Abstract
BackgroundThe prevalence of chronic disease is increasing rapidly. Health promotion models have shifted toward patient-centered care and self-efficacy. Devices and mobile app in the Internet of Things (IoT) have become critical self-management tools for collecting and analyzing personal data to improve individual health outcomes. However, the precise effects of Web-based interventions on self-efficacy and the related motivation factors behind individuals’ behavioral changes have not been determined.ObjectiveThe objective of this study was to gain insight into patients' self-efficacy with newly diagnosed diabetes (type 2 diabetes mellitus) and analyze the association of patient-centered health promotion behavior and to examine the implications of the results for IoT and mobile health mobile app features.MethodsThe study used data from the electronic health database (n=3128). An experimental design (n=121) and randomized controlled trials were employed to determine patient preferences in the health promotion program (n=62) and mobile self-management education (n=28). The transtheoretical model was used as a framework for observing self-management behavior for the improvement of individual health, and the theory of planned behavior was used to evaluate personal goals, execution, outcome, and personal preferences. A mobile app was used to determine individualized health promotion interventions and to apply these interventions to improve patients’ self-management and self-efficacy.ResultsMobile questionnaires were administered for pre- and postintervention assessment through mobile app. A dynamic questionnaire allocation method was used to follow up and monitor patient behavioral changes in the subsequent 6 to 18 months. Participants at a high risk of problems related to blood pressure (systolic blood pressure ≥120 mm Hg) and body mass index (≥23 kg/m2) indicated high motivation to change and to achieve high scores in the self-care knowledge assessment (n=49, 95% CI −0.26% to −0.24%, P=.052). The associated clinical outcomes in the case group with the mobile-based intervention were slightly better than in the control group (glycated hemoglobin mean −1.25%, 95% CI 6.36 to 7.47, P=.002). In addition, 86% (42/49) of the participants improved their health knowledge through the mobile-based app and information and communications technology. The behavior-change compliance rate was higher among the women than among the men. In addition, the personal characteristics of steadiness and dominance corresponded with a higher compliance rate in the dietary and wellness intervention (83%, 81/98). Most participants (71%, 70/98) also increased their attention to healthy eating, being active, and monitoring their condition (30% 21/70, 21% 15/70, and 20% 14/70, respectively).ConclusionsThe overall compliance rate was discovered to be higher after the mobile app–based health intervention. Various intervention strategies based on patient characteristics, health care–related word-of-mouth communication, and social media may be used to increase self-efficacy and improve clinical outcomes. Additional research should be conducted to determine the most influential factors and the most effective adherence management techniques.
Highlights
Financial BurdenIn China, noncommunicable chronic diseases are a critical health problem and impose a major economic burden
Various intervention strategies based on patient characteristics, health care–related word-of-mouth communication, and social media may http://diabetes.jmir.org/2019/2/e11017/
This study found that (1) self-efficacy influences the factors of the interactive personalized management framework (IPMF) intervention method and behavioral change model, and (2) a mobile app can be used to improve personalized care plans
Summary
In China, noncommunicable chronic diseases are a critical health problem and impose a major economic burden. Diabetes mellitus (DM) has been diagnosed in 415 million people, and DM and its complications are a global health emergency, accounting for 12% of global health expenditure [1]. The MOST survey revealed that 11.6% of adults in China (approximately 114 million people) have received DM diagnoses. DM is more prevalent in older age groups and among people living in economically developed regions. DM-related expenditure in 2013 was approximately US $548 billion, accounting for 10.8% of total health expenditure worldwide. Health promotion models have shifted toward patient-centered care and self-efficacy. The precise effects of Web-based interventions on self-efficacy and the related motivation factors behind individuals’ behavioral changes have not been determined
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