Department of Nursing, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
JMIR Mhealth Uhealth. 2014 Dec 11;2(4):e52. doi: 10.2196/mhealth.3535.
Self-management support for people with type 2 diabetes is essential in diabetes care. Thus, mobile health technology with or without low-intensity theory-based health counseling could become an important tool for promoting self-management.
The aim was to evaluate whether the introduction of technology-supported self-management using the Few Touch Application (FTA) diabetes diary with or without health counseling improved glycated hemoglobin (HbA1c) levels, self-management, behavioral change, and health-related quality of life, and to describe the sociodemographic, clinical, and lifestyle characteristics of the participants after 4 months.
A 3-armed randomized controlled trial was conducted in Norway during 2011-2013. In the 2 intervention groups, participants were given a mobile phone for 1 year, which provided access to the FTA diary, a self-help tool that recorded 5 elements: blood glucose, food habits, physical activity, personal goal setting, and a look-up system for diabetes information. One of the intervention groups was also offered theory-based health counseling with a specialist diabetes nurse by telephone for 4 months from baseline. Both intervention groups and the control group were provided usual care according to the national guidelines. Adults with type 2 diabetes and HbA1c ≥7.1% were included (N=151). There were 3 assessment points: baseline, 4 months, and 1 year. We report the short-term findings after 4 months. HbA1c was the primary outcome and the secondary outcomes were self-management (Health Education Impact Questionnaire, heiQ), behavioral change (diet and physical activity), and health-related quality of life (SF-36 questionnaire). The data were analyzed using univariate methods (ANOVA), multivariate linear, and logistic regression.
Data were analyzed from 124 individuals (attrition rate was 18%). The groups were well balanced at baseline. There were no differences in HbA1c between groups after 4 months, but there was a decline in all groups. There were changes in self-management measured using the health service navigation item in the heiQ, with improvements in the FTA group compared to the control group (P=.01) and in the FTA with health counseling group compared with both other groups (P=.04). This may indicate an improvement in the ability of patients to communicate health needs to their health care providers. Furthermore, the FTA group reported higher scores for skill and technique acquisition at relieving symptoms compared to the control group (P=.02). There were no significant changes in any of the domains of the SF-36.
The primary outcome, HbA1c, did not differ between groups after 4 months. Both of the intervention groups had significantly better scores than the control group for health service navigation and the FTA group also exhibited improved skill and technique acquisition.
对于 2 型糖尿病患者来说，自我管理支持在糖尿病护理中至关重要。因此，具有或不具有基于低强度理论的健康咨询的移动健康技术可能成为促进自我管理的重要工具。
本研究旨在评估使用 Few Touch Application（FTA）糖尿病日记进行技术支持的自我管理（具有或不具有健康咨询）是否可以改善糖化血红蛋白（HbA1c）水平、自我管理、行为改变和健康相关生活质量，并描述 4 个月后参与者的社会人口统计学、临床和生活方式特征。
这是一项在 2011-2013 年期间在挪威进行的 3 臂随机对照试验。在 2 个干预组中，参与者获得了一部手机，使用该手机可访问 FTA 日记，这是一种自我帮助工具，可记录 5 个要素：血糖、饮食习惯、身体活动、个人目标设定和糖尿病信息查询系统。其中一个干预组还在基线时通过电话接受了由专科糖尿病护士提供的基于理论的健康咨询，为期 4 个月。两组干预组和对照组均按照国家指南提供常规护理。纳入 HbA1c≥7.1%的 2 型糖尿病成人（N=151）。有 3 个评估点：基线、4 个月和 1 年。我们报告 4 个月后的短期结果。HbA1c 是主要结局，次要结局是自我管理（健康教育影响问卷，heiQ）、行为改变（饮食和身体活动）和健康相关生活质量（SF-36 问卷）。使用单变量方法（ANOVA）、多变量线性和逻辑回归分析数据。
对 124 名参与者（失访率为 18%）的数据进行了分析。基线时各组间平衡良好。4 个月后，各组之间的 HbA1c 无差异，但所有组均有所下降。使用 heiQ 中的健康服务导航项目测量的自我管理发生了变化，与对照组相比，FTA 组有改善（P=.01），与 FTA 联合健康咨询组相比，所有其他组均有改善（P=.04）。这可能表明患者与医疗保健提供者沟通健康需求的能力有所提高。此外，FTA 组在缓解症状方面的技能和技术获取方面的评分高于对照组（P=.02）。SF-36 的任何领域均无显著变化。
4 个月后，主要结局 HbA1c 各组间无差异。与对照组相比，两组干预组的健康服务导航评分均显著提高，而 FTA 组在技能和技术获取方面也有改善。
