Twelve-month outcomes of an Internet-based diabetes self-management support program

被引：141

作者：

Glasgow, Russell E. ^{[1
,2
]}

Kurz, Deanna ^{[2
]}

King, Diane ^{[2
]}

Dickman, Jennifer M. ^{[2
]}

Faber, Andrew J. ^{[2
]}

Halterman, Eve ^{[2
]}

Woolley, Tim ^{[4
]}

Toobert, Deborah J. ^{[3
]}

Strycker, Lisa A. ^{[3
]}

Estabrooks, Paul A. ^{[5
]}

Osuna, Diego ^{[2
]}

Ritzwoller, Debra ^{[2
]}

机构：

[1] NCI, Div Canc Control & Populat Sci, Rockville, MD 20852 USA

[2] Kaiser Permanente Colorado, Inst Hlth Res, Denver, CO USA

[3] Oregon Res Inst, Eugene, OR 97403 USA

[4] InterVis Media, Eugene, OR USA

[5] Virginia Polytech Inst & State Univ, Roanoke, VA USA

来源：

PATIENT EDUCATION AND COUNSELING | 2012年 / 87卷 / 01期

关键词：

Diabetes; Self-management; RCT; Internet intervention; Pragmatic trial; Multiple behavior change; PHYSICAL-ACTIVITY; WEIGHT-LOSS; INTERVENTIONS; ADULTS; RECRUITMENT; EDUCATION; TRIALS; ISSUES; RISK; CARE;

D O I：

10.1016/j.pec.2011.07.024

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Objective: Internet-based programs offer potential for practical, cost-effective chronic illness self-management programs. Methods: We report 12-month results of an Internet-based diabetes self-management program, with and without additional support, compared to enhanced usual care in a 3-arm practical randomized trial. Patients (n = 463) were randomized: 77.3% completed 12-month follow-up. Primary outcomes were changes in health behaviors of healthy eating, physical activity, and medication taking. Secondary outcomes were hemoglobin A1c, body mass index, lipids, blood pressure, and psychosocial factors. Results: Internet conditions improved health behaviors significantly vs. usual care over the 12-month period (d for effect size = .09-.16). All conditions improved moderately on biological and psychosocial outcomes. Latinos, lower literacy, and higher cardiovascular disease risk patients improved as much as other participants. Conclusions: The Internet intervention meets the reach and feasibility criteria for a potentially broad public health impact. However, 12-month magnitude of effects was small, suggesting that different or more intensive approaches are necessary to support long-term outcomes. Research is needed to understand the linkages between intervention and maintenance processes and downstream outcomes. Practice implications: Automated self-management interventions should be tailored and integrated into primary care; maintenance of patient self-management can be enhanced through links to community resources. Published by Elsevier Ireland Ltd.

引用

页码：81 / 92

页数：12

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