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A Mobile Health Intervention for Self-Management and Lifestyle Change for Persons With Type 2 Diabetes, Part 2: One-Year Results From the Norwegian Randomized Controlled Trial RENEWING HEALTH
| Content Provider | Semantic Scholar |
|---|---|
| Author | Holmen, Heidi Torbjørnsen, Astrid Wahl, Astrid Klopstad Jenum, Anne Karen Småstuen, Milada Cvancarova Årsand, Eirik Ribu, Lis |
| Copyright Year | 2014 |
| Abstract | BACKGROUND Self-management is crucial in the daily management of type 2 diabetes. It has been suggested that mHealth may be an important method for enhancing self-management when delivered in combination with health counseling. OBJECTIVE The objective of this study was to test whether the use of a mobile phone-based self-management system used for 1 year, with or without telephone health counseling by a diabetes specialist nurse for the first 4 months, could improve glycated hemoglobin A1c (HbA1c) level, self-management, and health-related quality of life compared with usual care. METHODS We conducted a 3-arm prospective randomized controlled trial involving 2 intervention groups and 1 control group. Eligible participants were persons with type 2 diabetes with an HbA1c level ≥7.1% (≥54.1 mmol/mol) and aged ≥18 years. Both intervention groups received the mobile phone-based self-management system Few Touch Application (FTA). The FTA consisted of a blood glucose-measuring system with automatic wireless data transfer, diet manual, physical activity registration, and management of personal goals, all recorded and operated using a diabetes diary app on the mobile phone. In addition, one intervention group received health counseling based on behavior change theory and delivered by a diabetes specialist nurse for the first 4 months after randomization. All groups received usual care by their general practitioner. The primary outcome was HbA1c level. Secondary outcomes were self-management (heiQ), health-related quality of life (SF-36), depressive symptoms (CES-D), and lifestyle changes (dietary habits and physical activity). Data were analyzed using univariate methods (t test, ANOVA) and multivariate linear and logistic regression. RESULTS A total of 151 participants were randomized: 51 to the FTA group, 50 to the FTA-health counseling (FTA-HC) group, and 50 to the control group. Follow-up data after 1 year were available for 120 participants (79%). HbA1c level decreased in all groups, but did not differ between groups after 1 year. The mean change in the heiQ domain skills and technique acquisition was significantly greater in the FTA-HC group after adjusting for age, gender, and education (P=.04). Other secondary outcomes did not differ between groups after 1 year. In the FTA group, 39% were substantial users of the app; 34% of the FTA-HC group were substantial users. Those aged ≥63 years used the app more than their younger counterparts did (OR 2.7; 95% CI 1.02-7.12; P=.045). CONCLUSIONS The change in HbA1c level did not differ between groups after the 1-year intervention. Secondary outcomes did not differ between groups except for an increase in the self-management domain of skill and technique acquisition in the FTA-HC group. Older participants used the app more than the younger participants did. |
| File Format | PDF HTM / HTML |
| DOI | 10.2196/mhealth.3882 |
| PubMed reference number | 25499872 |
| Journal | Medline |
| Volume Number | 2 |
| Alternate Webpage(s) | https://mhealth.jmir.org/article/download/mhealth_v2i4e57/2 |
| Alternate Webpage(s) | https://www.duo.uio.no/bitstream/handle/10852/59410/3882-49889-25-PB.pdf?isAllowed=y&sequence=1 |
| Alternate Webpage(s) | http://mhealth.jmir.org/article/viewFile/mhealth_v2i4e57/2 |
| Alternate Webpage(s) | http://munin.uit.no/bitstream/handle/10037/6963/article.pdf?sequence=1 |
| Alternate Webpage(s) | https://doi.org/10.2196/mhealth.3882 |
| Journal | JMIR mHealth and uHealth |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
