scholarly journals Enhanced Self-Efficacy and Behavioral Changes Among Patients With Diabetes: Cloud-Based Mobile Health Platform and Mobile App Service

JMIR Diabetes ◽  
10.2196/11017 ◽  
2019 ◽  
Vol 4 (2) ◽  
pp. e11017 ◽  
Author(s):  
Dyna YP Chao ◽  
Tom MY Lin ◽  
Wen-Ya Ma
Keyword(s):  
Mobile Health ◽  
Self Efficacy ◽  
Mobile App ◽  
Behavioral Changes ◽  
Patients With Diabetes

scholarly journals Enhanced Self-Efficacy and Behavioral Changes Among Patients With Diabetes: Cloud-Based Mobile Health Platform and Mobile App Service (Preprint)

2018 ◽  
Author(s):  
Dyna YP Chao ◽  
Tom MY Lin ◽  
Wen-Ya Ma
Keyword(s):  
Blood Pressure ◽  
Health Promotion ◽  
Mobile Health ◽  
Self Efficacy ◽  
Compliance Rate ◽  
Mobile App ◽  
Behavioral Changes ◽  
Self Management ◽  
Patient Centered ◽  
Individual Health

BACKGROUND The prevalence of chronic disease is increasing rapidly. Health promotion models have shifted toward patient-centered care and self-efficacy. Devices and mobile app in the Internet of Things (IoT) have become critical self-management tools for collecting and analyzing personal data to improve individual health outcomes. However, the precise effects of Web-based interventions on self-efficacy and the related motivation factors behind individuals’ behavioral changes have not been determined. OBJECTIVE The objective of this study was to gain insight into patients' self-efficacy with newly diagnosed diabetes (type 2 diabetes mellitus) and analyze the association of patient-centered health promotion behavior and to examine the implications of the results for IoT and mobile health mobile app features. METHODS The study used data from the electronic health database (n=3128). An experimental design (n=121) and randomized controlled trials were employed to determine patient preferences in the health promotion program (n=62) and mobile self-management education (n=28). The transtheoretical model was used as a framework for observing self-management behavior for the improvement of individual health, and the theory of planned behavior was used to evaluate personal goals, execution, outcome, and personal preferences. A mobile app was used to determine individualized health promotion interventions and to apply these interventions to improve patients’ self-management and self-efficacy. RESULTS Mobile questionnaires were administered for pre- and postintervention assessment through mobile app. A dynamic questionnaire allocation method was used to follow up and monitor patient behavioral changes in the subsequent 6 to 18 months. Participants at a high risk of problems related to blood pressure (systolic blood pressure ≥120 mm Hg) and body mass index (≥23 kg/m2) indicated high motivation to change and to achieve high scores in the self-care knowledge assessment (n=49, 95% CI −0.26% to −0.24%, P=.052). The associated clinical outcomes in the case group with the mobile-based intervention were slightly better than in the control group (glycated hemoglobin mean −1.25%, 95% CI 6.36 to 7.47, P=.002). In addition, 86% (42/49) of the participants improved their health knowledge through the mobile-based app and information and communications technology. The behavior-change compliance rate was higher among the women than among the men. In addition, the personal characteristics of steadiness and dominance corresponded with a higher compliance rate in the dietary and wellness intervention (83%, 81/98). Most participants (71%, 70/98) also increased their attention to healthy eating, being active, and monitoring their condition (30% 21/70, 21% 15/70, and 20% 14/70, respectively). CONCLUSIONS The overall compliance rate was discovered to be higher after the mobile app–based health intervention. Various intervention strategies based on patient characteristics, health care–related word-of-mouth communication, and social media may be used to increase self-efficacy and improve clinical outcomes. Additional research should be conducted to determine the most influential factors and the most effective adherence management techniques.

scholarly journals Mobile Health Use Predicts Self-Efficacy and Self-Management in Adolescents with Sickle Cell Disease

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 57-58
Author(s):  
Anna M Hood ◽  
Cara Nwankwo ◽  
Emily McTate ◽  
Naomi E Joffe ◽  
Charles T. Quinn ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Mobile Health ◽  
Self Efficacy ◽  
Mobile App ◽  
Self Management ◽  
Cell Disease ◽  
Management Skills ◽  
Pain Diary ◽  
Pain Symptoms ◽  
Improve Health

Background: Sickle cell disease (SCD) is associated with medical challenges that often worsen for adolescents and young adults (AYA) when caregivers begin to transfer responsibility for care. Living with SCD requires self-management and self-efficacy and is a critical concern for AYA as they navigate complex medical systems. However, previous research indicates that AYA with SCD often lack the ability, confidence, and skills to manage their disease effectively. As most AYA with SCD are now "technology natives," mobile health (mHealth) holds considerable promise for assessing and changing behaviors to improve health outcomes. In a previous feasibility and acceptability study, AYA with SCD provided qualitative feedback that they would use mHealth (a co-designed mobile app) and that it was beneficial for tracking health behaviors. Thus, we integrated the mHealth app into a group intervention (SCThrive) and hypothesized that more engagement with the mHealth app would result in increased self-management and self-efficacy for AYA with SCD. Methods: Our analysis from a single-site, randomized control trial (NCT02851615) assessed data from only AYA in the treatment arm (N = 26) who received the SCThrive intervention and used the mHealth app. The sample included AYA with SCD aged 13 to 21 years (Mage = 16.7 years; 54% female; 46% HbSS genotype; all African American/Black) who received six-weekly group sessions (3 in-person, 3 online). All SCThrive participants were provided with the mobile app (iManage) on an iPad. The Transition Readiness Assessment Questionnaire (TRAQ-5) assessed self-management skills and the Patient Activation Measure (PAM-13) assessed self-efficacy at baseline and posttreatment. We also assessed engagement (logins), confidence and completion of self-management goals (e.g., exercising, take medications), pain diary entries, and mood symptoms recorded on the iManage app (see Figure 1). Results: Preliminary analyses indicated that most AYA with SCD logged on to the iManage app (Mlogins = 7.8, SD = 9.1, range = 1 - 45) and viewed their pain diary (Mviews = 5.7, SD = 9.1, range = 1 - 45) at least once a week. Eighty-eight percent of AYA saved a pain diary entry and the most commonly used strategies for managing pain episodes were resting (22%), drinking water (19%), and using distraction (8%). AYA viewed their self-management goals about once every 11 days (Mdays = 11.24, SD = 13, range = 0 - 57). All AYA created (Mgoals = 5.7, SD = .72, range = 4 - 7), but only 54% of AYA completed at least one self-management goal. Of the 149 self-management goals created by the entire sample, only 37 (25%) were recorded as completed. AYA with a confidence level of 7 or lower were least likely to complete their self-management goals (14%) (see Figure 2). Correlation analyses demonstrated that logging on to the iManage app more frequently was associated with completing more self-management goals (r = .38), documenting pain symptoms more frequently (r = .54), and lower mood ratings (r = .54). Primary analyses demonstrated that after controlling for scores at baseline, the number of logins to the iManage app (p = .08, η2 = .13) predicted self-efficacy (PAM-13) and (p = .05, η2 = .17) self-management skills (TRAQ-5). Completing more self-management goals on the iManage app did not predict scores on the PAM-13, but, surprisingly, predicted lower scores (less self-management) on the TRAQ-5 (p = .08, η2 = .14). Conclusion: Lessons learned from our study indicate that it can be challenging to maintain engagement in mHealth for AYA with SCD, but for those who do engage there are significant benefits related to self-management goals, documenting pain symptoms, and mood. Supporting hypotheses, engaging more with the iManage app was related to higher-reported self-efficacy and self-management skills. Some AYA engaged with the app infrequently and did not create or complete self-management goals; others were "super users" and logged into the app daily. Increasing the frequency of reminder messages, encouraging more interactions with peers, and tailoring the opportunity to earn incentives are potential modifications for future interventions. However, our findings indicate that a mHealth app can be effectively integrated into a clinical trial and is related to positive outcomes. Although there are challenges to address, mHealth has the potential to bring about changes in behavior and improve health in the SCD population. Disclosures No relevant conflicts of interest to declare.

scholarly journals Capabilities of mobile health to treat diabetes in the conditions of the COVID-19 pandemic

2020 ◽  
pp. 132-137
Author(s):  
L. L. Bolotskaya
Keyword(s):  
Mobile Health ◽  
Diabetes Management ◽  
Modern Technology ◽  
Mobile App ◽  
Winter Period ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Medical Institutions ◽  
Short Period ◽  
Patients With Diabetes

Patients with diabetes mellitus (DM 1.2) are at high risk for changing the epidemiological situation during seasonal diseases (influenza, SARS), which mainly occur in the autumn-winter period. Under the current conditions in connection with the pandemic – СOVID-19, these patients turned out to be the most vulnerable, since the “isolation period” limits the possibility of dynamic observation of the patient by a general practitioner, an ophthalmologist, a specialist in the diabetic foot cabinet, and timely prescribing for preferential sugar-lowering drugs and resolving issues of planned hospitalization in specialized medical institutions. Patients who, for a numerous reasons have already have a low level of compliance with their chronic disease, were un-able to consult with a doctor on the topic of correction of sugar-lowering therapy in a short period of time. Any restriction on doctor’s consultation seriously affects the psycho-emotional state of patients with various types of diabetes, which often leads to an increase in blood glucose levels above the target level (5.5–6.5 mmol/L) and, as a result, leads to the development of acute and the progression of chronic diabetes complications. Modern technology in the form of a mobile diabetes management guide can serve as a helpful tool for patients during the “self-isolation”. In addition to the established communication with the doctor, the instructions will give patient the opportunity to make their own decisions and be involved in the treatment process. New time dictates the needs introduction of a new medical format consultation “doctor-patient”. The article presents the experience of providing counseling for patients with diabetes in the “mobile health care” format using the Contour Diabetes mobile app for the Contour™ Plus One meter (Contour Plus One).

scholarly journals Incorporating Behavioral Trigger Messages Into a Mobile Health App for Chronic Disease Management: Randomized Clinical Feasibility Trial in Diabetes

10.2196/15927 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e15927
Author(s):  
Scott Sittig ◽  
Jing Wang ◽  
Sriram Iyengar ◽  
Sahiti Myneni ◽  
Amy Franklin
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Mobile Health ◽  
Self Efficacy ◽  
Chronic Disease Management ◽  
Text Messages ◽  
Feasibility Trial ◽  
Significant Difference ◽  
Within Subjects ◽  
The Impact

Background Although there is a rise in the use of mobile health (mHealth) tools to support chronic disease management, evidence derived from theory-driven design is lacking. Objective The objective of this study was to determine the impact of an mHealth app that incorporated theory-driven trigger messages. These messages took different forms following the Fogg behavior model (FBM) and targeted self-efficacy, knowledge, and self-care. We assess the feasibility of our app in modifying these behaviors in a pilot study involving individuals with diabetes. Methods The pilot randomized unblinded study comprised two cohorts recruited as employees from within a health care system. In total, 20 patients with type 2 diabetes were recruited for the study and a within-subjects design was utilized. Each participant interacted with an app called capABILITY. capABILITY and its affiliated trigger (text) messages integrate components from social cognitive theory (SCT), FBM, and persuasive technology into the interactive health communications framework. In this within-subjects design, participants interacted with the capABILITY app and received (or did not receive) text messages in alternative blocks. The capABILITY app alone was the control condition along with trigger messages including spark and facilitator messages. A repeated-measures analysis of variance (ANOVA) was used to compare adherence with behavioral measures and engagement with the mobile app across conditions. A paired sample t test was utilized on each health outcome to determine changes related to capABILITY intervention, as well as participants’ classified usage of capABILITY. Results Pre- and postintervention results indicated statistical significance on 3 of the 7 health survey measures (general diet: P=.03; exercise: P=.005; and blood glucose: P=.02). When only analyzing the high and midusers (n=14) of capABILITY, we found a statistically significant difference in both self-efficacy (P=.008) and exercise (P=.01). Although the ANOVA did not reveal any statistically significant differences across groups, there is a trend among spark conditions to respond more quickly (ie, shorter log-in lag) following the receipt of the message. Conclusions Our theory-driven mHealth app appears to be a feasible means of improving self-efficacy and health-related behaviors. Although our sample size is too small to draw conclusions about the differential impact of specific forms of trigger messages, our findings suggest that spark triggers may have the ability to cue engagement in mobile tools. This was demonstrated with the increased use of capABILITY at the beginning and conclusion of the study depending on spark timing. Our results suggest that theory-driven personalization of mobile tools is a viable form of intervention. Trial Registration ClinicalTrials.gov NCT04132089; http://clinicaltrials.gov/ct2/show/NCT004122089

scholarly journals Foot Self Efficacy dan Foot Self Care Behaviour pada Lansia dengan Diabetes Melitus

2019 ◽  
Vol 3 (1) ◽  
pp. 12-18
Author(s):  
Ainul Yaqin Salam ◽  
Nur Hamim
Keyword(s):  
Self Efficacy ◽  
Self Care ◽  
Cross Sectional Study ◽  
Foot Care ◽  
Cross Sectional ◽  
Foot Complications ◽  
Patients With Diabetes ◽  
Main Determinants ◽  
And Gender ◽  
Care Behavior

 AbstrakLansia dengan diabetes adalah kelompok khusus yang memiliki resiko tinggi komplikasipada kakinya. Self-efficacymenjadi salah satu determinan faktor utama untuk meningkatkan perilaku perawatan kaki. Penelitian ini bertujuan untuk mengidentifikasi tingkat efikasi diri kaki (Foot Self Efficacy) dan perilaku perawatan kaki (Foot Crae Behaviour) dan hubungannya dengan karakteristik demografis pada lansia dengan diabetes.Studi cross-sectional digunakandi Desa Karangren Kecamatan Krejengan Probolinggo dari Mei hingga Juni 2019. Kriteria khusus dipilih untuk berpartisipasi dalam penelitian ini. Para responden diwawancarai menggunakan seperangkat kuesioner yang telah divalidasi. Statistik deskriptif dan inferensial (regresi linier berganda) digunakan untuk menjawab hipotesis penelitiandengan bantuanSPSS 19. Hasil penelitian menyebutkan rata-ratafoot self-efficacysebesar 29,79 dengan standar deviasi 8,26 danrata-ratafoot care behavior sebesar 28,72 dengan SD 6,33. Terdapat hubungan positif dan signifikan antara foot self-efficacy (β = 0,43, p <0,001), tingkat pendidikan (β = 0,43, p <0,001), dan jenis kelamin (β = 0,31, p <0,001) dengan perilaku perawatan kaki. Program edukasi self-efficacydapat menjadi pertimbangan yang krusial  untuk meningkatkan perilaku perawatan kaki. Lansia dengan diabetes harus diajari pemeriksaan kaki secara mandiri.Perawatan kaki diabetes yang tepat dan berkelanjutan dapat secara signifikan mencegah terjadinya komplikasi pada kaki lebih lanju yang berefek pada peningkatan kualitas hidup.                                                                                                     Kata kunci: diabetes, lansia, efikasi diri, perilaku perawatan diri, kaki  AbstractThe elderly with diabetes is a special group that has a high risk of complications in the legs. Self-efficacy is one of the main determinants of improving foot care behavior.The essential aims of this study were to identify the level of self-efficacy and foot care behavior and its relationship to demographic characteristics in elderly patients with diabetes. The cross-sectional study has been done in Karangren Village, Krejengan Probolinggo district from May to June 2019. Specific criteria  were chosen to participate in this study. The respondents interviewed used a set of validated questionnaires. Descriptive and inferential statistics (multiple linear regression) were used to answer the research hypothesisby SPSS 19. The results mentioned that the average foot self-efficacy was 29.79, with a standard deviation of 8.26, and the normal foot care behavior was 28.72, with an SD of 6.33. There is a significant relationship between foot self-efficacy (β = 0.43, p <0.001), level of education (β = 0.43, p <0.001), and gender (β = 0.31, p <0.001) with foot care behavior. The self-efficacy education program can be a crucial considerateness for improving foot care behavior.Elderly with diabetes must be taught foot examinations independently. Appropriate and ongoing diabetes foot care can significantly prevent diabetic foot complications, which affect improving the quality of life. Keywords: diabetes, elderly, self-efficacy, self-care behavior, feet

scholarly journals Patient testing of a mobile health app and review of educational materials designed for gout patient self-management (Preprint)

2018 ◽  
Author(s):  
Amy Danh Nguyen ◽  
Lauren J Frensham ◽  
Michael XC Wong ◽  
Sylvain MM Meslin ◽  
Paige Martin ◽  
...  
Keyword(s):  
Uric Acid ◽  
Mobile Health ◽  
Elevated Serum ◽  
Chronic Arthritis ◽  
Mobile App ◽  
Self Management ◽  
Educational Materials ◽  
Future Health ◽  
Mobile Health Applications ◽  
App Design

BACKGROUND Gout is a form of chronic arthritis caused by elevated serum uric acid (SUA) and culminates in painful gout attacks. Effective uric acid-lowering therapies exist, however adherence is low. This is partly due to the lack of support for patients to self-manage their disease. Mobile health applications (apps) have been used in self-management of chronic conditions. However, not all are developed with patients, limiting their effectiveness. OBJECTIVE This study aimed to design an effective gout self-management app by collecting feedback from gout patients. METHODS Two mixed-methods studies were conducted. In Study 1, researchers developed a short educational video and written materials about gout management, designed to be embedded into an app. Six interviews and one focus group were held with gout patients to gather feedback on these materials. Usability testing in Study 2 involved additional gout patients using a pilot version of Healthy.me Gout, a gout self-management app, for two weeks. Following the trial, patients participated in an interview about their experiences using the app. RESULTS Patients viewed the gout educational material positively, appreciating the combined use of video, text and images. Patients were receptive to using a mobile app to self-manage their gout. Feedback about Healthy.me Gout was generally positive, with patients reporting that the tracking and diary features were most useful. Patients also provided suggestions for improving the app and educational materials. CONCLUSIONS These studies involved patients in the development of a gout self-management app. Patients provided insight to improve the app’s presentation and usability, and general lessons on useful features for chronic disease apps. Gout patients enjoyed tracking their SUA concentrations and gout attack triggers. These capabilities can be translated to self-management apps for chronic diseases that require monitoring of pathological values, medication adherence and/or symptoms. Future health app design should integrate patient input and be developed iteratively to address concerns identified by patients.

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