一款移动健康应用程序干预对2型糖尿病患者的可接受性及其与初始自我管理的关联：随机对照试验
Acceptability of an mHealth App Intervention for Persons With Type 2 Diabetes and its Associations With Initial Self-Management: Randomized Controlled Trial.
作者信息
Torbjørnsen Astrid, Småstuen Milada Cvancarova, Jenum Anne Karen, Årsand Eirik, Ribu Lis
机构信息
Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
Institute of Health and Society, General Practice Research Unit, Department of General Practice, University of Oslo, Oslo, Norway.
出版信息
JMIR Mhealth Uhealth. 2018 May 21;6(5):e125. doi: 10.2196/mhealth.8824.
BACKGROUND
Mobile health interventions are increasingly used in health care. The level of acceptability may indicate whether and how such digital solutions will be used.
OBJECTIVE
This study aimed to explore associations between the level of acceptability of a mobile diabetes app and initial ability of self-management for patients with type 2 diabetes.
METHODS
Participants with type 2 diabetes were recruited from primary health care settings to a 3-armed randomized controlled trial in the Norwegian study in the RENEWING HEALTH project. At the 1-year follow-up, 75 out of 101 participants from the intervention groups completed an acceptability questionnaire (The Service User Technology Acceptability Questionnaire). In the randomized controlled trial, the 2 intervention groups (n=101 in total) received a mobile phone with a diabetes diary app, and one of the groups received additional health counseling given by telephone calls from a diabetes specialist nurse (n=50). At baseline, we collected clinical variables from medical records, whereas demographic data and self-management (The Health Education Impact Questionnaire) measures were self-reported. Log data from the use of the app by self-monitoring were registered continuously. Associations between initial ability to self-manage at baseline and acceptability of the diabetes diary app after 1 year were analyzed using linear regression.
RESULTS
We found statistically significant associations between 5 of the 8 self-management domains and perceived benefit, one of the acceptability factors. However, when adjusting for age, gender, and frequency of use, only 1 domain, skill and technique acquisition, remained independently associated with perceived benefit. Frequency of use of the app was the factor that revealed the strongest association with the acceptability domain perceived benefit.
CONCLUSIONS
Our findings indicate that persons with diabetes may accept the app, despite its perceived benefit being associated with only one of the 8 domains of their initial level of self-management.
TRIAL REGISTRATION
ClinicalTrials.gov NCT01315756; https://clinicaltrials.gov/show/NCT01315756 (Archived by WebCite at http://www.webcitation.org/6z46qPhWl).
背景
移动健康干预在医疗保健中的应用日益广泛。可接受程度可能表明此类数字解决方案是否会被使用以及如何被使用。
目的
本研究旨在探讨2型糖尿病患者对一款移动糖尿病应用程序的可接受程度与自我管理初始能力之间的关联。
方法
在挪威“更新健康”项目的一项研究中，从初级卫生保健机构招募2型糖尿病患者参与一项三臂随机对照试验。在1年随访时，干预组的101名参与者中有75人完成了一份可接受性调查问卷（服务使用者技术可接受性调查问卷）。在随机对照试验中，2个干预组（共101人）获得一部装有糖尿病日记应用程序的手机，其中一组还接受了糖尿病专科护士通过电话提供的额外健康咨询（50人）。在基线时，我们从病历中收集临床变量，而人口统计学数据和自我管理（健康教育影响问卷）指标则由患者自行报告。通过自我监测使用应用程序的日志数据被持续记录。使用线性回归分析基线时自我管理的初始能力与1年后糖尿病日记应用程序的可接受性之间的关联。
结果
我们发现8个自我管理领域中的5个与可接受性因素之一即感知益处之间存在统计学上的显著关联。然而，在对年龄、性别和使用频率进行调整后，只有一个领域，即技能和技术获取，仍与感知益处独立相关。应用程序的使用频率是与可接受性领域感知益处关联最强的因素。
结论
我们的研究结果表明，糖尿病患者可能会接受该应用程序，尽管其感知益处仅与他们初始自我管理水平的8个领域之一相关。
试验注册
ClinicalTrials.gov NCT01315756；https://clinicaltrials.gov/show/NCT01315756（由WebCite存档于http://www.webcitation.org/6z46qPhWl）。
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