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Woolley A, Hadjiconstantinou M, Bodicoat DH, Khunti K, Davies MJ, Seidu S. A cross-sectional time series of cardiometabolic health education format preferences across sociodemographic groups. Diabet Med 2024:e15404. [PMID: 38994926 DOI: 10.1111/dme.15404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 06/07/2024] [Accepted: 06/25/2024] [Indexed: 07/13/2024]
Abstract
AIMS Health education is integral to cardiometabolic disease (CMD) management. This study aimed to assess whether and how education preferences have changed over time, and whether trends differ by sociodemographic characteristics (education status, age, ethnicity, and sex). METHODS A cross-sectional questionnaire was deployed across five counties in the East Midlands, UK between 2017 and 2022 to adults with CMD (type 2 diabetes, cardiovascular disease or cerebrovascular disease). Respondent demographic data were collected alongside health education preferences. Statistical analyses ascertained whether demographic characteristics influenced preferences. The distribution of preferences over time was charted to identify trends. RESULTS A total of 4301 eligible responses were collected. Face-to-face one-to-one education was preferred (first choice for 75.1% of participants) but popularity waned over the five-year period. Trends were similar amongst demographic groups. Online education showed a U-shaped trend: In 2017, 44% of respondents ranked it as acceptable, peaking at 53% in 2019, but declining again, to below base line, 43%, by 2022. This modality was more popular with participants aged younger than 65 years, but popularity in people older than 65 years increased over the study period. The popularity of printed information also declined over time across all demographic groups except those of South Asian ethnicity, for whom it remained static. CONCLUSIONS The overwhelming preference for face-to-face one-to-one health education from a doctor or nurse highlights the importance of preserving access to this modality, even in the face of current NHS pressures and trends towards digitalisation. Trends are changing, and should continue to be monitored, including between different sociodemographic groups.
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Affiliation(s)
- Angharad Woolley
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | | | | | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Samuel Seidu
- Diabetes Research Centre, University of Leicester, Leicester, UK
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Taylor LL, Hong AS, Hahm K, Kim D, Smith-Morris C, Zaha VG. Health Literacy, Individual and Community Engagement, and Cardiovascular Risks and Disparities: JACC: CardioOncology State-of-the-Art Review. JACC CardioOncol 2024; 6:363-380. [PMID: 38983375 PMCID: PMC11229558 DOI: 10.1016/j.jaccao.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 03/13/2024] [Indexed: 07/11/2024] Open
Abstract
Cardiovascular and cancer outcomes intersect within the realm of cardio-oncology survivorship care, marked by disparities across ethnic, racial, social, and geographical landscapes. Although the clinical community is increasingly aware of this complex issue, effective solutions are trailing. To attain substantial public health impact, examinations of cancer types and cardiovascular risk mitigation require complementary approaches that elicit the patient's perspective, scale it to a population level, and focus on actionable population health interventions. Adopting such a multidisciplinary approach will deepen our understanding of patient awareness, motivation, health literacy, and community resources for addressing the unique challenges of cardio-oncology. Geospatial analysis aids in identifying key communities in need within both granular and broader contexts. In this review, we delineate a pathway that navigates barriers from individual to community levels. Data gleaned from these perspectives are critical in informing interventions that empower individuals within diverse communities and improve cardio-oncology survivorship.
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Affiliation(s)
| | - Arthur S Hong
- UT Southwestern Medical Center, Dallas, Texas, USA
- UT Southwestern Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas, USA
- UT Southwestern O'Donnell School of Public Health, Dallas, Texas, USA
| | - Kristine Hahm
- University of Texas at Dallas, Richardson, Texas, USA
| | - Dohyeong Kim
- University of Texas at Dallas, Richardson, Texas, USA
| | | | - Vlad G Zaha
- UT Southwestern Medical Center, Dallas, Texas, USA
- UT Southwestern Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas, USA
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Velázquez López L, Achar de la Macorra R, Colin Ramirez E, Muñoz Torres AV, Pineda Del Aguila I, Medina Bravo PG, Klünder Klünder M, Medina Gómez OS, Escobedo de la Peña J. The diabetes education material on diabetes for website: Results of a validation process. J Healthc Qual Res 2023; 38:346-353. [PMID: 37567853 DOI: 10.1016/j.jhqr.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/27/2023] [Accepted: 07/14/2023] [Indexed: 08/13/2023]
Abstract
OBJECTIVE To validate an educational material on diabetes through an expert consensus for its implementation into a web site. MATERIAL AND METHODS An observational study was carried out in a group of health professionals, for which an educational material was developed for patients with diabetes. Topics included nutrition, physical exercise, control indicators, complications, pharmacological treatment, among others. The language, text and figures were focused on easy comprehension, additionally, a section of didactic activities to be answered by the patient with diabetes at the end of each module was included. To evaluate the educational material by health professionals, an instrument was designed and validated. Once all the educational material was available, each of the modules was sent by e-mail to at least three clinical experts in the assigned topic, as well as the instrument for the evaluation of the module. RESULTS Thirty-seven experts were included in the study, 76% rated the educational modules evaluated as highly adequate, while only 24% rated them as adequate. The instrument used obtained a good level of internal consistency, with a Cronbach's alpha coefficient of 0.92. In the dimensions of the instrument, the lowest Cronbach's alpha score was that of "call-to-action", with a value of 0.71. CONCLUSION The diabetes educational material was rated as highly appropriate by the clinical experts. The developed instrument has an adequate content validity, as well as a good level of internal consistency.
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Affiliation(s)
- L Velázquez López
- Unidad de Investigación en Epidemiología Clínica, Hospital Regional No 1, "Dr. Carlos Mac Gregor Sánchez Navarro" Instituto Mexicano del Seguro Social, Ciudad de México, Mexico.
| | - R Achar de la Macorra
- Departamento de Salud, Universidad Iberoamericana, sede Santa Fe, Ciudad de México, Mexico
| | - E Colin Ramirez
- Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac, México Campus Norte, Huixquilucan Edo. de México 52786, Mexico
| | - A V Muñoz Torres
- Departmento de Salud Publica, Escuela de Medicina, Universidad Nacional Autónoma de México, 04510 Mexico City, Mexico
| | - I Pineda Del Aguila
- Unidad de Investigación en Epidemiología Clínica, Hospital Regional No 1, "Dr. Carlos Mac Gregor Sánchez Navarro" Instituto Mexicano del Seguro Social, 03100 Mexico City, Mexico
| | - P G Medina Bravo
- Departamento de Endocrinología, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - M Klünder Klünder
- Departamento de Investigación, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - O S Medina Gómez
- Unidad de Investigación en Epidemiología Clínica, Hospital Regional No 1, "Dr. Carlos Mac Gregor Sánchez Navarro" Instituto Mexicano del Seguro Social, 03100 Mexico City, Mexico
| | - J Escobedo de la Peña
- Unidad de Investigación en Epidemiología Clínica, Hospital Regional No 1, "Dr. Carlos Mac Gregor Sánchez Navarro" Instituto Mexicano del Seguro Social, 03100 Mexico City, Mexico
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Pogrebnoy D, Dennett AM, Simpson DB, MacDonald-Wicks L, Patterson AJ, English C. Effects of Using Websites on Physical Activity and Diet Quality for Adults Living With Chronic Health Conditions: Systematic Review and Meta-Analysis. J Med Internet Res 2023; 25:e49357. [PMID: 37856187 PMCID: PMC10623240 DOI: 10.2196/49357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/20/2023] [Accepted: 08/09/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Adults with chronic health conditions need support to manage modifiable risk factors such as physical inactivity and poor diet. Disease-specific websites with health information on physical activity and diet quality may be effective in supporting adults in managing their chronic illnesses. OBJECTIVE The primary aim of this review was to determine whether using websites with health information can lead to improvements in physical activity levels or diet quality in adults with chronic health conditions. METHODS Randomized controlled trials evaluating the effectiveness of website use on levels of physical activity or diet quality in adults with chronic health conditions were included. MEDLINE, Embase, CINAHL, and the Physiotherapy Evidence Database were searched from the earliest available record until February 2023. Data for outcomes measuring physical activity levels; diet quality; and, where reported, self-efficacy and quality of life were independently extracted by 2 reviewers. The risk of bias was assessed using the Physiotherapy Evidence Database scale, and the overall certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Where values were presented as the same unit of measure, postintervention scores were pooled for meta-analysis to yield an overall mean difference (MD). A standardized MD (SMD) was calculated for the pooled data in which different units for the same outcome were used. Individual trial data were described in cases where the data of trials could not be pooled. RESULTS A total of 29 trials (N=6418 participants) across 8 different disease groups with intervention periods ranging from 4 weeks to 12 months were included in the analysis. There was moderate-certainty evidence that using websites with health information increased levels of moderate to vigorous physical activity (MD=39 min/wk, 95% CI 18.60-58.47), quality of life (SMD=0.36, 95% CI 0.12-0.59), and self-efficacy (SMD=0.26, 95% CI 0.05-0.48) and high-certainty evidence for reduction in processed meat consumption (MD=1.1 portions/wk, 95% CI 0.70-1.58) when compared with usual care. No differences were detected in other measures of diet quality. There was no increased benefit for website users who were offered additional support. CONCLUSIONS The use of websites for risk factor management has the potential to improve physical activity levels, quality of life, and self-efficacy as well as reduce processed meat consumption for adults living with chronic health conditions when compared with usual care. However, it remains unclear whether using websites leads to meaningful and long-lasting behavior change. TRIAL REGISTRATION PROSPERO CRD42021283168; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=283168.
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Affiliation(s)
- Dina Pogrebnoy
- School of Health Sciences, University of Newcastle, Newcastle, Australia
- Department of Physiotherapy, Western Health, St Albans, Australia
| | - Amy M Dennett
- Allied Health Clinical Research Office, Eastern Health, Melbourne, Australia
- School of Allied Health, Human Services and Sport, Latrobe University, Melbourne, Australia
| | - Dawn B Simpson
- School of Health Sciences, University of Newcastle, Newcastle, Australia
- Heart and Stroke Program, Hunter Medical Research Institute, Newcastle, Australia
| | - Lesley MacDonald-Wicks
- School of Health Sciences, University of Newcastle, Newcastle, Australia
- Food and Nutrition Program, Hunter Medical Institute, Newcastle, Australia
| | - Amanda J Patterson
- School of Health Sciences, University of Newcastle, Newcastle, Australia
- Food and Nutrition Program, Hunter Medical Institute, Newcastle, Australia
| | - Coralie English
- School of Health Sciences, University of Newcastle, Newcastle, Australia
- Heart and Stroke Program, Hunter Medical Research Institute, Newcastle, Australia
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Quinn LM, Woolley AK, Davies MJ, Bodicoat DH, Seidu S, Khunti K, Hadjiconstantinou M. Educational preferences in individuals with cardiometabolic disease differs with age, ethnicity and educational status. PATIENT EDUCATION AND COUNSELING 2022; 105:3479-3486. [PMID: 36150978 DOI: 10.1016/j.pec.2022.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/12/2022] [Accepted: 08/27/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES To evaluate how sociodemographic factors influence educational modality preferences in people with cardiometabolic disease. METHODS This was a cross-sectional study performed in people with diabetes and cardiovascular disease, who completed a questionnaire to denote their previous experience and ranked preferences for different educational modalities. RESULTS The questionnaire was completed by 3751 people, of whom 59% were men, median (interquartile range) age was 68 (59-76) years, and 78% were White European. In total, 73% had diabetes, 35% had heart disease, and 10% had history of stroke; the majority (83.4%) had one of these conditions. Overall preference was for one-to-one education (77% ranked first choice), and telephone education ranked the lowest. People tended to prefer modalities they had previously experienced. CONCLUSIONS We highlight the importance of considering factors that could influence selection of educational modalities including age, ethnicity, gender and educational level. We anticipate this approach will aid in the design, delivery and tailoring of educational programmes that are accessible to the diverse cohort of people living with chronic diseases, including diabetes and cardiovascular disease. PRACTICE IMPLICATIONS Given the influence of multiple demographic factors and previous experiences on expressed preferences, providers should support individuals to make informed decisions about educational interventions to maximise engagement.
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Affiliation(s)
- Lauren M Quinn
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Angharad Kate Woolley
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Melanie J Davies
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK; Diabetes Research Centre, University of Leicester, Leicester, UK
| | | | - Samuel Seidu
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK; Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Kamlesh Khunti
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK; Diabetes Research Centre, University of Leicester, Leicester, UK
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The Effect of an Educational Intervention on Self-Care in Patients with Venous Leg Ulcers-A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084657. [PMID: 35457524 PMCID: PMC9028307 DOI: 10.3390/ijerph19084657] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/31/2022] [Accepted: 04/11/2022] [Indexed: 11/25/2022]
Abstract
Background: Although patients with venous leg ulcers are involved in ulcer management, little is known about why and how these patients self-treat their ulcers without direct supervision by health professionals. Yet patients’ knowledge of ulcer management can be important for achieving ulcer closure and/or preventing recurrence. This study thus investigates the effects of an educational intervention on knowledge of self-care among patients with venous leg ulcers, mainly on wound dressing practice, compression therapy, physical activity and nutrition. Methods and participants: This research was conducted in three outpatient hospitals in central Croatia. An educational brochure was made and distributed to patients; patients were surveyed about caring for venous leg ulcers before the brochure was distributed and after 3 months. Results: In total, 208 patients were involved in the study: 112 in the experimental group and 96 in the control group. The educational intervention increased awareness of compression therapy, knowledge of recurrence prevention, appropriate lifestyle habits, and warning signs related to venous leg ulcers. Conclusions: Patient education on illness and self-care is necessary to achieve positive effects in self-care knowledge. In this study, patients learned how to change dressings, learned how to improve their lifestyle, and were empowered to deal with their illness.
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Paalimäki-Paakki K, Virtanen M, Henner A, Nieminen MT, Kääriäinen M. Effectiveness of Digital Counseling Environments on Anxiety, Depression, and Adherence to Treatment Among Patients Who Are Chronically Ill: Systematic Review. J Med Internet Res 2022; 24:e30077. [PMID: 34989681 PMCID: PMC8778552 DOI: 10.2196/30077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 11/21/2021] [Indexed: 12/17/2022] Open
Abstract
Background Patients who are chronically ill need novel patient counseling methods to support their self-care at different stages of the disease. At present, knowledge of how effective digital counseling is at managing patients’ anxiety, depression, and adherence to treatment seems to be fragmented, and the development of digital counseling will require a more comprehensive view of this subset of interventions. Objective This study aims to identify and synthesize the best available evidence on the effectiveness of digital counseling environments at improving anxiety, depression, and adherence to treatment among patients who are chronically ill. Methods Systematic searches of the EBSCO (CINAHL), PubMed, Scopus, and Web of Science databases were conducted in May 2019 and complemented in October 2020. The review considered studies that included adult patients aged ≥18 years with chronic diseases; interventions evaluating digital (mobile, web-based, and ubiquitous) counseling interventions; and anxiety, depression, and adherence to treatment, including clinical indicators related to adherence to treatment, as outcomes. Methodological quality was assessed using the standardized Joanna Briggs Institute critical appraisal tool for randomized controlled trials or quasi-experimental studies. As a meta-analysis could not be conducted because of considerable heterogeneity in the reported outcomes, narrative synthesis was used to synthesize the results. Results Of the 2056 records screened, 20 (0.97%) randomized controlled trials, 4 (0.19%) pilot randomized controlled trials, and 2 (0.09%) quasi-experimental studies were included. Among the 26 included studies, 10 (38%) digital, web-based interventions yielded significantly positive effects on anxiety, depression, adherence to treatment, and the clinical indicators related to adherence to treatment, and another 18 (69%) studies reported positive, albeit statistically nonsignificant, changes among patients who were chronically ill. The results indicate that an effective digital counseling environment comprises high-quality educational materials that are enriched with multimedia elements and activities that engage the participant in self-care. Because of the methodological heterogeneity of the included studies, it is impossible to determine which type of digital intervention is the most effective for managing anxiety, depression, and adherence to treatment. Conclusions This study provides compelling evidence that digital, web-based counseling environments for patients who are chronically ill are more effective than, or at least comparable to, standard counseling methods; this suggests that digital environments could complement standard counseling.
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Affiliation(s)
- Karoliina Paalimäki-Paakki
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.,Degree Programme of Radiography and Radiation Therapy, Oulu University of Applied Sciences, Oulu, Finland
| | - Mari Virtanen
- School of Rehabilitation and Examination, Helsinki Metropolia University of Applied Sciences, Helsinki, Finland
| | - Anja Henner
- Degree Programme of Radiography and Radiation Therapy, Oulu University of Applied Sciences, Oulu, Finland
| | - Miika T Nieminen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Maria Kääriäinen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Oulu University Hospital, Oulu, Finland
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Sigamani A, Gupta R. Revisiting secondary prevention in coronary heart disease. Indian Heart J 2022; 74:431-440. [PMID: 36455667 PMCID: PMC9773289 DOI: 10.1016/j.ihj.2022.11.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/22/2022] [Accepted: 11/21/2022] [Indexed: 11/30/2022] Open
Abstract
Secondary prevention in coronary heart disease is the prevention of occurrence of recurrent coronary events after clinical diagnosis. High level of adherence to secondary prevention interventions, especially aggressive lifestyle changes and pharmacotherapy can lead to significant decline in recurrent coronary events. Both international and Indian studies have reported low adherence to such therapies. Evidence-based useful interventions include regular physical activity, yoga, intake of healthy diet, smoking and tobacco use cessation and weight management. Pharmacotherapeutic interventions useful are anti-platelet therapy, target oriented lipid lowering therapy with statins, beta blockers and angiotensin converting enzyme inhibitors in patients with impaired left ventricular function. Hypertension and diabetes management with control to targets is important. Novel strategies include use of anticoagulants, anti-inflammatory drugs, and triglyceride lowering for residual risk. Physician and patient level interventions using multifaceted educational, socioeconomic and technological innovations are important to promote life-long adherence to these strategies.
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Affiliation(s)
- Alben Sigamani
- Numen Health, Bengaluru, Karnataka, 560095, India,Corresponding author. Numen Health, Bengaluru, Karnataka, 560095, India.
| | - Rajeev Gupta
- Department of Preventive Cardiology and Medicine, Eternal Heart Care Centre & Research Institute, Jaipur, Rajasthan, 302017, India
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Nkhoma DE, Soko CJ, Bowrin P, Manga YB, Greenfield D, Househ M, Li Jack YC, Iqbal U. Digital interventions self-management education for type 1 and 2 diabetes: A systematic review and meta-analysis. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 210:106370. [PMID: 34492544 DOI: 10.1016/j.cmpb.2021.106370] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 08/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To describe and assess digital health-led diabetes self-management education and support (DSMES) effectiveness in improving glycosylated hemoglobin, diabetes knowledge, and health-related quality of life (HrQoL) of Type 1 and 2 Diabetes in the past 10 years. DESIGN Systematic Review and Meta-Analysis. The protocol was registered on PROSPERO registration number CRD42019139884. DATA SOURCES PubMed, EMBASE, Cochrane library, Web of Science, and Scopus between January 2010 and August 2019. Study Selection and Appraisal: Randomized control trials of digital health-led DSMES for Type 1 (T1DM) or 2 (T2DM) diabetes compared to usual care were included. Outcomes were change in HbA1c, diabetes knowledge, and HrQoL. Cochrane Risk of Bias 2.0 tool was used to assess bias and GRADEpro for overall quality. The analysis involved narrative synthesis, subgroup and pooled meta-analyses. RESULTS From 4286 articles, 39 studies (6861 participants) were included. Mean age was 51.62 years, range (13-70). Meta-analysis revealed intervention effects on HbA1c for T2DM with difference in means (MD) from baseline -0.480% (-0.661, -0.299), I275% (6 months), -0.457% (-0.761, -0.151), I2 81% (12 months), and for T1DM -0.41% (-1.022, 0.208) I2 83% (6 months), -0.03% (-0.210, 0.142) I2 0% (12 months). Few reported HrQoL with Hedges' g 0.183 (-0.039, 0.405), I2 0% (6 months), 0.153 (-0.060, 0.366), I2 0% (12 months) and diabetes knowledge with Hedges' g 1.003 (0.068, 1.938), I2 87% (3 months). CONCLUSION Digital health-led DSMES are effective in improving HbA1c and diabetes knowledge, notably for T2DM. Research shows non-significant changes in HrQoL. Intervention effect on HbA1c was more impressive if delivered through mobile apps or patient portals. Further research is needed on the impact of DSMES on these outcomes, especially for newly diagnosed diabetes patients.
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Affiliation(s)
- Dumisani Enricho Nkhoma
- Master Program in Global Health and Development Department, College of Public Health, Taipei Medical University, Taipei City, Taiwan; Nkhata Bay District Hospital, Nkhata Bay District Health Office, Nkhata Bay, Mkondezi, Malawi
| | - Charles Jenya Soko
- Master Program in Global Health and Development Department, College of Public Health, Taipei Medical University, Taipei City, Taiwan
| | - Pierre Bowrin
- PhD Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei City, Taiwan
| | - Yankuba B Manga
- Graduate Institute of Biomedical Materials and Tissue Engineering and School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei City, Taiwan
| | - David Greenfield
- The Simpson Centre for Health Services Research, South Western Sydney Clinical School, The University of New South Wales (UNSW) Medicine, Sydney, Australia
| | - Mowafa Househ
- College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
| | - Yu-Chuan Li Jack
- International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei City, Taiwan; Graduate Insitute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei City, Taiwan; Dermatology Department, Wan-Fang Hospital, Taipei City, Taiwan; International Medical Informatics Association (IMIA), Switzerland
| | - Usman Iqbal
- Master Program in Global Health and Development Department, College of Public Health, Taipei Medical University, Taipei City, Taiwan; PhD Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei City, Taiwan; International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei City, Taiwan.
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10
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Stamler LL, Hanna KM, Kupzyk KA, DeSouza C. Testing the Psychometric Characteristics of the Revised Mastery of Stress Instrument in Adults With Type 2 Diabetes. J Nurs Meas 2021; 30:518-529. [PMID: 34518394 DOI: 10.1891/jnm-d-20-00137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE A promising, yet lengthy measure to identify mastery of patient-identified stress is Younger's (1991, 1993) Mastery of Stress Instrument (MSI). With a goal for a parsimonious and valid measure, this study determined the psychometric properties of a reduced item instrument with adults diagnosed with type 2 diabetes. METHODS First, an expert content analysis was completed. Second, item and confirmatory factor analysis were completed with a sample of 200 adults with a diagnosis of type 2 diabetes. RESULTS Eight items were removed through content validity and seven items were removed with Item analysis. Factor analysis supported Younger's four sub-concepts. CONCLUSIONS Future research with this revised MSI scale is advocated to identify those who may need strategies to increase their mastery of stress.
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Simonsmeier BA, Flaig M, Simacek T, Schneider M. What sixty years of research says about the effectiveness of patient education on health: a second order meta-analysis. Health Psychol Rev 2021; 16:450-474. [PMID: 34384337 DOI: 10.1080/17437199.2021.1967184] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Although meta-analyses have examined the association between patient education and health, the validity and quality of this evidence have not been comprehensively assessed. This second order meta-analysis combined previous meta-analyses that examined the effectiveness of patient education on health outcomes as an overall weighted grand mean d¯¯. Further, measures of methodological quality, meaningful variability across first order meta-analyses, and evidence for publication bias were examined. Forty meta-analyses were identified, investigating 156 associations between patient education and health summarizing data from over 776 studies including more than 74.947 patients. Quantitative analyses showed that patient education positively affects health outcomes with d¯¯ = 0.316 (95% CI [0.304, 0.329]). Summarizing data exclusively from randomized controlled trials indicated a causal effect. Patient education was effective for patients with neoplasms, diabetes, mental and behavioral disorders, diseases of the circulatory system, the respiratory system, and the musculoskeletal system. Patient education was effective in the reduction of medication use, pain, and visits to medical facilities, and significantly improved physiological, physical, psychological outcomes, and patients' general function. Overall, the findings reveal firm evidence for the effectiveness of patient education on health outcomes. However, theory-based interventions are lacking and need to be implemented to enable a successful transfer from theory to practice.
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Affiliation(s)
| | - Maja Flaig
- University of Tübingen, Tübingen, Germany
| | - Thomas Simacek
- Department of Educational Psychology, University of Trier, Trier, Germany
| | - Michael Schneider
- Department of Educational Psychology, University of Trier, Trier, Germany
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12
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Irony A, Magnezi R, Vilensky Sela Y. Self-Efficacy Effects of Maccabi Telcare Center Diabetes Mellitus Intervention: Do Men and Women Benefit Equally? Res Theory Nurs Pract 2021; 35:RTNP-D-20-00083. [PMID: 34162759 DOI: 10.1891/rtnp-d-20-00083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE A growing body of evidence points to physiological and psychological gender differences in the manifestation and treatment of type 2 diabetes mellitus. This study is part of a large-scale, prospective trial investigating the effects of Maccabi Telecare Center (MTC) interventions on self-efficacy. Here, we focus on the effects of gender on diabetes self-efficacy related to depressive symptom severity and illness representation. METHODS A prospective open-label study investigating the effect of tele-based intervention on diabetes self-efficacy. Participants completed the following questionnaires: Diabetes Management Self-Efficacy Scale (DMSES) (self-efficacy), Patient Health Questionnaire 9 (PHQ-9) (depression), and Illness Perception Questionnaire-Revised (IPQ-R) (illness representation). Data were collected at three time points: Baseline (T1), 3-4 months (T2), and 8-9 months (T3). RESULTS Although men and women exhibited similar baseline self-efficacy levels, men scored significantly higher than women over time, at T2 (p < .05) and T3 (p < .05). Consistent gender differences were observed throughout the study in depression and illness representations: women scored higher than men on PHQ-9 (3.94 vs. 5.57, p < .001), and perceived their diabetes consequences as more severe than men (p < .001). A linear regression analyses indicated that MTC intervention, age, baseline self-efficacy, and depression at T3 explained 39.8% of the variance of selfefficacy at the conclusion of the study for both genders, although more strongly for men. IMPLICATIONS FOR PRACTICE This study indicates that the effects of a treatment intervention for individuals with type 2 diabetes mellitus are gender specific. Thus, gender-tailored interventions may be advised to further improve outcomes for women with type 2 diabetes mellitus.
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Affiliation(s)
- Angela Irony
- Chief Nursing & Medical Centers Officer, Maccabi HealthCare Services Israel, Tel Aviv, Israel
| | - Racheli Magnezi
- Head of Public Health and Health Systems Management Program, Bar-Ilan University, Ramat Gan, Israel
| | - Yael Vilensky Sela
- Department of Nursing, Faculty of Social and Community Science, Ruppin Academic Center, Emek-Hefer, Israel
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Shin SH, Kim MJ, Moon HJ, Lee EH. Development and Effectiveness of a Patient Safety Education Program for Inpatients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3262. [PMID: 33809882 PMCID: PMC8004212 DOI: 10.3390/ijerph18063262] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/12/2021] [Accepted: 03/17/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Patient safety is considered an important issue in the field of healthcare, and most advanced countries. PURPOSE This study was designed to evaluate a patient safety education program among hospitalized patients. Of the 69 participants, 33 completed the patient safety education program while the 36 remaining participants were given educational booklets. The program was used to measure knowledge about patient safety, patient safety perception, and willingness to participate in patient safety. METHODS Patient safety education was developed by the analysis-design-development-implementation-evaluation model considering expert advice, patient needs, and an extensive literature review. Data were collected from 20 July to 13 November 2020. Data were analyzed using SPSS statistical program. The effectiveness of the experimental and control groups before and after education was analyzed using paired t-tests, and the difference in the amount of increase in the measured variables for each group was analyzed using independent t-tests. RESULTS The experimental group had significantly higher patient safety scores (t = 2.52, p = 0.014) and patient safety perception (t = 2.09, p = 0.040) than those of the control group. However, there was no significant difference between the two groups regarding the willingness to participate in patient safety. CONCLUSION The patient safety education program developed using mobile tablet PCs could be an effective tool to enhance patient involvement in preventing events that may threaten the safety of patients. Further studies are recommended to develop a variety of educational interventions to increase patient safety knowledge and perceptions of patients and caregivers.
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Affiliation(s)
- Sun Hwa Shin
- College of Nursing, Sahmyook University, Seoul 01795, Korea;
| | - Mi Jung Kim
- Sahmyook Medical Center, Seoul 02500, Korea; (M.J.K.); (H.J.M.)
| | - Ho Jin Moon
- Sahmyook Medical Center, Seoul 02500, Korea; (M.J.K.); (H.J.M.)
| | - Eun Hye Lee
- College of Nursing, Sahmyook University, Seoul 01795, Korea;
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Physical Activity as Part of an Intramural Health Promotion Programme for People with and without Chronic Diseases. A New Tool in Health Care Run by a Public Social Health Insurance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207491. [PMID: 33076243 PMCID: PMC7602375 DOI: 10.3390/ijerph17207491] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/13/2020] [Accepted: 10/13/2020] [Indexed: 12/26/2022]
Abstract
Background: Regular physical activity is a corner stone for healthy living, and preventing the onset or progression of diseases. The Social Insurance Fund for Public Service, Railway and Mining Industries is building an intramural health promotion facility in Austria with the aim to provide a comprehensive evidence-based health promotion programme for their insured. The target group are all people who, regardless of their health status and the presence of diseases, are ready to make their lifestyle more health-oriented. The health promotion facility offers health promotion measures in five areas: promoting physical training, optimizing nutritional patterns, managing everyday stress, increasing social capital, and improving health literacy. The focus is on increasing resources and on overcoming barriers. Depending on age, previous illnesses, range of motion, stress level, body weight and personal aims and expectations, the measures are individually tailored. The stay is divided into a two-week initial stay and a follow-up week. A comprehensive scientific evaluation concept of all measures and the entire stay is an integral part of the design. Conclusion: This project combines the advantages of comprehensive active health promotion, and an intramural stay. It is a pioneering social insurance project for sustainable health promotion and integrated care.
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Greenwood DA, Howell F, Scher L, Yousef G, Rinker J, Yehl K, Isaacs D, Peeples MM. A Framework for Optimizing Technology-Enabled Diabetes and Cardiometabolic Care and Education: The Role of the Diabetes Care and Education Specialist. DIABETES EDUCATOR 2020; 46:315-322. [DOI: 10.1177/0145721720935125] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PurposeThe purpose of this article is to present a framework for optimizing technology-enabled diabetes and cardiometabolic care and education using a standardized approach. This approach leverages the expertise of the diabetes care and education specialist, the multiplicity of technologies, and integration with the care team. Technology can offer increased opportunity to improve health outcomes while also offering conveniences for people with diabetes and cardiometabolic conditions. The adoption and acceptance of technology is crucial to recognize the full potential for improving care. Understanding and incorporating the perceptions and behaviors associated with technology use can prevent a fragmented health care experience.ConclusionDiabetes care and education specialists (DCES) have a history of utilizing technology and data to deliver care and education when managing chronic conditions. With this unique skill set, DCES are strategically positioned to provide leadership to develop and deliver technology-enabled diabetes and cardiometabolic health services in the rapidly changing healthcare environment.
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Affiliation(s)
| | - Fran Howell
- CeQur Corporation, Marlborough, Massachusetts, USA
| | | | - Gretchen Yousef
- MedStar Health Diabetes Institute, Washington, District of Columbia, USA
| | - Joanne Rinker
- Association of Diabetes Care & Education Specialists, Chicago, Illinois, USA
| | - Kirsten Yehl
- Association of Diabetes Care & Education Specialists, Chicago, Illinois, USA
| | - Diana Isaacs
- Cleveland Clinic Diabetes Center, Cleveland, Ohio, USA
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Woolley AK, Chudasama Y, Seidu SI, Gillies C, Schreder S, Davies MJ, Khunti K. Influence of sociodemographic characteristics on the preferred format of health education delivery in individuals with type 2 diabetes mellitus and or cardiovascular disease: a questionnaire study. Diabet Med 2020; 37:982-990. [PMID: 32096573 DOI: 10.1111/dme.14275] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/22/2020] [Indexed: 12/27/2022]
Abstract
AIM To examine the influence of sociodemographic factors of interest on preference for a particular health education format among people with type 2 diabetes and/or cardiovascular disease. METHODS A questionnaire was used to collect information on the influence of six sociodemographic factors of interest on the preference for health education formats in people with type 2 diabetes and/or cardiovascular disease. Chi-squared tests were used to examine the distribution of preferences between groups. The characteristics of the population preferring the online format were then examined in more detail using logistic regression. RESULTS Responses were received from 1559 participants. Overall the preferred health education format was one-to-one learning from a doctor or nurse (67%). Age, gender, diagnosis and educational level all affected the preferences expressed. The characteristics showing most consistent and significant influence were age and educational level. Overall, 29% ranked the online format highly (scores 1 or 2). This group were more likely to be aged < 65 years (P < 0.001) and to have a higher level of educational attainment (upper secondary education or higher; P < 0.001). CONCLUSIONS Significant differences between sociodemographic groups exist in preferences for health education formats among people with type 2 diabetes and/or cardiovascular disease. Preferences should be considered when designing educational interventions to ensure they are accessible to the target group and to avoid increases in health inequality.
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Affiliation(s)
- A K Woolley
- Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
| | - Y Chudasama
- Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
| | - S I Seidu
- Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
| | - C Gillies
- Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
| | - S Schreder
- Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
| | - M J Davies
- Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
| | - K Khunti
- Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
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Hadjiconstantinou M, Schreder S, Brough C, Northern A, Stribling B, Khunti K, Davies MJ. Using Intervention Mapping to Develop a Digital Self-Management Program for People With Type 2 Diabetes: Tutorial on MyDESMOND. J Med Internet Res 2020; 22:e17316. [PMID: 32391797 PMCID: PMC7248797 DOI: 10.2196/17316] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/31/2020] [Accepted: 02/07/2020] [Indexed: 01/20/2023] Open
Abstract
Digital health interventions (DHIs) are increasingly becoming integrated into diabetes self-management to improve behavior. Despite DHIs becoming available to people with chronic conditions, the development strategies and processes undertaken are often not well described. With theoretical frameworks available in current literature, it is vital that DHIs follow a shared language and communicate a robust development process in a comprehensive way. This paper aims to bring a unique perspective to digital development, as it describes the systematic process of developing a digital self-management program for people with type 2 diabetes, MyDESMOND. We provide a step-by-step guide, based on the intervention mapping (IM) framework to illustrate the process of adapting an existing face-to-face self-management program (diabetes education and self- management for ongoing and newly diagnosed, DESMOND) and translating it to a digital platform (MyDESMOND). Overall, this paper describes the 4 IM steps that were followed to develop MyDESMOND—step 1 to establish a planning group and a patient and public involvement group to describe the context of the intervention and program goals, step 2 to identify objectives and determinants at early design stages to maintain a focus on the strategies adopted, step 3 to generate the program components underpinned by appropriate psychological theories and models, and step 4 to develop the program content and describe the iterative process of refining the content and format of the digital program for implementation. This paper concludes with a number of key learnings collated throughout our development process, which we hope other researchers may find useful when developing DHIs for chronic conditions.
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Affiliation(s)
| | - Sally Schreder
- Leicester Diabetes Centre, NHS Trust, University Hospitals of Leicester, Leicester, United Kingdom
| | - Christopher Brough
- Leicester Diabetes Centre, NHS Trust, University Hospitals of Leicester, Leicester, United Kingdom
| | - Alison Northern
- Leicester Diabetes Centre, NHS Trust, University Hospitals of Leicester, Leicester, United Kingdom
| | - Bernie Stribling
- Leicester Diabetes Centre, NHS Trust, University Hospitals of Leicester, Leicester, United Kingdom
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, United Kingdom
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, United Kingdom
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da Rocha RB, Silva CS, Cardoso VS. Self-Care in Adults with Type 2 Diabetes Mellitus: A Systematic Review. Curr Diabetes Rev 2020; 16:598-607. [PMID: 31267873 DOI: 10.2174/1573399815666190702161849] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/17/2019] [Accepted: 06/20/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Self-care is essential for the prevention of complications in patients with diabetes, but several authors report that even with health education programs, the incidence of complications in patients with diabetes continues to increase. OBJECTIVE We aimed to examine adherence to self-care strategies and the repercussions of adherence on the clinical profiles of individuals with type 2 diabetes. METHODS We performed a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. We searched for related studies in 4 databases: PubMed, Web of Science, Scopus, and Latin American and Caribbean Health Science Literature (LILACS). We included observational studies in English and Portuguese that evaluated the effects of selfcare in individuals with type 2 diabetes. RESULTS The search resulted in the identification of 615 articles, of which 34 met all the inclusion criteria. General self-care was considered unsatisfactory. Physical exercise was classified as the self-care activity that was performed less frequently by individuals with type 2 diabetes mellitus; adherence to medication was the most frequent behavior among volunteers. CONCLUSION The studies indicated poor adherence of the population to good self-care practices, reflected by the increase in complications related to DM.
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Affiliation(s)
- Rebeca Barbosa da Rocha
- Center of Medical Specialties, Parnaíba, Piauí, Brazil
- Biosignal Laboratory, Parnaíba, Piauí, Brazil
| | - Cristiano Sales Silva
- Center of Medical Specialties, Parnaíba, Piauí, Brazil
- Biosignal Laboratory, Parnaíba, Piauí, Brazil
- School of Physical Therapy, Federal University of Piauí, Parnaíba, Piauí, Brazil
| | - Vinícius Saura Cardoso
- Center of Medical Specialties, Parnaíba, Piauí, Brazil
- Biosignal Laboratory, Parnaíba, Piauí, Brazil
- School of Physical Therapy, Federal University of Piauí, Parnaíba, Piauí, Brazil
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