BMC Med Inform Decis Mak - A web-based intervention to support self-management of patients with type 2 diabetes mellitus: effect on self-efficacy, self-care and diabetes distress.


{ patient(2315) diseas(1263) diabet(1191) }
{ intervent(3218) particip(2042) group(1664) }
{ inform(2794) health(2639) internet(1427) }
{ survey(1388) particip(1329) question(1065) }
{ model(2656) set(1616) predict(1553) }
{ time(1939) patient(1703) rate(768) }
{ howev(809) still(633) remain(590) }
{ data(3963) clinic(1234) research(1004) }
{ import(1318) role(1303) understand(862) }
{ data(1737) use(1416) pattern(1282) }
{ analysi(2126) use(1163) compon(1037) }
{ use(1733) differ(960) four(931) }
{ care(1570) inform(1187) nurs(1089) }
{ model(3404) distribut(989) bayesian(671) }
{ measur(2081) correl(1212) valu(896) }
{ error(1145) method(1030) estim(1020) }
{ blood(1257) pressur(1144) flow(957) }
{ ehr(2073) health(1662) electron(1139) }
{ assess(1506) score(1403) qualiti(1306) }
{ chang(1828) time(1643) increas(1301) }
{ control(1307) perform(991) simul(935) }
{ method(984) reconstruct(947) comput(926) }
{ studi(1410) differ(1259) use(1210) }
{ record(1888) medic(1808) patient(1693) }
{ age(1611) year(1155) adult(843) }
{ estim(2440) model(1874) function(577) }
{ can(774) often(719) complex(702) }
{ network(2748) neural(1063) input(814) }
{ treatment(1704) effect(941) patient(846) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ data(1714) softwar(1251) tool(1186) }
{ risk(3053) factor(974) diseas(938) }
{ studi(1119) effect(1106) posit(819) }
{ research(1218) medic(880) student(794) }
{ patient(2837) hospit(1953) medic(668) }
{ data(3008) multipl(1320) sourc(1022) }
{ first(2504) two(1366) second(1323) }
{ patient(1821) servic(1111) care(1106) }
{ use(2086) technolog(871) perceiv(783) }
{ can(981) present(881) function(850) }
{ health(1844) social(1437) communiti(874) }
{ activ(1452) weight(1219) physic(1104) }
{ imag(1947) propos(1133) code(1026) }
{ system(1976) rule(880) can(841) }
{ imag(1057) registr(996) error(939) }
{ bind(1733) structur(1185) ligand(1036) }
{ sequenc(1873) structur(1644) protein(1328) }
{ method(1219) similar(1157) match(930) }
{ featur(3375) classif(2383) classifi(1994) }
{ imag(2830) propos(1344) filter(1198) }
{ imag(2675) segment(2577) method(1081) }
{ take(945) account(800) differ(722) }
{ studi(2440) review(1878) systemat(933) }
{ motion(1329) object(1292) video(1091) }
{ framework(1458) process(801) describ(734) }
{ problem(2511) optim(1539) algorithm(950) }
{ learn(2355) train(1041) set(1003) }
{ concept(1167) ontolog(924) domain(897) }
{ clinic(1479) use(1117) guidelin(835) }
{ algorithm(1844) comput(1787) effici(935) }
{ extract(1171) text(1153) clinic(932) }
{ method(1557) propos(1049) approach(1037) }
{ design(1359) user(1324) use(1319) }
{ model(2220) cell(1177) simul(1124) }
{ general(901) number(790) one(736) }
{ search(2224) databas(1162) retriev(909) }
{ featur(1941) imag(1645) propos(1176) }
{ case(1353) use(1143) diagnosi(1136) }
{ perform(999) metric(946) measur(919) }
{ research(1085) discuss(1038) issu(1018) }
{ system(1050) medic(1026) inform(1018) }
{ model(2341) predict(2261) use(1141) }
{ visual(1396) interact(850) tool(830) }
{ compound(1573) activ(1297) structur(1058) }
{ perform(1367) use(1326) method(1137) }
{ spatial(1525) area(1432) region(1030) }
{ health(3367) inform(1360) care(1135) }
{ model(3480) simul(1196) paramet(876) }
{ monitor(1329) mobil(1314) devic(1160) }
{ state(1844) use(1261) util(961) }
{ data(2317) use(1299) case(1017) }
{ medic(1828) order(1363) alert(1069) }
{ signal(2180) analysi(812) frequenc(800) }
{ cost(1906) reduc(1198) effect(832) }
{ group(2977) signific(1463) compar(1072) }
{ sampl(1606) size(1419) use(1276) }
{ gene(2352) biolog(1181) express(1162) }
{ activ(1138) subject(705) human(624) }
{ structur(1116) can(940) graph(676) }
{ high(1669) rate(1365) level(1280) }
{ cancer(2502) breast(956) screen(824) }
{ use(976) code(926) identifi(902) }
{ drug(1928) target(777) effect(648) }
{ result(1111) use(1088) new(759) }
{ implement(1333) system(1263) develop(1122) }
{ decis(3086) make(1611) patient(1517) }
{ process(1125) use(805) approach(778) }
{ method(1969) cluster(1462) data(1082) }
{ method(2212) result(1239) propos(1039) }
{ detect(2391) sensit(1101) algorithm(908) }


CKGROUND: Management of diabetes mellitus is complex and involves controlling multiple risk factors that may lead to complications. Given that patients provide most of their own diabetes care, patient self-management training is an important strategy for improving quality of care. Web-based interventions have the potential to bridge gaps in diabetes self-care and self-management. The objective of this study was to determine the effect of a web-based patient self-management intervention on psychological (self-efficacy, quality of life, self-care) and clinical (blood pressure, cholesterol, glycemic control, weight) outcomes.METHODS: For this cohort study we used repeated-measures modelling and qualitative individual interviews. We invited patients with type 2 diabetes to use a self-management website and asked them to complete questionnaires assessing self-efficacy (primary outcome) every three weeks for nine months before and nine months after they received access to the website. We collected clinical outcomes at three-month intervals over the same period. We conducted in-depth interviews at study conclusion to explore acceptability, strengths and weaknesses, and mediators of use of the website. We analyzed the data using a qualitative descriptive approach and inductive thematic analysis.RESULTS: Eighty-one participants (mean age 57.2 years, standard deviation 12) were included in the analysis. The self-efficacy score did not improve significantly more than expected after nine months (absolute change 0.12; 95% confidence interval -0.028, 0.263; p=0.11), nor did clinical outcomes. Website usage was limited (average 0.7 logins/month). Analysis of the interviews (n=21) revealed four themes: 1) mediators of website use; 2) patterns of website use, including role of the blog in driving site traffic; 3) feedback on website; and 4) potential mechanisms for website effect.CONCLUSIONS: A self-management website for patients with type 2 diabetes did not improve self-efficacy. Website use was limited. Although its perceived reliability, availability of a blog and emailed reminders drew people to the website, participants' struggles with type 2 diabetes, competing priorities in their lives, and website accessibility were barriers to its use. Future interventions should aim to integrate the intervention seamlessly into the daily routine of end users such that it is not seen as yet another chore.

Resumo Limpo

ckground manag diabet mellitus complex involv control multipl risk factor may lead complic given patient provid diabet care patient selfmanag train import strategi improv qualiti care webbas intervent potenti bridg gap diabet selfcar selfmanag object studi determin effect webbas patient selfmanag intervent psycholog selfefficaci qualiti life selfcar clinic blood pressur cholesterol glycem control weight outcomesmethod cohort studi use repeatedmeasur model qualit individu interview invit patient type diabet use selfmanag websit ask complet questionnair assess selfefficaci primari outcom everi three week nine month nine month receiv access websit collect clinic outcom threemonth interv period conduct indepth interview studi conclus explor accept strength weak mediat use websit analyz data use qualit descript approach induct themat analysisresult eightyon particip mean age year standard deviat includ analysi selfefficaci score improv signific expect nine month absolut chang confid interv p clinic outcom websit usag limit averag loginsmonth analysi interview n reveal four theme mediat websit use pattern websit use includ role blog drive site traffic feedback websit potenti mechan websit effectconclus selfmanag websit patient type diabet improv selfefficaci websit use limit although perceiv reliabl avail blog email remind drew peopl websit particip struggl type diabet compet prioriti live websit access barrier use futur intervent aim integr intervent seamless daili routin end user seen yet anoth chore

Resumos Similares

J. Med. Internet Res. - Use of behavioral change techniques in web-based self-management programs for type 2 diabetes patients: systematic review. ( 0,788603133542896 )
Appl Clin Inform - Novel computerized health risk appraisal may improve longitudinal health and wellness in primary care: a pilot study. ( 0,773629116753181 )
J. Med. Internet Res. - Type 1 diabetes eHealth psychoeducation: youth recruitment, participation, and satisfaction. ( 0,771352132109861 )
J Am Med Inform Assoc - Increasing the response rate of text messaging data collection: a delayed randomized controlled trial. ( 0,749552172796405 )
J. Med. Internet Res. - Perceptions of successful cues to action and opportunities to augment behavioral triggers in diabetes self-management: qualitative analysis of a mobile intervention for low-income Latinos with diabetes. ( 0,740380985789992 )
Telemed J E Health - Increasing access to chronic disease self-management programs in rural and remote communities using telehealth. ( 0,736873077539317 )
J Am Med Inform Assoc - Online disease management of diabetes: engaging and motivating patients online with enhanced resources-diabetes (EMPOWER-D), a randomized controlled trial. ( 0,721357331521354 )
Telemed J E Health - Patient and phaRmacist telephonic encounters (PARTE) in an underserved rural patient population with asthma: results of a pilot study. ( 0,721272606287208 )
J. Med. Internet Res. - Effects of a Web-based intervention for adults with chronic conditions on patient activation: online randomized controlled trial. ( 0,718201502086071 )
J. Med. Internet Res. - Directed use of the internet for health information by patients with chronic kidney disease: prospective cohort study. ( 0,71169397797973 )
J. Med. Internet Res. - Pedometer-based internet-mediated intervention for adults with chronic low back pain: randomized controlled trial. ( 0,71026129652906 )
J Telemed Telecare - Effects of tooth scaling reminders for dental outpatients. ( 0,701340134530686 )
Telemed J E Health - Shared care combined with telecare improves glycemic control of diabetic patients in a rural underserved community. ( 0,701074257094677 )
Int J Comput Assist Radiol Surg - Speech and motion control for interventional radiology: requirements and feasibility. ( 0,699304424862747 )
Telemed J E Health - A novel telemonitoring device for improving diabetes control: protocol and results from a randomized clinical trial. ( 0,69749168379143 )
J. Med. Internet Res. - Diabetes self-management smartphone application for adults with type 1 diabetes: randomized controlled trial. ( 0,696701261609977 )
BMC Med Inform Decis Mak - A tailored, dialogue-based health communication application for patients with chronic low back pain: study protocol of a randomised controlled trial. ( 0,695412951544536 )
BMC Med Inform Decis Mak - Protocol for population testing of an Internet-based Personalised Decision Support system for colorectal cancer screening. ( 0,683352510782774 )
J Am Med Inform Assoc - Secure messaging and diabetes management: experiences and perspectives of patient portal users. ( 0,681786856446647 )
J Telemed Telecare - Effectiveness and safety of a glucose data-filtering system with automatic response software to reduce the physician workload in managing type 2 diabetes. ( 0,672489299845938 )
J. Med. Internet Res. - Effects of Internet popular opinion leaders (iPOL) among Internet-using men who have sex with men. ( 0,665846117467112 )
J Telemed Telecare - Effect of mobile phone short text messages on glycaemic control in children with type 1 diabetes. ( 0,665580267309018 )
Health Informatics J - Information and decision support needs in patients with type 2 diabetes. ( 0,663772214281967 )
J. Med. Internet Res. - From online randomized controlled trials to participant preference studies: morphing the San Francisco Stop Smoking site into a worldwide smoking cessation resource. ( 0,660520273325876 )
J. Med. Internet Res. - Engagement in a diabetes self-management website: usage patterns and generalizability of program use. ( 0,658855348057742 )
AMIA Annu Symp Proc - The Impact of HIT on Cost and Quality in Patient-Centered Medical Home Practices. ( 0,656907666785614 )
J. Med. Internet Res. - Understanding usage of a hybrid website and smartphone app for weight management: a mixed-methods study. ( 0,656577248699737 )
J Am Med Inform Assoc - Internet-based randomized controlled trials: a systematic review. ( 0,65500069901618 )
J. Med. Internet Res. - A smart web aid for preventing diabetes in rural China: preliminary findings and lessons. ( 0,653663408076702 )
J. Med. Internet Res. - Text messaging data collection for monitoring an infant feeding intervention program in rural China: feasibility study. ( 0,648504110276505 )
J. Med. Internet Res. - Usage and effectiveness of a fully automated, open-access, Spanish Web-based smoking cessation program: randomized controlled trial. ( 0,646425906247475 )
J Telemed Telecare - Automated home telephone self-monitoring reduces hospitalization in patients with advanced heart failure. ( 0,645728071212618 )
Int J Med Inform - Knowledge, use and attitude toward eHealth among patients with chronic lung diseases. ( 0,645413729367399 )
Med Decis Making - Impact of literacy and numeracy on motivation for behavior change after diabetes genetic risk testing. ( 0,643336205186373 )
Int J Med Inform - An asthma management system in a pediatric emergency department. ( 0,641714758665236 )
J. Med. Internet Res. - Assessing adolescent asthma symptoms and adherence using mobile phones. ( 0,640589763804052 )
Telemed J E Health - The Cardiovascular Intervention Improvement Telemedicine Study (CITIES): rationale for a tailored behavioral and educational pharmacist-administered intervention for achieving cardiovascular disease risk reduction. ( 0,640160231847097 )
Telemed J E Health - Asynchronous virtual visits for the follow-up of chronic conditions. ( 0,638939282841503 )
Telemed J E Health - What makes teens start using and keep using health information web sites? A mixed model analysis of teens with chronic illnesses. ( 0,638072420009716 )
Telemed J E Health - Outcomes of a home telehealth intervention for patients with diabetes and hypertension. ( 0,636032976682597 )
J. Med. Internet Res. - The potential of Web-based interventions for heart disease self-management: a mixed methods investigation. ( 0,635306462733758 )
J. Med. Internet Res. - Mobile phone-based telemonitoring for heart failure management: a randomized controlled trial. ( 0,63405904554811 )
BMC Med Inform Decis Mak - A tailored, interactive health communication application for patients with type 2 diabetes: study protocol of a randomised controlled trial. ( 0,632279410120499 )
J. Med. Internet Res. - Considerations for community-based mHealth initiatives: insights from three Beacon Communities. ( 0,631997627032693 )
J. Med. Internet Res. - Seeking health information and support online: does it differ as a function of engagement in risky health behaviors? Evidence from the health information national trends survey. ( 0,629257464004211 )
J. Med. Internet Res. - A web-based peer-modeling intervention aimed at lifestyle changes in patients with coronary heart disease and chronic back pain: sequential controlled trial. ( 0,628692667610355 )
Telemed J E Health - Delivering healthcare information via the internet: cardiac patients' access, usage, perceptions of usefulness, and web site content preferences. ( 0,626432410356754 )
J. Med. Internet Res. - Demographic, behavioral, and psychosocial correlates of using the website component of a worksite physical activity and healthy nutrition promotion program: a longitudinal study. ( 0,623038770456954 )
J. Med. Internet Res. - Evaluation of a Web-based intervention providing tailored advice for self-management of minor respiratory symptoms: exploratory randomized controlled trial. ( 0,620929017088228 )
J. Med. Internet Res. - Impact of seasonality on recruitment, retention, adherence, and outcomes in a web-based smoking cessation intervention: randomized controlled trial. ( 0,619204075260753 )
J. Med. Internet Res. - Comparison of trial participants and open access users of a web-based physical activity intervention regarding adherence, attrition, and repeated participation. ( 0,616884125849242 )
Int J Med Inform - Narratives of empowerment and compliance: studies of communication in online patient support groups. ( 0,616479474768424 )
BMC Med Inform Decis Mak - Phase 1 pilot study of e-mail support for people with long term conditions using the Internet. ( 0,615240753025469 )
BMC Med Inform Decis Mak - Evaluation of the use of decision-support software in carcino-embryonic antigen (CEA)-based follow-up of patients with colorectal cancer. ( 0,612848192055438 )
Health Informatics J - Adoption of online health management tools among healthy older adults: An exploratory study. ( 0,612299318791387 )
J. Med. Internet Res. - Effectiveness of a Web-based tailored intervention (E-health4Uth) and consultation to promote adolescents' health: randomized controlled trial. ( 0,609352691316941 )
Health Informatics J - Trust in health information websites: A systematic literature review on the antecedents of trust. ( 0,60812285216884 )
J Telemed Telecare - A pilot study using interactive SMS support groups to prevent mother-to-child HIV transmission in South Africa. ( 0,608089128564809 )
Telemed J E Health - Evaluating opportunities for text message communication: a survey of parents and teens. ( 0,606317640134465 )
J Telemed Telecare - A brief self-guided telehealth intervention for post-traumatic stress disorder in combat veterans: a pilot study. ( 0,604633949034662 )
BMC Med Inform Decis Mak - User-centered design of a web-based self-management site for individuals with type 2 diabetes - providing a sense of control and community. ( 0,604272555726056 )
J. Med. Internet Res. - Short-term effectiveness of web-based guided self-help for phobic outpatients: randomized controlled trial. ( 0,602338805251031 )
Appl Clin Inform - Care everywhere, a point-to-point HIE tool: utilization and impact on patient care in the ED. ( 0,602073930774598 )
J. Med. Internet Res. - Evaluation of an eHealth intervention in chronic care for frail older people: why adherence is the first target. ( 0,601586766348578 )
J. Med. Internet Res. - Online advertising to reach and recruit Latino smokers to an internet cessation program: impact and costs. ( 0,601528332506125 )
Int J Med Inform - Online self-management interventions for chronically ill patients: cognitive impairment and technology issues. ( 0,599288931555048 )
Telemed J E Health - Comparing the effectiveness of telemedicine and traditional surveillance in providing diabetic retinopathy screening examinations: a randomized controlled trial. ( 0,598339635065083 )
J. Med. Internet Res. - Supporting self-care for families of children with eczema with a Web-based intervention plus health care professional support: pilot randomized controlled trial. ( 0,598004118199424 )
Telemed J E Health - TEAhM-Technologies for Enhancing Access to Health Management: a pilot study of community-based telehealth. ( 0,597248925268514 )
AMIA Annu Symp Proc - A Comparison of Data Driven-based Measures of Adherence to Oral Hypoglycemic Agents in Medicaid Patients. ( 0,59704226969059 )
J. Med. Internet Res. - Engagement and retention: measuring breadth and depth of participant use of an online intervention. ( 0,596943426077183 )
J. Med. Internet Res. - Engagement promotes abstinence in a web-based cessation intervention: cohort study. ( 0,595740968231101 )
J Telemed Telecare - Effects on diabetes management of a health-care provider mediated, remote coaching system via a PDA-type glucometer and the Internet. ( 0,595593868972078 )
J Am Med Inform Assoc - Personal health records and hypertension control: a randomized trial. ( 0,595118570252615 )
BMC Med Inform Decis Mak - Designing and evaluating a web-based self-management site for patients with type 2 diabetes--systematic website development and study protocol. ( 0,594818671408423 )
J. Med. Internet Res. - The ins and outs of an online bipolar education program: a study of program attrition. ( 0,594127496465687 )
J. Med. Internet Res. - Supporting health care professionals to improve the processes of shared decision making and self-management in a web-based intervention: randomized controlled trial. ( 0,593177615564684 )
J. Med. Internet Res. - An experimental test of the persuasive effect of source similarity in narrative and nonnarrative health blogs. ( 0,591909876485234 )
J. Med. Internet Res. - Improving diabetes management with a patient portal: a qualitative study of diabetes self-management portal. ( 0,590847003847718 )
J Med Syst - An assessment of patient behavior over time-periods: a case study of managing type 2 diabetes through blood glucose readings and insulin doses. ( 0,590065970894631 )
J Biomed Inform - glUCModel: a monitoring and modeling system for chronic diseases applied to diabetes. ( 0,589305721228725 )
BMC Med Inform Decis Mak - Impact of a chronic kidney disease registry and provider education on guideline adherence--a cluster randomized controlled trial. ( 0,588153702426552 )
J Telemed Telecare - Access, use and completion of a brief disaster mental health intervention among Hispanics, African-Americans and Whites affected by Hurricane Ike. ( 0,586912936846247 )
AMIA Annu Symp Proc - Patient moderator interaction in online health communities. ( 0,586855410477538 )
J. Med. Internet Res. - Effectiveness of Web-based versus face-to-face delivery of education in prescription of falls-prevention exercise to health professionals: randomized trial. ( 0,586520675048702 )
AMIA Annu Symp Proc - Race and medication adherence and glycemic control: findings from an operational health information exchange. ( 0,586388209879841 )
J. Med. Internet Res. - Use of a text message program to raise type 2 diabetes risk awareness and promote health behavior change (part I): assessment of participant reach and adoption. ( 0,584359642606781 )
Telemed J E Health - Home-based telesurveillance program in chronic heart failure: effects on clinical status and implications for 1-year prognosis. ( 0,58396853192789 )
Telemed J E Health - The acceptance of e-health solutions among patients with chronic respiratory conditions. ( 0,583117947828186 )
J Am Med Inform Assoc - Predicting changes in hypertension control using electronic health records from a chronic disease management program. ( 0,582989891011097 )
J. Med. Internet Res. - The Sexunzipped trial: young people's views of participating in an online randomized controlled trial. ( 0,581644891587707 )
J. Med. Internet Res. - A systematic review of web-based interventions for patient empowerment and physical activity in chronic diseases: relevance for cancer survivors. ( 0,581087103609817 )
J. Med. Internet Res. - Providing web-based feedback and social norms information to reduce student alcohol intake: a multisite investigation. ( 0,579032991473813 )
J. Med. Internet Res. - Motivators and motivations to persist with online psychological interventions: a qualitative study of treatment completers. ( 0,578711992810263 )
Telemed J E Health - Sustained effects of a nurse coaching intervention via telehealth to improve health behavior change in diabetes. ( 0,578650171307413 )
J. Med. Internet Res. - Participants, usage, and use patterns of a web-based intervention for the prevention of depression within a randomized controlled trial. ( 0,578456269869325 )
BMC Med Inform Decis Mak - Internet use, needs and expectations of web-based information and communication in childbearing women with type 1 diabetes. ( 0,578076226963928 )
Perspect Health Inf Manag - A patient-centric, provider-assisted diabetes telehealth self-management intervention for urban minorities. ( 0,577567847368034 )
J. Med. Internet Res. - Using virtual reality to provide health care information to people with intellectual disabilities: acceptability, usability, and potential utility. ( 0,576111860622356 )
J Telemed Telecare - Telemonitoring in chronic obstructive airway disease and adult patients with cystic fibrosis. ( 0,575558899358438 )