Abstract
BackgroundGiven that patients provide the majority of their own diabetes care, patient self-management training has increasingly become recognized as an important strategy with which to improve quality of care. However, participation in self management programs is low. In addition, the efficacy of current behavioural interventions wanes over time, reducing the impact of self-management interventions on patient health. Web-based interventions have the potential to bridge the gaps in diabetes care and self-management.MethodsOur objective is to improve self-efficacy, quality of life, self-care, blood pressure, cholesterol and glycemic control and promote exercise in people with type 2 diabetes through the rigorous development and use of a web-based patient self-management intervention. This study consists of five phases: (1) intervention development; (2) feasibility testing; (3) usability testing; (4) intervention refinement; and (5) intervention evaluation using mixed methods. We will employ evidence-based strategies and tools, using a theoretical framework of self-efficacy, then elicit user feedback through focus groups and individual user testing sessions. Using iterative redesign the intervention will be refined. Once finalized, the impact of the website on patient self-efficacy, quality of life, self-care, HbA1c, LDL-cholesterol, blood pressure and weight will be assessed through a non-randomized observational cohort study using repeated measures modeling and individual interviews.DiscussionIncreasing use of the World Wide Web by consumers for health information and ongoing revolutions in social media are strong indicators that users are primed to welcome a new era of technology in health care. However, their full potential is hindered by limited knowledge regarding their effectiveness, poor usability, and high attrition rates. Our development and research agenda aims to address these limitations by improving usability, identifying characteristics associated with website use and attrition, and developing strategies to sustain patient use in order to maximize clinical outcomes.
Highlights
Given that patients provide the majority of their own diabetes care, patient self-management training has increasingly become recognized as an important strategy with which to improve quality of care
We will identify factors that correlate with website use and effectiveness in order to guide future intervention development and research
This study builds on previous work using the most rigorous approach to intervention development, including usability testing, qualitative studies of acceptability, iterative refinement, and measures the impact on self-efficacy, quality of life and risk factor control using a repeated measures design
Summary
Given that patients provide the majority of their own diabetes care, patient self-management training has increasingly become recognized as an important strategy with which to improve quality of care. Given that patients provide the majority of their own diabetes care [1], patient self-management training is an important strategy with which to improve quality of care [1]. Several systematic reviews have examined the impact of self-management interventions on glycemic control, cardiac risk factors and psychological outcomes. These reviews have demonstrated positive effects on knowledge [2], self-reported dietary habits [2], quality of life [3], and glycemic control [2,4]. Characteristics of effective interventions include patient collaboration and regular reinforcement [2]
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