Format

Send to

Choose Destination
Patient Educ Couns. 2012 Apr;87(1):81-92. doi: 10.1016/j.pec.2011.07.024. Epub 2011 Sep 15.

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

Author information

1
Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA. glasgowre@mail.nih.gov

Abstract

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.

PMID:
21924576
PMCID:
PMC3253192
DOI:
10.1016/j.pec.2011.07.024
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center