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PLoS One. 2018 Mar 7;13(3):e0192807. doi: 10.1371/journal.pone.0192807. eCollection 2018.

Individual differences in regulatory mode moderate the effectiveness of a pilot mHealth trial for diabetes management among older veterans.

Author information

1
Department of Psychology, University of Maryland, College Park, Maryland, United States of America.
2
Center for Health Information & Decision Systems, Robert H Smith School of Business, University of Maryland, College Park, Maryland, United States of America.
3
College of Information Studies, University of Maryland, College Park, Maryland, United States of America.
4
Decision, Operations, & Information Technologies, Robert H Smith School of Business, University of Maryland, College Park, Maryland, United States of America.
5
Department of Biology, Emory University, Atlanta, Georgia, United States of America.
6
Maryland Veterans Administration Health Care Center, Baltimore, Maryland, United States of America.
7
University of Maryland School of Medicine, Baltimore, Maryland, United States of America.

Abstract

mHealth tools to help people manage chronic illnesses have surged in popularity, but evidence of their effectiveness remains mixed. The aim of this study was to address a gap in the mHealth and health psychology literatures by investigating how individual differences in psychological traits are associated with mHealth effectiveness. Drawing from regulatory mode theory, we tested the role of locomotion and assessment in explaining why mHealth tools are effective for some but not everyone. A 13-week pilot study investigated the effectiveness of an mHealth app in improving health behaviors among older veterans (n = 27) with poorly controlled Type 2 diabetes. We developed a gamified mHealth tool (DiaSocial) aimed at encouraging tracking of glucose control, exercise, nutrition, and medication adherence. Important individual differences in longitudinal trends of adherence, operationalized as points earned for healthy behavior, over the course of the 13-week study period were found. Specifically, low locomotion was associated with unchanging levels of adherence during the course of the study. In contrast, high locomotion was associated with generally stronger adherence although it exhibited a quadratic longitudinal trend. In addition, high assessment was associated with a marginal, positive trend in adherence over time while low assessment was associated with a marginal, negative trend. Next, we examined the relationship between greater adherence and improved clinical outcomes, finding that greater adherence was associated with greater reductions in glycated hemoglobin (HbA1c) levels. Findings from the pilot study suggest that mHealth technologies can help older adults improve their diabetes management, but a "one size fits all" approach may yield suboptimal outcomes.

PMID:
29513683
PMCID:
PMC5841664
DOI:
10.1371/journal.pone.0192807
[Indexed for MEDLINE]
Free PMC Article

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