Min-Kyung Lee 1 , Da Young Lee 2 , Hong-Yup Ahn 3 , Cheol-Young Park 4 Show Affiliations »
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BACKGROUND: Mobile health applications have been developed to support diabetes self-management, but their effectiveness could depend on patient engagement. Therefore, patient engagement must be examined through multifactorial tailored behavioral interventions from an individual perspective. OBJECTIVE: This study aims to evaluate the usefulness of a novel user utility score (UUS ) as a tool to measure patient engagement by using a mobile health application for diabetes management. METHODS: We conducted a subanalysis of results from a 12-month randomized controlled trial of a tailored mobile coaching (TMC) system among insurance policyholders with type 2 diabetes . UUS was calculated as the sum of the scores for 4 major core components (range 0-8): frequency of self-monitoring blood glucose testing, dietary and exercise records, and message reading rate. We explored the association between UUS for the first 3 months and glycemic control over 12 months. In addition, we investigated the relationship of UUS with blood pressure, lipid profile, and self-report scales assessing diabetes self-management . RESULTS: We divided 72 participants into 2 groups based on UUS for the first 3 months : UUS:0 -4 (n=38) and UUS :5-8 (n=34). There was a significant between-group difference in glycated hemoglobin test (HbA1c) levels for the 12-months study period (P=.011). The HbA1c decrement at 12 months in the UUS :5-8 group was greater than that of the UUS:0 -4 group [-0.92 (SD 1.24%) vs -0.33 (SD 0.80%); P=.049]. After adjusting for confounding factors, UUS was significantly associated with changes in HbA1c at 3, 6, and 12 months; the regression coefficients were -0.113 (SD 0.040; P=.006), -0.143 (SD 0.045; P=.002), and -0.136 (SD 0.052; P=.011), respectively. Change differences in other health outcomes between the 2 groups were not observed throughout a 12-month follow-up. CONCLUSIONS: UUS as a measure of patient engagement was associated with changes in HbA1c over the study period of the TMC system and could be used to predict improved glycemic control in diabetes self-management through mobile health interventions. TRIAL REGISTRATION: ClinicalTrial.gov NCT03033407; https://clinicaltrials.gov/ct2/show/NCT03033407. ©Min-Kyung Lee, Da Young Lee, Hong-Yup Ahn, Cheol-Young Park. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 24.02.2021.
RCT Entities: Population
Interventions
Outcomes
BACKGROUND: Mobile health applications have been developed to support diabetes self-management, but their effectiveness could depend on patient engagement. Therefore, patient engagement must be examined through multifactorial tailored behavioral interventions from an individual perspective. OBJECTIVE: This study aims to evaluate the usefulness of a novel user utility score (UUS ) as a tool to measure patient engagement by using a mobile health application for diabetes management. METHODS: We conducted a subanalysis of results from a 12-month randomized controlled trial of a tailored mobile coaching (TMC ) system among insurance policyholders with type 2 diabetes . UUS was calculated as the sum of the scores for 4 major core components (range 0-8): frequency of self-monitoring blood glucose testing, dietary and exercise records, and message reading rate. We explored the association between UUS for the first 3 months and glycemic control over 12 months. In addition, we investigated the relationship of UUS with blood pressure, lipid profile, and self-report scales assessing diabetes self-management. RESULTS: We divided 72 participants into 2 groups based on UUS for the first 3 months: UUS :0-4 (n=38) and UUS :5-8 (n=34). There was a significant between-group difference in glycated hemoglobin test (HbA1c) levels for the 12-months study period (P=.011). The HbA1c decrement at 12 months in the UUS :5-8 group was greater than that of the UUS :0-4 group [-0.92 (SD 1.24%) vs -0.33 (SD 0.80%); P=.049]. After adjusting for confounding factors, UUS was significantly associated with changes in HbA1c at 3, 6, and 12 months; the regression coefficients were -0.113 (SD 0.040; P=.006), -0.143 (SD 0.045; P=.002), and -0.136 (SD 0.052; P=.011), respectively. Change differences in other health outcomes between the 2 groups were not observed throughout a 12-month follow-up. CONCLUSIONS: UUS as a measure of patient engagement was associated with changes in HbA1c over the study period of the TMC system and could be used to predict improved glycemic control in diabetes self-management through mobile health interventions. TRIAL REGISTRATION: ClinicalTrial.gov NCT03033407; https://clinicaltrials.gov/ct2/show/NCT03033407. ©Min-Kyung Lee, Da Young Lee, Hong-Yup Ahn, Cheol-Young Park. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 24.02.2021.
Entities: Chemical
Disease
Gene
Species
Keywords:
diabetes management; mobile applications; patient engagement; type 2 diabetes
Year: 2021
PMID： 33625363 PMCID： PMC7946585 DOI： 10.2196/17573
Source DB: PubMed Journal: JMIR Mhealth Uhealth ISSN： 2291-5222 Impact factor: 4.773