Twelve-month outcomes of an Internet-based diabetes self-management support program

PATIENT EDUCATION AND COUNSELING

卷:87

Article

Glasgow, Russell E.^1,2  Kurz, Deanna²  King, Diane²  Dickman, Jennifer M.²  Faber, Andrew J.²  Halterman, Eve²  Woolley, Tim⁴  Toobert, Deborah J.³  Strycker, Lisa A.³  Estabrooks, Paul A.⁵  Osuna, Diego²  Ritzwoller, Debra² 

[1] NCI, Div Canc Control & Populat Sci, Rockville, MD 20852 USA

[2] Kaiser Permanente Colorado, Inst Hlth Res, Denver, CO USA

[3] Oregon Res Inst, Eugene, OR 97403 USA

[4] InterVis Media, Eugene, OR USA

[5] Virginia Polytech Inst & State Univ, Roanoke, VA USA

关键词: Diabetes;    Self-management;    RCT;    Internet intervention;    Pragmatic trial;    Multiple behavior change;   

DOI  :  10.1016/j.pec.2011.07.024

来源: Elsevier

【 摘 要 】

Objective: Internet-based programs offer potential for practical, cost-effective chronic illness self-management programs. Methods: We report 12-month results of an Internet-based diabetes self-management program, with and without additional support, compared to enhanced usual care in a 3-arm practical randomized trial. Patients (n = 463) were randomized: 77.3% completed 12-month follow-up. Primary outcomes were changes in health behaviors of healthy eating, physical activity, and medication taking. Secondary outcomes were hemoglobin A1c, body mass index, lipids, blood pressure, and psychosocial factors. Results: Internet conditions improved health behaviors significantly vs. usual care over the 12-month period (d for effect size = .09-.16). All conditions improved moderately on biological and psychosocial outcomes. Latinos, lower literacy, and higher cardiovascular disease risk patients improved as much as other participants. Conclusions: The Internet intervention meets the reach and feasibility criteria for a potentially broad public health impact. However, 12-month magnitude of effects was small, suggesting that different or more intensive approaches are necessary to support long-term outcomes. Research is needed to understand the linkages between intervention and maintenance processes and downstream outcomes. Practice implications: Automated self-management interventions should be tailored and integrated into primary care; maintenance of patient self-management can be enhanced through links to community resources. Published by Elsevier Ireland Ltd.

【 授权许可】

Free