scholarly journals Digital Health Interventions for Adults With Type 2 Diabetes: Qualitative Study of Patient Perspectives on Diabetes Self-Management Education and Support

2018 ◽  
Vol 20 (2) ◽  
pp. e40 ◽  
Author(s):  
Kingshuk Pal ◽  
Charlotte Dack ◽  
Jamie Ross ◽  
Susan Michie ◽  
Carl May ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Qualitative Study ◽  
Management Education ◽  
Digital Health ◽  
Health Interventions ◽  
Patient Perspectives ◽  
Self Management

scholarly journals Digital Health Interventions for Adults With Type 2 Diabetes: Qualitative Study of Patient Perspectives on Diabetes Self-Management Education and Support (Preprint)

2017 ◽  
Author(s):  
Kingshuk Pal ◽  
Charlotte Dack ◽  
Jamie Ross ◽  
Susan Michie ◽  
Carl May ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Care Services ◽  
Unmet Needs ◽  
Management Education ◽  
Digital Health ◽  
Health Interventions ◽  
Self Management ◽  
Behavioral Support ◽  
Care Services

BACKGROUND The prevalence of type 2 diabetes is increasing globally, and health services in many countries are struggling with the morbidity, mortality, and costs associated with the complications of this long-term condition. Diabetes self-management education (DSME) and behavioral support can reduce the risks of developing diabetes-related complications and improve glycemic control. However, their uptake is low. Digital health interventions (DHI) can provide sustained support and may overcome challenges associated with attending diabetes self-management sessions. They have the potential for delivery at multiple locations at convenient times, anonymity, and presentation of content in attractive and tailored formats. This study investigates the needs and wants of patients with type 2 diabetes to inform the development of digital self-management education and support. OBJECTIVE The objective of this study was to explore patient perspectives on unmet needs for self-management and support and the role of DHI in adults living with type 2 diabetes. METHODS This study used a qualitative approach based on data generated from 4 focus groups with 20 patients. RESULTS The data generated by the focus groups illustrated the significant burden that the diagnosis of diabetes places on many patients and the negative impacts on their emotional well-being, work, social life, and physical health. Although patients’ experiences of the health care services varied, there was agreement that even the best services were unable to meet all users’ needs to support the emotional regulation, psychological adjustment, and behavioral changes needed for successful self-management. CONCLUSIONS By focusing on medical management and information provision, existing health care services and education programs may not be adequately meeting all the needs of patients with type 2 diabetes. DHIs have the potential to improve access to DSME and behavioral support and extend the range of content offered by health services to fit with a wider range of patient needs. Features that could help DHIs address some of the unmet needs described by participants in this study included placing an emphasis on emotional and role management, being available at all times, having up-to-date evidence-based guidance for patients, and providing access to peer-generated and professional advice.

scholarly journals Crossing the Digital Divide in Online Self-Management Support: Analysis of Usage Data From HeLP-Diabetes (Preprint)

2018 ◽  
Author(s):  
Shoba Poduval ◽  
Saddif Ahmed ◽  
Louise Marston ◽  
Fiona Hamilton ◽  
Elizabeth Murray
Keyword(s):  
Type 2 Diabetes ◽  
Health Services ◽  
Digital Divide ◽  
Digital Health ◽  
Target Population ◽  
Health Interventions ◽  
Self Management ◽  
Weak Evidence ◽  
Minority Ethnic

BACKGROUND Digital health is increasingly recognized as a cost-effective means to support patient self-care. However, there are concerns about whether the “digital divide,” defined as the gap between those who do and do not make regular use of digital technologies, will lead to increased health inequalities. Access to the internet, computer literacy, motivation to use digital health interventions, and fears about internet security are barriers to use of digital health interventions. Some of these barriers disproportionately affect people of older age, black or minority ethnic background, and low socioeconomic status. HeLP-Diabetes (Healthy Living for People with type 2 Diabetes), a theoretically informed online self-management program for adults with type 2 diabetes, was developed to meet the needs of people from a broad demographic background. OBJECTIVE This study aimed to determine whether there was evidence of a digital divide when HeLP-Diabetes was integrated into routine care. This was achieved by (1) comparing the characteristics of people who registered for the program against the target population (people with type 2 diabetes in inner London), (2) comparing the characteristics of people who registered for the program and used it with those who did not use it, and (3) comparing sections of the website visited by different demographic groups. METHODS A retrospective analysis of data on the use of HeLP-Diabetes in routine clinical practice in 4 inner London clinical commissioning groups was undertaken. Data were collected from patients who registered for the program as part of routine health services.. Data on gender, age, ethnicity, and educational attainment were collected at registration, and data on webpage visits (user identification number, date, time, and page visited) were collected automatically by software on the server side of the website. RESULTS The characteristics of people who registered for the program were found to reflect those of the target population. The mean age was 58.4 years (SD=28.0), over 50.0% were from black and minority ethnic backgrounds, and nearly a third (29.8%) had no qualifications beyond school leaving age. There was no association between demographic characteristics and use of the program, apart from weak evidence of less use by the mixed ethnicity group. There was no evidence of the differential use of the program by any demographic group, apart from weak evidence for people with degrees and school leavers being more likely to use the “Living and working with diabetes” (P=.03) and “Treating diabetes” (P=.04) sections of the website. CONCLUSIONS This study is one of the first to provide evidence that a digital health intervention can be integrated into routine health services without widening health inequalities. The relative success of the intervention may be attributed to integration into routine health care, and careful design with extensive user input and consideration of literacy levels. Developers of digital health interventions need to acknowledge barriers to access and use, and collect data on the demographic profile of users, to address inequalities.

Reasons for participation in group-based type 2 diabetes self-management education. A qualitative study

2010 ◽  
Vol 38 (8) ◽  
pp. 788-793 ◽  
Author(s):  
Lisbeth Ø. Rygg ◽  
Marit By Rise ◽  
Borghild Lomundal ◽  
Hilde Strøm Solberg ◽  
Aslak Steinsbekk
Keyword(s):  
Type 2 Diabetes ◽  
Qualitative Study ◽  
Management Education ◽  
Self Management
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