Evidence Table 22

Outcomes in studies addressing the impact of CHI applications on intermediate outcomes in diabetes

Author,yearOutcomesControl InterventionnMeasure at BLMeasure at final time pointratios at time pointsSignificance
Diabetes mellitus
Glasgow, 20031Kristal total (Dietary behavior)ControlMean, 2.22 SD, 0.4510 months: mean, 2.03 SD, 0.38
Tailored self-management interventionMean, 2.19 SD, 0.4610 months: mean, 1.93 SD, 0.38
Estimated grams of daily fat (grams)ControlMean, 44.4 SD, 33.810 months mean, 29.8 SD, 14.3
Tailored self-managementMean, 40.8 SD, 23.810 months mean, 27.9 SD, 14.3
Minutes activity per day (minutes/day)ControlMean, 26.8 SD, 20.410 months mean, 32.1 SD, 22.9
Tailored self-managementMean, 33.4 SD, 25.410 months mean, 30.9 SD, 23
Minutes activity per dayControlMean, 66.68 SD, 20.6610 months mean, 79.97 SD, 14.81
Tailored self-managementMean, 63.32 SD, 19.6910 months mean, 78.4 SD, 14.81
Guidelines met (% guidelines met)ControlMean, 7.43 SD, 1.7110 months mean, 7.67 SD, 1.1
Tailored self-managementmean, 1.5310 months mean, 7.42 SD, 1.1
Hemoglobin A1CControlMean, 5.18 SD, 1.4410 months: mean, 5.02 SD, 1.17
Tailored self-managementMean, 5.7 SD, 1.8910 months: mean, 5.13 SD, 1.16
Lipid ratioControlMean, 17.9 SD, 10.5610 months mean, 12.93 SD, 9.11
Tailored self-managementMean, 18 SD, 10.0210 months mean, 13.72 SD, 9.12
CES-D totalControlMean, 4.14 SD, 1.3210 months mean, 4.96 SD, 1.12
Tailored self-managementMean, 4.14 SD, 1.210 months mean, 4.97 SD, 1.12
Homko, 20072Self-efficacy (DES)Control25Score on DES37 weeks gestation: mean, 4 SD, 0.5NS
Telemedicine32Score on DES37 weeks gestation: mean, 4.4 SD, 0.5
System use (# of sets of information sent on telemedicine system)Control25Frequency of monitoring (sets of data reported)37 weeks gestation mean, 73.7 SD, 56.7NS
Telemedicine2837 weeks gestation mean, 94.8 SD, 60
FBSControl25FBS (mg/dl)37 weeks gestation mean, 88.6 SD, 9.5NS
Telemedicine3237 weeks gestation mean, 90.8 SD, 11.8
A1c at time of deliveryControl25A1c at delivery (%)37 weeks gestation mean, 6.2 SD, 2.2NS
Telemedicine3237 weeks gestation mean, 6.1 SD, 0.8
McKay, 20013Moderate-to-vigorous exercise Unadjusted (minutes/day)Control33Mean, 7.3 SD, 6.28 weeks mean, 18 SD, 17.3
Internet-based physical activity intervention35Mean, 5.6 SD, 6.28 weeks mean, 17.6 SD, 15.3
Walking Unadjusted (minutes/day)Control33Mean, 8.4 SD, 8.48 weeks mean, 16.8 SD, 22.8
Internet-based physical activity intervention35Mean, 6.4 SD, 6.28 weeks mean, 12.5 SD, 9.5
Depressive symptomsControl33Mean, 17.6 SD, 10.48 weeks mean, 19.9 SD, 14.2
Internet-based physical activity intervention35Mean, 16.9 SD, 11.68 weeks mean, 14.9 SD, 12.5
Richardson, 2007 4 DiabetesTotal StepEmploying lifestyle goals for overall steps recorded from the pedometer174,157 ± 1,737 stps6,279 ± 3,306Diff: 2,122 ± 3,179Ns
Employing structured goals that emphasize PA using computerized feedback mechanisms135,171 ± 1,7696,868 ± 3,751Diff: 1,697 ± 3,564NS
Bout StepsEmploying lifestyle goals for overall steps recorded from the pedometer17286 ± 5992,070 ± 2,8141,783 ± 2,741S
Employing lifestyle goals for overall steps recorded from the pedometer13516 ± 801 (NS from above)2,616 ± 2,706 (NS diff from above)2,101 ± 2,815 (NS Diff from above)S
SatisfactionEmploying lifestyle goals for overall steps recorded from the pedometer17100%
Employing lifestyle goals for overall steps recorded from the pedometer1362%P =0.006
UsefulnessEmploying lifestyle goals for overall steps recorded from the pedometer1771%
Employing lifestyle goals for overall steps recorded from the pedometer1331%P = 0.03
Adherence (Likelihood of wearing a pedometer)Employing lifestyle goals for overall steps recorded from the pedometer17(3)
Employing lifestyle goals for overall steps recorded from the pedometer13(15)P < 0.001
Adherence (Mean hours of wearing a pedometer)Employing lifestyle goals for overall steps recorded from the pedometer1716.5h
Employing lifestyle goals for overall steps recorded from the pedometer1314.5hP = 0.038
Wangberg, 20065Summary of Diabetes Self Care ActivitiesLow self-efficacy15Mean, 29.47 SD, 9.491 month - analyzed: mean, 30.60 SD, 8.92
High self-efficacy14Mean, 27.64 SD, 8.551 month - analyzed: mean, 32.07 SD, 7.5
Perceived competence scaleLow self-efficacy15Mean, 52.20 SD, 13.191 month - analyzed mean, 49.73 SD, 14.18
High low self-efficacy14Mean, 52.07 SD, 10.661 month - analyzed mean, 49.93 SD, 10.83
Wise, 1986 6 DiabetesIDDM Patients
Knowledge Index (KAP Questionnaire) 4—6moAssessment of KAP only24Knowledge Score: 79 SE 282 SE 2Ns
Assessment + Feedback2278 SE 283 SE 3significant
Assessment + Interactive computer2077 SE 283 SE 2Significant
NIDDM Patients
Knowledge Index (KAP Questionnaire) 4—6moAssessment of KAP only22Knowledge UNSUNSNs
Assessment + Feedback2464 SE 273 SE 2significant
Assessment + Interactive computer2160 SE 370 SE 2Significant
IDDM Patients
Knowledge Index (KAP Questionnaire) 4—6moControl20HBA1c: 8.9%8.8%NS
Assessment of KAP only249.1 SE 0.28.4 SE 0.1Significant
Assessment + Feedback229.3 SE 0.58.1 SE 0.4significant
Assessment + Interactive computer209.3 SE 0.28.6 SE 0.3Significant
NIDDM Patients
Knowledge Index (KAP Questionnaire) 4—6moControl21HBA1c: 8.7%8.5%NS
Assessment of KAP only229.6 SE 0.48.8 SE 0.3Significant
Assessment + Feedback249.2 SE 0.47.9 SE 0.4significant
Assessment + Interactive computer218.7 SE 0.77.9 SE 0.6Significant
Diabetes, heart disease or chronic lung disease
Lorig, 20067Change in health distress (0–5)Control426CHANGE in score on Health Distress Scale12 months: mean, −0.193 SD, 1.070.–13 (ANCOVA) 0.025 (repeated measures)
Online intervention354CHANGE in score on Health Distress Scale12 months: mean, −0.377 SD, 1.11
Change in self reported global health(0–5)Control4260–5 scale12 months mean, −0.068 SD, 0.6450.340 (logistic) 0.514 (repeated measures)
Online intervention35412 months mean, −0.102 SD, 0.768
Change in illness intrusivenessControl4261–7scale12 months mean, −0.064 SD, 0.9260.704 (ANCOVA), 0.061 (repeated measures)
Online intervention35412 months mean, −0.150 SD, 1.023
Change in disabilityControl4260–3 Scale12 months mean, −0.142 SD, 0.32BL, 0.051 (ANCOVA) 0.335 repeated measures
Online intervention35412 months mean, −0.166 SD, 0.345
Change in fatigueControl4260–10scale12 months: mean, −0.358 SD, 2.09
Online intervention35412 months: mean, −0.720 SD, 2.14
Change in painControl4260–10 scale12 months mean, −0.047 SD, 2.46
Online intervention35412 months mean, −0.367 SD, 2.72
Change in shortness of breathControl4260–10 scale12 months mean, −0.216 SD, 2.4
Online intervention35412 months mean, −0.537 SD, 2.41
Change in self-efficacyControl4261–10 Scale12 months: mean, 0.200 SD, 1.82
Online intervention3541–10 Scale12 months: mean, 0.406 SD, 1.98

FBS = fasting blood sugar, DES = Diabetes Empowerment Scale, BL = baseline, NS = not significant, mg/dl = milligrams/deciliter

Reference List

1

Glasgow RE, Boles SM, McKay HG, Feil EG, Barrera M Jr. The D-Net diabetes self-management program: long-term implementation, outcomes, and generalization results. Prev Med 2003; 36(4):410–9.

2

Homko CJ, Santamore WP, Whiteman V et al. Use of an internet-based telemedicine system to manage underserved women with gestational diabetes mellitus. Diabetes Technol Ther 2007; 9(3):297–306.

3

McKay HG, King D, Eakin EG, Seeley JR, Glasgow RE. The diabetes network internet-based physical activity intervention: a randomized pilot study. Diabetes Care 2001; 24(8):1328–34.

4

Richardson CR, Mehari KS, McIntyre LG et al. A randomized trial comparing structured and lifestyle goals in an internet-mediated walking program for people with type 2 diabetes. Int J Behav Nutr Phys Act 2007; 4:59.

5

Wangberg SC. An Internet-based diabetes self-care intervention tailored to self-efficacy. Health Educ Res 2008; 23(1):170–9.

6

Wise PH, Dowlatshahi DC, Farrant S. Effect of computer-based learning on diabetes knowledge and control. 1986; 9(5):504–8.

7

Lorig KR, Ritter PL, Laurent DD, Plant K. Internet-based chronic disease self-management: a randomized trial. Med Care 2006; 44(11):964–71.

From: Appendix G

Cover of Impact of Consumer Health Informatics Applications
Impact of Consumer Health Informatics Applications.
Evidence Reports/Technology Assessments, No. 188.
Gibbons MC, Wilson RF, Samal L, et al.

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