Coventry Peter, Bower Peter, Blakemore Amy, Baker Elizabeth, Hann Mark, Li Jinshuo, Paisley Angela, Gibson Martin
1Department of Health Sciences and Centre for Reviews and Dissemination, University of York, York, UK.
2NIHR School for Primary Care Research, Centre for Primary Care, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
NPJ Digit Med. 2019 Feb 4;2:5. doi: 10.1038/s41746-019-0080-6. eCollection 2019.
International evidence shows that lifestyle interventions can effectively reduce the risk of developing diabetes in people with non-diabetic hyperglycaemia (NDH). A candidate intervention that has potential to be rolled out at population level is health coaching. Digital interventions offer the means to potentially enhance user satisfaction with health coaching and improve efficiencies. We used a randomised controlled trial to test whether a digitally-enabled health coaching intervention that included an online dashboard and telephone health coaching improved user satisfaction and cost-efficiencies compared with a telephone only health coaching intervention. The primary outcome was satisfaction measured by Client Satisfaction Questionnaire (CSQ-8). 103 participants with NDH were allocated to the telephone coaching only intervention and 106 participants with NDH were allocated to the digital and telephone coaching intervention. In an intention-to-treat analysis satisfaction was higher in participants allocated to the digital and telephone coaching intervention than those allocated to the telephone only intervention, but the difference was not significant. There were no significant differences between the groups on secondary outcomes (HbA1c, BMI, activation, depression, self-management, health status). From a service commissioning perspective the mean incremental cost of the digitally-enabled intervention was £236 ($332; €270). Call times, including administration, were longer for participants allocated to the digitally-enabled intervention. The results show that user satisfaction with digitally-enabled intervention is broadly equivalent with that of telephone delivered interventions in the context of routinely delivered diabetes prevention programmes. There is scope for future work that assesses how economies of scale can be achieved at larger user bases.
国际证据表明,生活方式干预可有效降低非糖尿病性高血糖(NDH)患者患糖尿病的风险。一种有可能在人群层面推广的候选干预措施是健康指导。数字干预提供了潜在提高用户对健康指导满意度并提高效率的手段。我们采用随机对照试验来测试,与仅采用电话健康指导干预相比,包含在线仪表盘和电话健康指导的数字化健康指导干预是否能提高用户满意度和成本效益。主要结局是通过客户满意度问卷(CSQ - 8)测量的满意度。103名NDH患者被分配到仅电话指导干预组,106名NDH患者被分配到数字与电话指导干预组。在意向性分析中,分配到数字与电话指导干预组的参与者的满意度高于仅分配到电话指导干预组的参与者,但差异不显著。两组在次要结局(糖化血红蛋白、体重指数、活跃度、抑郁、自我管理、健康状况)方面无显著差异。从服务委托的角度来看,数字化干预的平均增量成本为236英镑(332美元;270欧元)。分配到数字化干预组的参与者的通话时间(包括管理时间)更长。结果表明,在常规开展的糖尿病预防项目中,用户对数字化干预的满意度与电话干预的满意度大致相当。未来有工作空间来评估如何在更大用户群体中实现规模经济。