scholarly journals Patient Experience Connecting Mobile-Based Self-Monitoring of Diet and Physical Activity to Diabetes Educators through a Connected Interface in an Electronic System for Diabetes Education

Iproceedings ◽  
10.2196/11905 ◽  
2018 ◽  
Vol 4 (2) ◽  
pp. e11905
Author(s):  
Jing Wang ◽  
Brittney Lewis ◽  
Linda Siminerio
Keyword(s):  
Physical Activity ◽  
Patient Experience ◽  
Diabetes Education ◽  
Electronic System ◽  
Self Monitoring ◽  
Diet And Physical Activity ◽  
Diabetes Educators

scholarly journals Patient Experience Connecting Mobile-Based Self-Monitoring of Diet and Physical Activity to Diabetes Educators through a Connected Interface in an Electronic System for Diabetes Education (Preprint)

2018 ◽  
Author(s):  
Jing Wang ◽  
Brittney Lewis ◽  
Linda Siminerio
Keyword(s):  
Physical Activity ◽  
Diabetes Education ◽  
Smartphone Application ◽  
Perceived Benefits ◽  
Self Monitoring ◽  
Activity Tracker ◽  
Activity Trackers ◽  
Diet And Exercise ◽  
Diet And Physical Activity ◽  
Diabetes Educators

BACKGROUND Smartphone applications and wearable activity trackers have become popular tools in recent years in managing chronic diseases such as diabetes. More recently, studies have focused on connecting patient-generated health data from mobile devices directly to health care providers and educators. However, not much is known regarding the patient experience in using these mobile devices for diabetes management, particularly the implications of allowing educators direct access to patients’ diet and exercise data. OBJECTIVE The objective of this study was to identify patients’ perceived benefits and concerns about using a smartphone application and wristband activity tracker to monitor diet and physical activity, as well as the perceived benefits and concerns of allowing educators access to such data. METHODS We conducted a qualitative, descriptive study as an axillary study to a clinical trial testing a connected interface to link patient self-monitoring diet and physical activity to a nationally used electronic diabetes education system. Our axillary study examined 13 type 2 diabetes patients’ views on perceived benefits and concerns about using a smartphone application and wristband activity tracker to monitor diet and physical activity for three months. A focus group interview was administered to obtain general and specific understanding of the use of smartphone applications and activity trackers during the study period. The central interview questions guiding the discussion included “What did you think about the UP24 wristband and app?”, “What are your thoughts about the connection of UP24 data with Chronicle, the Web-based diabetes education system, so that your diabetes educators can see your behavior?”, and “Has knowing that someone else has access to your diet and exercise data affected your behavior and self-monitoring?” The interviewer also asked specific questions to gain deeper understanding of the following topics: (1) the app and wristband features used to record and monitor diet and physical activity, (2) materials used for intervention orientation, (3) additional data (eg, weight and blood glucose) that participants would like to share with educators, and (4) suggestions for improvement in diabetes self-management and communication with educators and physicians. The focus group sessions were audio-recorded and transcribed. Transcribed data were analyzed to identify key themes based on interpretive coding procedures. RESULTS We identified 11 key themes under three major categories and described these themes with illustrative quotations. The three major categories of themes covered (1) self-monitoring themes: varied experience and self-monitoring patterns and adherence exist among patients using the wearable tracker and its companion smartphone application; (2) themes related to sharing self-monitoring of diet and physical activity data with diabetes educators: sharing self-monitoring diet influences patient self-monitoring adherence and dietary and activity changes, and communication with educators; and (3) research study-related themes: technical barriers, utilization of manuals and tutorial videos in beginning use of the connected health tools, and desired features on combining lifestyle data with glucose data and caregiver access. CONCLUSIONS Connected technology aiming to incorporate patient-generated health lifestyle data into clinical workflow should consider patient perspectives in terms of their experience and motivation for generating and sharing such data and technical barriers in using such tools.

scholarly journals Diabetes Educators� Insights Regarding Connecting Mobile Phone� and Wearable Tracker�Collected Self-Monitoring Information to a Nationally-Used Electronic Health Record System for Diabetes Education: Descriptive Qualitative Study (Preprint)

2018 ◽  
Author(s):  
Jing Wang ◽  
Chin-Fun Chu ◽  
Chengdong Li ◽  
Laura Hayes ◽  
Linda Siminerio
Keyword(s):  
Mobile Phone ◽  
Management Education ◽  
Diabetes Education ◽  
Health Care Team ◽  
Self Management ◽  
Activity Data ◽  
Self Monitoring ◽  
Diabetes Educators ◽  
Monitoring Information ◽  
Behavioral Goal

BACKGROUND Diabetes educators are integral to a clinical team in providing diabetes self-management education and support; however, current mobile and Web-based self-management tools are not integrated into clinical diabetes care to support diabetes educators’ education efforts. OBJECTIVE The objective of our study was to seek diabetes educators’ insights regarding the development of an interface within the Chronicle Diabetes system, a nationally used electronic health record (EHR) system for diabetes education documentation with behavioral goal-setting functions, to transfer mobile phone- and wearable tracker-collected self-monitoring information from patients to diabetes educators to facilitate behavioral goal monitoring. METHODS A descriptive qualitative study was conducted to seek educators’ perspectives on usability and interface development preferences in developing a connected system. Educators can use the Chronicle Diabetes system to set behavioral goals with their patients. Individual and group interviews were used to seek educators’ preferences for viewing mobile phone- and wearable tracker-collected information on diet, physical activity, and sleep in the Chronicle Diabetes system using open-ended questions. Interview data were transcribed verbatim and analyzed for common themes. RESULTS Five common themes emerged from the discussion. First, educators expressed enthusiasm for and concerns about viewing diet and physical activity data in Chronicle Diabetes system. Second, educators valued viewing detailed dietary macronutrients and activity data; however, they preferred different kinds of details depending on patients’ needs, conditions, and behavioral goals and educators’ training background. Third, all educators liked the integration of mobile phone-collected data into Chronicle Diabetes system and preferably with current EHR systems. Fourth, a need for a health care team and a central EHR system to be formed was realized for educators to share summaries of self-monitoring data with other providers. Fifth, educators desired advanced features for the mobile app and the connected interface that can show self-monitoring data. CONCLUSIONS Flexibility is needed for educators to track the details of mobile phone- and wearable tracker-collected diet and activity information, and the integration of such data into Chronicle Diabetes and EHR systems is valuable for educators to track patients’ behavioral goals, provide diabetes self-management education and support, and share data with other health care team members to faciliate team-based care in clinical practice.

scholarly journals A Behavioral Lifestyle Intervention to Improve Frailty in Overweight or Obese Older Adults with Type 2 Diabetes: A Feasibility Study

2021 ◽  
pp. 1-9
Author(s):  
R. Jiwani ◽  
J. Wang ◽  
C. Li ◽  
B. Dennis ◽  
D. Patel ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Older Adults ◽  
Lifestyle Intervention ◽  
Self Monitoring ◽  
Potential Efficacy ◽  
Session Attendance ◽  
Diet And Physical Activity

Background: Older adults with Type 2 diabetes (T2D) are more likely to be frail, which increases the risk for disability and mortality. Objectives: To determine the feasibility of a behavioral lifestyle intervention, enhanced with mobile health technology for self-monitoring of diet and activity, to improve frailty in overweight/obese older adults (≥65 years) diagnosed with T2D. Design, Setting, and Participants: Single arm, 6-month study of a behavioral lifestyle intervention in 20 overweight/obese (BMI>25) older adults (≥ 65 years) with self-reported T2D diagnosis who owned a smartphone. A Fitbit tracker was provided to all participants for self-monitoring of diet and physical activity. Our primary outcome of feasibility was measured by session attendance, adherence to Fitbit usage to self-monitor diet and physical activity, and study retention. Secondary outcomes included the preliminary efficacy of the intervention on frailty, physical function, quality of life, and T2D-related outcomes. Results: Eighteen participants completed the study. The mean age was 71.5 (SD ± 5.3) years, 56% were female, and half were Hispanic. At baseline, 13 (72%) were pre-frail, 4 (22%) were frail, and 1 (6%) were non-frail. At follow-up, frailty scores improved significantly from 1.61 ± 1.15 to 0.94 ± 0.94 (p=0.01) and bodyweight improved from 205.66 ± 45.52 lbs. to 198.33 ± 43.6 lbs. (p=<0.001). Conclusion: This study provides evidence for the feasibility of a behavioral lifestyle intervention in overweight/obese older adults with T2D and preliminary results support its potential efficacy in improving frailty score.

scholarly journals Design and Development of a Digital Weight Management Intervention (ToDAy): Qualitative Study

10.2196/17919 ◽  
2020 ◽  
Vol 8 (9) ◽  
pp. e17919
Author(s):  
Charlene L Shoneye ◽  
Barbara Mullan ◽  
Andrea Begley ◽  
Christina M Pollard ◽  
Jonine Jancey ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Qualitative Study ◽  
Focus Groups ◽  
Weight Management ◽  
Self Monitoring ◽  
Management Intervention ◽  
Monitoring Tools ◽  
Diet And Physical Activity ◽  
Weight Management Intervention

Background The Tailored Diet and Activity (ToDAy) study aims to build on the campaign by adding a digital intervention with the potential to provide wide-reaching, cost-effective weight management support. Objective The ToDAy study aims to build a tailored intervention using mobile technology to improve diet and physical activity behaviours in adults with overweight and obesity. The main objectives were to identify behavior change techniques for diet and physical activity (PA) change for weight loss and explore preferences for digital intervention features that would be effective in changing diet and PA behaviors. Methods This qualitative study uses the principles of a person-based approach to intervention development; the behavioral intervention technology framework; and the capability, opportunity, motivation, and behavior (COM-B) framework. Focus groups and telephone interviews were conducted with 56 adults in Western Australia. Open-ended questions and example intervention features were used to explore the usability and acceptability of the self-monitoring tools, knowledge about effective weight-loss strategies, and acceptability of tailored feedback. Findings from the focus groups and interviews were analyzed using thematic analysis. Results Qualitative findings revealed an awareness of key public health messages but a lack of confidence in how to perform these behaviors to help manage their weight. A total of 4 major themes were identified and mapped to the domains of the COM-B framework: (1) misinformation, (2) environmental support, (3) social norms, and (4) confidence. Conclusions This study explores users’ capability, opportunity, and motivation to perform the target behaviors for weight loss. The findings suggested that a digital weight management intervention using a mobile food record and activity trackers to inform tailored feedback may be acceptable and feasible. Participants expressed a preference for simple expert advice, digital self-monitoring tools, and visual feedback. International Registered Report Identifier (IRRID) RR2-10.2196/12782

scholarly journals Connecting Smartphone and Wearable Fitness Tracker Data with a Nationally Used Electronic Health Record System for Diabetes Education to Facilitate Behavioral Goal Monitoring in Diabetes Care: Protocol for a Pragmatic Multi-Site Randomized Trial (Preprint)

2018 ◽  
Author(s):  
Jing Wang ◽  
Deidra Carroll Coleman ◽  
Justin Kanter ◽  
Brad Ummer ◽  
Linda Siminerio
Keyword(s):  
Electronic Health Record ◽  
Diabetes Education ◽  
Electronic Health Record System ◽  
Health Record ◽  
Record System ◽  
Self Monitoring ◽  
Electronic Health ◽  
Fitness Tracker ◽  
Diabetes Educators ◽  
Behavioral Goal

BACKGROUND Mobile and wearable technology have been shown to be effective in improving diabetes self-management; however, integrating data from these technologies into clinical diabetes care to facilitate behavioral goal monitoring has not been explored. OBJECTIVE The objective of this paper is to report on a study protocol for a pragmatic multi-site trial along with the intervention components, including the detailed connected health interface. This interface was developed to integrate patient self-monitoring data collected from a wearable fitness tracker and its companion smartphone app to an electronic health record system for diabetes self-management education and support (DSMES) to facilitate behavioral goal monitoring. METHODS A 3-month multi-site pragmatic clinical trial was conducted with eligible patients with diabetes mellitus from DSMES programs. The Chronicle Diabetes system is currently freely available to diabetes educators through American Diabetes Association–recognized DSMES programs to set patient nutrition and physical activity goals. To integrate the goal-setting and self-monitoring intervention into the DSMES process, a connected interface in the Chronicle Diabetes system was developed. With the connected interface, patient self-monitoring information collected from smartphones and wearable fitness trackers can facilitate educators’ monitoring of patients’ adherence to their goals. Feasibility outcomes of the 3-month trial included hemoglobin A1c levels, weight, and the usability of the connected system. RESULTS An interface designed to connect data from a wearable fitness tracker with a companion smartphone app for nutrition and physical activity self-monitoring into a diabetes education electronic health record system was successfully developed to enable diabetes educators to facilitate goal setting and monitoring. A total of 60 eligible patients with type 2 diabetes mellitus were randomized into either group 1) standard diabetes education or 2) standard education enhanced with the connected system. Data collection for the 3-month pragmatic trial is completed. Data analysis is in progress. CONCLUSIONS If results of the pragmatic multi-site clinical trial show preliminary efficacy and usability of the connected system, a large-scale implementation trial will be conducted. CLINICALTRIAL ClinicalTrials.gov NCT02664233; https://clinicaltrials.gov/ct2/show/NCT02664233 (Archived by WebCite at http://www.webcitation.org/6yDEwXHo5)

scholarly journals Design and Development of a Digital Weight Management Intervention (ToDAy): Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Charlene L Shoneye ◽  
Barbara Mullan ◽  
Andrea Begley ◽  
Christina M Pollard ◽  
Jonine Jancey ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Qualitative Study ◽  
Focus Groups ◽  
Weight Management ◽  
Self Monitoring ◽  
Management Intervention ◽  
Monitoring Tools ◽  
Diet And Physical Activity ◽  
Weight Management Intervention

BACKGROUND The Tailored Diet and Activity (ToDAy) study aims to build on the campaign by adding a digital intervention with the potential to provide wide-reaching, cost-effective weight management support. OBJECTIVE The ToDAy study aims to build a tailored intervention using mobile technology to improve diet and physical activity behaviours in adults with overweight and obesity. The main objectives were to identify behavior change techniques for diet and physical activity (PA) change for weight loss and explore preferences for digital intervention features that would be effective in changing diet and PA behaviors. METHODS This qualitative study uses the principles of a person-based approach to intervention development; the behavioral intervention technology framework; and the capability, opportunity, motivation, and behavior (COM-B) framework. Focus groups and telephone interviews were conducted with 56 adults in Western Australia. Open-ended questions and example intervention features were used to explore the usability and acceptability of the self-monitoring tools, knowledge about effective weight-loss strategies, and acceptability of tailored feedback. Findings from the focus groups and interviews were analyzed using thematic analysis. RESULTS Qualitative findings revealed an awareness of key public health messages but a lack of confidence in how to perform these behaviors to help manage their weight. A total of 4 major themes were identified and mapped to the domains of the COM-B framework: (1) misinformation, (2) environmental support, (3) social norms, and (4) confidence. CONCLUSIONS This study explores users’ capability, opportunity, and motivation to perform the target behaviors for weight loss. The findings suggested that a digital weight management intervention using a mobile food record and activity trackers to inform tailored feedback may be acceptable and feasible. Participants expressed a preference for simple expert advice, digital self-monitoring tools, and visual feedback. INTERNATIONAL REGISTERED REPORT RR2-10.2196/12782

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