Interactive behavioral technologies and diabetes self-management support: recent research findings from clinical trials.

A review of recent interactive behavioral technology (IBT) interventions applied to diabetes self-management identified 12 clinical trials, the majority being randomized controlled trials. Encouragingly, the studies used a wide range of technologies, were typically based in primary care settings, and mostly recruited disadvantaged or under-represented patients or those with little computer experience. However, only one third of the studies had incorporated behavioral theories or models into the interventions. Control conditions typically received some dose of the intervention or its components. Blood glucose control (A1c) was not significantly improved in 60% of studies, and where the intervention group was significantly improved over the control condition only modest improvements were found (-0.18% to 0.4%). Patient-reported outcomes were encouraging, but weak attention to psychometrics (eg, responsiveness) was evident. Health care utilization was reduced for several uncontrolled studies. Future research should target patient motivation to participate more intensely and consistently and integrate IBT interventions into routine medical care.