating equations to estimate changes in outcomes. The final sample consisted of 229 patients. Participants were 61.6% (141/229) male, had a mean age of 62.9 years, mean glycated hemoglobin (HbA Our study produced mixed results with improvement in PAM scores and outcomes in both the intervention and control groups. Structural design issues may have hampered the influence of tailored behavioral messaging within the intervention group. ClinicalTrials.gov NCT02949037; https://clinicaltrials.gov/ct2/show/NCT02949037. RR2-10.2196/resprot.6993.
Sections du résumé
BACKGROUND
Past mobile health (mHealth) efforts to empower type 2 diabetes (T2D) self-management include portals, text messaging, collection of biometric data, electronic coaching, email, and collection of lifestyle information.
OBJECTIVE
The primary objective was to enhance patient activation and self-management of T2D using the US Department of Defense's Mobile Health Care Environment (MHCE) in a patient-centered medical home setting.
METHODS
A multisite study, including a user-centered design and a controlled trial, was conducted within the US Military Health System. Phase I assessed preferences regarding the enhancement of the enabling technology. Phase II was a single-blinded 12-month feasibility study that randomly assigned 240 patients to either the intervention (n=123, received mHealth technology and behavioral messages tailored to Patient Activation Measure [PAM] level at baseline) or the control group (n=117, received equipment but not messaging. The primary outcome measure was PAM scores. Secondary outcome measures included Summary of Diabetes Self-Care Activities (SDSCA) scores and cardiometabolic outcomes. We used generalized estimating equations to estimate changes in outcomes.
RESULTS
The final sample consisted of 229 patients. Participants were 61.6% (141/229) male, had a mean age of 62.9 years, mean glycated hemoglobin (HbA
CONCLUSIONS
Our study produced mixed results with improvement in PAM scores and outcomes in both the intervention and control groups. Structural design issues may have hampered the influence of tailored behavioral messaging within the intervention group.
TRIAL REGISTRATION
ClinicalTrials.gov NCT02949037; https://clinicaltrials.gov/ct2/show/NCT02949037.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
RR2-10.2196/resprot.6993.
Identifiants
pubmed: 32329438
pii: v22i5e17968
doi: 10.2196/17968
pmc: PMC7284404
doi:
Banques de données
ClinicalTrials.gov
['NCT02949037']
Types de publication
Journal Article
Multicenter Study
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
e17968Informations de copyright
©Ronald W Gimbel, Lior M Rennert, Paul Crawford, Jeanette R Little, Khoa Truong, Joel E Williams, Sarah F Griffin, Lu Shi, Liwei Chen, LingLing Zhang, Jennie B Moss, Robert C Marshall, Karen W Edwards, Kristy J Crawford, Marie Hing, Amanda Schmeltz, Brandon Lumsden, Morgan Ashby, Elizabeth Haas, Kelly Palazzo. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.05.2020.
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