scholarly journals Type 2 Diabetes: Advancing Real-world Gains in Efficacy Through Technology and Skill Building (TARGETS). A Pilot Evaluation of the Time2Focus Mobile Application for Diabetes Education (Preprint)

2019 ◽  
Author(s):  
Bryan Batch ◽  
Susan Spratt ◽  
Dan Blalock ◽  
Chad Benditz ◽  
Andi Weiss ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Pilot Study ◽  
Self Efficacy ◽  
Mobile Application ◽  
Illness Perceptions ◽  
Diabetes Education ◽  
Severity Of Illness ◽  
Diabetes Distress

BACKGROUND A significant cause of morbidity and mortality, Type 2 diabetes affects 30 million Americans. Self-management support (SMS) is an important component of chronic illness care and is a key pillar of the Chronic Care Model. Face-to-face teaching and patient education materials suffer from being static or incompatible with mobile lifestyles. Digital applications (apps) provide an SMS alternative that is convenient and scalable. OBJECTIVE This pilot study tested the real-world deployment of a self-guided mobile app for diabetes education (titled Time2Focus), which utilizes evidence-based content and gamification to deliver an interactive learning experience. METHODS Primary care providers were approached for permission to invite their patients to participate. Eligible patients were 18 to 89 years of age, had a diagnosis of Type 2 diabetes, hemoglobin A1c (HbA1c) ≥8% and <12% in the past 3 months, an active online patient portal account (tied to the electronic health record), and access to an iOS or Android smartphone. Interested patients were emailed a baseline survey, and once this was completed, sent instructions for downloading the Time2Focus app (MicroMass Communications, Inc; Cary, NC). After completing all 12 levels, participants were sent a follow-up survey. The primary outcome was change in HbA1c. Secondary outcomes included medication adherence, self-care activities, self-reporting of physical activities, diabetes self-efficacy, illness perceptions, diabetes distress scale, and users’ engagement with and rating of the app. RESULTS Of 1355 potentially eligible patients screened, 201 were consented. One hundred (49.7%) did not download the app. Seventeen (8.4%) downloaded the app but completed zero levels. Twenty-six (12.9%) completed 1 through 4 levels, 10 (5.0%) completed 5 through 11 levels, and 48 (23.9%) completed all 12 levels. Those completing one or more levels had a mean pre-/post-HbA1c change of -0.41% (compared to -0.32% among those who completed zero levels). The unadjusted 2-tailed t-test was not statistically significant (p=0.73). Diabetes self-efficacy showed a large and significant increase during app usage (ΔM=1.28, p<.001, d=0.83). Severity of illness perceptions showed a small but significant decrease during app usage (ΔM=-0.51, p=.004, d=0.43). Diabetes distress showed a small but significant decrease during app usage (ΔM=-0.45, p=.006, d=0.41). Net Promoter Score (NPS) was 62.5, indicating those who completed all levels of the app rated it highly and would recommend it to others. CONCLUSIONS Participants who used the Time2Focus mobile application showed an improvement in diabetes self-efficacy and a decrease in severity of illness perceptions. The decrease in HbA1c observed in app users relative to nonusers during this limited pilot study was not statistically significant. However, uptake and application of lessons learned from SMS may be delayed. Further research is needed to address how to increase engagement through SMS and to investigate if follow up over a longer period of time demonstrates significant change in outcomes like HbA1c. CLINICALTRIAL none

621-P: Digital Diabetes Education Program Improves Knowledge, Self-Efficacy, and Health Behaviors among People with Type 2 Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 621-P
Author(s):  
ZACHARY WHITE ◽  
RYAN WOOLLEY ◽  
SHEILA AMANAT ◽  
KELLY MUELLER
Keyword(s):  
Type 2 Diabetes ◽  
Health Behaviors ◽  
Education Program ◽  
Self Efficacy ◽  
Diabetes Education

scholarly journals Effectiveness and economic impact of a diabetes education program among adults with type 2 diabetes in South Texas

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Matthew Lee Smith ◽  
Lixian Zhong ◽  
Shinduk Lee ◽  
Samuel D. Towne ◽  
Marcia G. Ory
Keyword(s):  
Type 2 Diabetes ◽  
Health Disparities ◽  
Education Program ◽  
Hemoglobin A1c ◽  
Diabetes Education ◽  
Cost Savings ◽  
South Texas ◽  
Outcome Variable

Abstract Background The long-term growth and sustained high prevalence of obesity in the US is likely to increase the burden of Type 2 diabetes. Hispanic individuals are particularly burdened by a larger share of diabetes than non-Hispanic White individuals. Given the existing health disparities facing this population, we aimed to examine the effectiveness and potential cost savings of the Diabetes Education Program (DEP) offered as part of Healthy South Texas, a state-legislated initiative to reduce health disparities in 27 counties in South Texas with a high proportion of Hispanic adults. Methods DEP is an 8-h interactive workshop taught in English and Spanish. After the workshop, participants receive quarterly biometric screenings and continuing education with a health educator for one year. Data were analyzed from 3859 DEP participants with Type 2 diabetes living in South Texas at five time points (baseline, 3-months, 6-months, 9-months, 12-months). The primary outcome variable of interest for study analyses was A1c. A series of independent sample t-tests and linear mixed-model regression analyses were used to identify changes over time. Two methods were then applied to estimate healthcare costs savings associated with A1c reductions among participants. Results The majority of participants were ages 45–64 years (58%), female (60%), Hispanic (66%), and had a high school education or less (75%). At baseline, the average hemoglobin A1c was 8.57%. The most substantial reductions in hemoglobin A1c were identified from baseline to 3-month follow-up (P < 0.001); however, the reduction in A1c remained significant from baseline to 12-month follow-up (P < 0.001). The healthcare cost savings associated with improved A1c for the program was estimated to be between $5.3 to $5.6 million over a two to three year period. Conclusion Findings support the effectiveness of DEP with ongoing follow-up for sustained diabetes risk management. While such interventions foster clinical-community collaboration and can improve patient adherence to recommended lifestyle behaviors, opportunities exist to complement DEP with other resources and services to enhance program benefits. Policy makers and other key stakeholders can assess the lessons learned in this effort to tailor and expand similar initiatives to potentially at-risk populations. Trial registration This community-based intervention is not considered a trial by ICMJE definitions, and has not be registered as such.

scholarly journals Outcomes of a type 2 diabetes education program adapted to the cultural contexts of Saudi women. A pilot study

2015 ◽  
Vol 36 (7) ◽  
pp. 869-873 ◽  
Author(s):  
Hana Al-Bannay ◽  
Lyn Jongbloed ◽  
Tal Jarus ◽  
Sami Alabdulwahab ◽  
Tawfik Khoja ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Pilot Study ◽  
Education Program ◽  
Diabetes Education ◽  
Cultural Contexts ◽  
Saudi Women

Improving Foot Self-Care Knowledge, Self-Efficacy, and Behaviors in Patients With type 2 Diabetes at Low Risk for Foot Ulceration

2013 ◽  
Vol 23 (6) ◽  
pp. 627-643 ◽  
Author(s):  
Lifeng Fan ◽  
Souraya Sidani ◽  
Angela Cooper-Brathwaite ◽  
Kelly Metcalfe
Keyword(s):  
Type 2 Diabetes ◽  
Pilot Study ◽  
Educational Intervention ◽  
Self Efficacy ◽  
Self Care ◽  
Low Risk ◽  
Adult Patients ◽  
Foot Ulceration ◽  
And Behaviors

The pilot study aimed to explore the effects of an educational intervention on patients’ foot self-care knowledge, self-efficacy, and behaviors in adult patients with type 2 diabetes at low risk for foot ulceration. The intervention consisted of three sessions and was given over a 3-week period. A total of 70 eligible consenting participants were recruited for this pilot study. Fifty-six participants completed the study. The outcomes were assessed at pretest, following the first two sessions, and 3-month follow-up. The findings indicated that the foot self-care educational intervention was effective in improving foot self-care knowledge, self-efficacy and behaviors in adult patients with type 2 diabetes at low risk for foot ulceration. The findings support the effects of the intervention. Future research should evaluate its efficacy using a randomized clinical trial design, and a large sample of patients with type 2 diabetes at low risk for foot ulcerations.

scholarly journals Person-Centred, Occupation Based Intervention Program Supported with Problem-Solving Therapy for Type 2 Diabetes: a randomized controlled trial

2020 ◽  
Author(s):  
Zeynep Bahadır Ağce ◽  
Gamze Ekici
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Problem Solving ◽  
Self Efficacy ◽  
Intervention Group ◽  
Well Being ◽  
Problem Solving Therapy

Abstract Background: Individuals with diabetes mellitus both have difficulty in solving problems in daily life and have similar difficulties with self-care regimens. We examined the effect of occupation-based intervention supported with problem-solving therapy of individuals with type 2 diabetes mellitus on participation and satisfaction of meaningful occupations, diabetes-related psychosocial self-efficacy, preferred coping strategies and individual well-being. Methods: This study was planned as a single-blind, randomized controlled study with 3-months’ follow-up involving sixty-seven adults with type 2 diabetes. The Canadian Occupational Performance Measure, the Diabetes Empowerment Scale, the Brief COPE and the Five-item World Health Organization Well-Being Index were used. The intervention was conducted in 6 modules, and each implemented about 60 minutes and for 1 session per week. The six modules included evaluations, diabetes education, and problem-solving therapy. The most important feature of the program is its focus on meaningful occupations for the person and provided an opportunity for the participants to apply problem-solving therapy through valued occupation. Differences between groups were analysed with the Mann Whitney U test, and the Friedman test was used to calculate group-time interaction differences (i.e. baseline, after six modules and after three months). Results: Individuals with type 2 diabetes mellitus in both groups identified the most significant meaningful activity problems in self-care as personal care. Significant improvement was reported in the intervention group when compared to the control group regarding the participation in meaningful occupation, the satisfaction of performance, psychological self-efficacy and well-being results (p<0.001) after the six modules and 3 months follow-up. The participants' use of the effective coping strategies, active coping and acceptance strategies, self-efficacy as revealed results showed improvement in favor of the intervention group (p<0.05). The intervention group showed significantly improving between measurements at baseline and after three months of modules except for ineffective coping style (p<0.001). Conclusions: The person-centred occupation-based problem-solving therapy encourages participation in meaningful occupations, positive effects on psychological self-efficacy, and improves effective coping styles and well-being of type 2 diabetes mellitus. Problem-solving therapies that incorporate individuals’ priorities via meaningful occupation could be used to supported to lead a meaningful life of individuals of type 2 diabetes mellitus. Trial Registration: ClinicalTrials.gov Identifier: NCT03783598. Retrospectively Registered. First Posted-December 21, 2018, Last Update Posted-February 18, 2020. Key words: Diabetes mellitus, Person-centred, Occupation-based, Problem-solving, Psychosocial self-efficacy, Coping, Well-being, Quality of life, Occupational therapy

scholarly journals Diabetes Distress, Depressive Symptoms and Type 2 Diabetes Management and Glycemic Control: the Mediating Role of Self-efficacy

2020 ◽  
Author(s):  
Yuexia Gao ◽  
Yarong Han ◽  
Xin Zou ◽  
Judy Xu ◽  
Dean Getrude Mawen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Depressive Symptoms ◽  
Glycemic Control ◽  
Self Efficacy ◽  
Diabetes Management ◽  
Diabetes Distress ◽  
Hierarchical Regression ◽  
Psychological Variables ◽  
Diabetes Outcomes

Abstract Background: Diabetes distress has been distinguished from depressive symptoms in the linkages to type 2 diabetes management and glycemic control. There are few evidences in rural China untangled the underlying pathways among them. The aim of our study was to examine whether self-efficacy reduced the detrimental effects of psychological variables on diabetes outcomes such as self-care behaviors, glycemic control and health-related quality of life (HRQoL).Methods: 1574 adults diagnosed with type 2 diabetes from 31 rural clinics in China were assessed for psychological variables, self-management and HRQoL. Hemoglobin A1c (HbA1c) data at 6 months after the survey were extracted from electronic medical records. Hierarchical regression model examined independent effects of psychological variables, self-efficacy on diabetes outcomes. KHB method and bootstrapping confidence intervals were employed to test the mediating effect of self-efficacy.Results: Hierarchical regression analysis showed both diabetes distress and depressive symptoms were significantly related to diet and HRQoL, but not related to glycemic control and medication adherence. Depressive symptoms, but not diabetes distress, was directly associated with physical activity. Mediation analysis demonstrated self-efficacy mediated the relationships of both diabetes distress and depressive symptoms on self-care behaviors, glycemic control and HRQoL.Conclusions: Self-efficacy may contribute to better diabetes outcome by ameliorating the effects of diabetes distress and depressive symptoms. Patients with psychological conditions may need tailored intervention that enhance self-efficacy to improve diabetes management.

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