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Ahmann E. Health and Wellness Coaching and Sustained Gains: A Rapid Systematic Review. Am J Lifestyle Med 2024; 18:162-180. [PMID: 38559782 PMCID: PMC10979731 DOI: 10.1177/15598276231180117] [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: 04/04/2024] Open
Abstract
The Transtheoretical Model of Change identifies key stages in behavior change, including a maintenance stage occurring when a behavior has been upheld for at least 6 months. Health and wellness coaching has demonstrated support for health behavior change, but maintenance of gains has received little attention. Our rapid systematic literature review characterizes both the research exploring sustained gains with health and wellness coaching and what is known about sustained gains after the completion of a health and wellness coaching engagement. Guided by The Cochrane Rapid Reviews Methods Group "Interim Guidance," we drew 231 studies from the 2018 and 2020 Sforzo et al "Compendium of the health and wellness coaching literature," and "Addendum…" appendices. Initial screening and coding for inclusion and exclusion criteria yielded 28 studies for data extraction. We examined studies across outcome categories (physiological, behavioral, psychological, and health risk assessment) to determine whether outcome measures were: not sustained; partially sustained; fully sustained; or improved from immediate post-intervention to a later follow-up period. Twenty-five of the 28 studies reviewed demonstrated partially, or fully, sustained or improved outcomes in one or more variables studied, with sustained gains demonstrated across outcome categories, strengthening confidence in HWC as a facilitator of lasting change.
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Affiliation(s)
- Elizabeth Ahmann
- Maryland University of Integrative Health, Laurel, MD, USA & Springer Institute, Cheverly, MD, USA
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Albrechtsen TL, Toft U, Benthien KS. Action plans in telephone-based self-management support among patients at risk of hospitalization - A process evaluation of the Danish RCT Proactive Health Support (PaHS). PATIENT EDUCATION AND COUNSELING 2024; 120:108094. [PMID: 38101089 DOI: 10.1016/j.pec.2023.108094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/26/2023] [Accepted: 11/29/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE Self-management support (SMS) aims to improve management of chronic diseases. While SMS core components are frequently documented, person-centered action plans and goal achievement is unknown. The aim of this study was to explore predictors of goal achievement in action plans during the Proactive Health Support study (PaHS). METHOD PaHS is a Danish randomized controlled trial of telephone-based SMS for patients at risk of hospitalization. The present study includes the trial intervention group with completed action plans as part of the trial process evaluation. The association between baseline characteristics of action plans and subsequent goal achievement were analyzed with logistic regression. RESULTS In this study, 1400 participants with a total of 2363 action plans were included. The results show higher goal achievement when the patients' goals were related to management of disease and treatment compared to health behavior. Furthermore, a stronger feeling of empowerment was associated with subsequent goal achievement. CONCLUSION Goal achievement in PaHS was generally high. The probability of goal achievement was highest with goals related to disease management, everyday-life management, and treatment. Higher baseline empowerment was associated with increased goal achievement. PRACTICE IMPLICATIONS SMS should focus on treatment management and patients with lower levels of active engagement and motivation.
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Affiliation(s)
- Tannie Lund Albrechtsen
- Department of Anesthesia and Intensive Care, Copenhagen University Hospital - Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark; Center for Clinical Research and Prevention, Copenhagen University Hospital, Frederiksberg, Denmark.
| | - Ulla Toft
- Center for Clinical Research and Prevention, Copenhagen University Hospital, Frederiksberg, Denmark
| | - Kirstine Skov Benthien
- Center for Clinical Research and Prevention, Copenhagen University Hospital, Frederiksberg, Denmark; Palliative Care Unit, Copenhagen University Hospital, Hvidovre, Denmark
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Mulyana AM, Rakhmawati W, Wartakusumah R, Fitri SYR, Juniarti N. The Efficacy of Internet-Based Interventions in Family-Centered Empowerment Among Children with Chronic Diseases: A Mixed-Methods Systematic Review. J Multidiscip Healthc 2023; 16:3415-3433. [PMID: 37964797 PMCID: PMC10642539 DOI: 10.2147/jmdh.s440082] [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: 09/13/2023] [Accepted: 11/03/2023] [Indexed: 11/16/2023] Open
Abstract
Background The incidence of chronic diseases in children is increasing worldwide, which can disrupt the quality of life. Family empowerment (FE) is one approach to strengthen family care among children with chronic diseases. In addition, internet has the potential in healthcare service interventions for families. Purpose This study aimed to determine the efficacy of internet-based family empowerment interventions among children with chronic diseases. Methods The study used a mixed-methods systematic review. A literature review was conducted following PRISMA guidelines using the PubMed, Scopus, ScienceDirect, and CINAHL databases. We used the PCC framework: chronic diseases (Population), family empowerment (Concept), and internet-based intervention (Context). Studies were eligible if published between 2013 and 2023, full-text, original study design, and focused on family empowerment in children with chronic diseases. Studies would be excluded if they were not in English or if the population was adults. The quality of the studies was assessed using the Mixed Methods Appraisal Tool (MMAT) version 2018. The study analysis used Sequential Explanatory Synthesis, which is a quantitative study (QUAN) synthesis followed by a qualitative study (QUAL) synthesis, then integrated using the QUAL data transformation technique. Results We highlight the quantitative study findings that an internet-based family empowerment intervention positively impacted family members' ability to care for children with chronic diseases with a mean Family Empowerment Scale (FES) total score of 4.13. We analyzed six study and identified four themes regarding efficacy of internet-based interventions in empowering families with children with chronic diseases: knowledge; availability of resources and time-saving; connectedness and communication; and family management and self-confidence. Conclusion Our study highlights that online-based interventions in family empowerment positively impact enhancing all domains of empowerment. This findings suggest that internet-based family interventions need to be adopted to fulfill the care needs of children with chronic diseases sustainably.
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Affiliation(s)
- Aep Maulid Mulyana
- Nursing Internship Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
| | - Windy Rakhmawati
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
| | - Riki Wartakusumah
- Departement of Nursing Science, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada, Sleman, Yogyakarta, 55284, Indonesia
| | - Siti Yuyun Rahayu Fitri
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
| | - Neti Juniarti
- Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
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Herbert J, Schumacher T, Brown LJ, Clarke ED, Collins CE. Delivery of telehealth nutrition and physical activity interventions to adults living in rural areas: a scoping review. Int J Behav Nutr Phys Act 2023; 20:110. [PMID: 37715234 PMCID: PMC10504780 DOI: 10.1186/s12966-023-01505-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/20/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Lifestyle behaviours related to smoking, alcohol, nutrition, and physical activity are leading risk factors for the development of chronic disease. For people in rural areas, access to individualised lifestyle services targeting behaviour change may be improved by using telehealth. However, the scope of literature investigating telehealth lifestyle behaviour change interventions for rural populations is unknown, making it difficult to ascertain whether telehealth interventions require adaptation for rural context via a systematic review. This scoping review aimed to address this gap, by mapping existing literature describing telehealth lifestyle interventions delivered to rural populations to determine if there is scope for systematic review of intervention effectiveness in this research topic. METHODS The PRISMA extension for scoping review checklist guided the processes of this scoping review. A search of eight electronic databases reported in English language until June 2023 was conducted. Eligible studies included adults (18 years and over), who lived in rural areas of high-income countries and undertook at least one synchronous (video or phone consultation) telehealth intervention that addressed either addictive (smoking or alcohol), or non-addictive lifestyle behaviours (nutrition or physical activity). Studies targeting addictive and non-addictive behaviours were separated after full text screening to account for the involvement of addictive substances in smoking and alcohol studies that may impact behaviour change interventions described. Studies targeting nutrition and/or physical activity interventions are presented here. RESULTS The search strategy identified 17179 citations across eight databases, with 7440 unique citations once duplicates were removed. Full texts for 492 citations were retrieved and screened for inclusion with 85 publications reporting on 73 studies eligible for data extraction and analysis. Of this, addictive behaviours were comprised of 15 publications from 13 studies. Non-addictive behaviours included 70 publications from 58 studies and are reported here. Most interventions were delivered within the United States of America (n = 43, 74.1%). The most common study design reported was Randomised Control Trial (n = 27, 46.6%). Included studies involved synchronous telehealth interventions targeting nutrition (11, 18.9%), physical activity (5, 8.6%) or nutrition and physical activity (41, 70.7%) and were delivered predominately via videoconference (n = 17, 29.3%). CONCLUSIONS Despite differences in intervention characteristics, the number of randomised control trials published suggests sufficient scope for future systematic reviews to determine intervention effectiveness related to nutrition and physical activity telehealth interventions for rural populations. TRIAL REGISTRATION The scoping review protocol was not pre-registered.
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Affiliation(s)
- Jaimee Herbert
- School of Health Sciences (Nutrition and Dietetics), Department of Rural Health, University of Newcastle, 114/148 Johnston St, North Tamworth, NSW, 2340, Australia
| | - Tracy Schumacher
- School of Health Sciences (Nutrition and Dietetics), Department of Rural Health, University of Newcastle, 114/148 Johnston St, North Tamworth, NSW, 2340, Australia
| | - Leanne J Brown
- School of Health Sciences (Nutrition and Dietetics), Department of Rural Health, University of Newcastle, 114/148 Johnston St, North Tamworth, NSW, 2340, Australia
| | - Erin D Clarke
- School of Health Sciences (Nutrition and Dietetics), University of Newcastle, ATC 205, ATC Building, University Drive Callaghan, Newcastle, NSW, 2308, Australia
| | - Clare E Collins
- School of Health Sciences (Nutrition and Dietetics), University of Newcastle, ATC 310, ATC Building, University Drive Callaghan, Newcastle, NSW, 2308, Australia.
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Hurmuz MZM, Jansen-Kosterink SM, van Velsen L. How to Prevent the Drop-Out: Understanding Why Adults Participate in Summative eHealth Evaluations. JOURNAL OF HEALTHCARE INFORMATICS RESEARCH 2023; 7:125-140. [PMID: 36910916 PMCID: PMC9995638 DOI: 10.1007/s41666-023-00131-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 03/07/2023]
Abstract
The aim of this study was to investigate why adults participate in summative eHealth evaluations, and whether their reasons for participating affect their (non-)use of eHealth. A questionnaire was distributed among adults (aged ≥ 18 years) who participated in a summative eHealth evaluation. This questionnaire focused on participants' reason to enroll, their expectations, and on whether the study met their expectations. Answers to open-ended questions were coded by two researchers independently. With the generalized estimating equations method we tested whether there is a difference between the type of reasons in use of the eHealth service. One hundred and thirty-one adults participated (64.9% female; mean age 62.5 years (SD = 10.5)). Their reasons for participating were mainly health-related (e.g., being more active). Between two types of motivations there was a difference in the use of the eHealth service: Participants with an intellectual motivation were more likely to drop out, compared to participants with an altruistic motivation. The most prevalent expectations when joining a summative eHealth evaluation were health-related (like expecting to improve one's health). 38.6% of the participants said their expectation was fulfilled by the study. In conclusion, We encourage eHealth evaluators to learn about adults' motivation to participate in their summative evaluation, as this motivation is very likely to affect their results. Including altruistically motivated participants biases the results by their tendency to continue participating in a study.
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Affiliation(s)
- Marian Z M Hurmuz
- Roessingh Research and Development, Roessinghsbleekweg 33B, 7522 AH Enschede, The Netherlands.,Biomedical Signal and Systems Group, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands
| | - Stephanie M Jansen-Kosterink
- Roessingh Research and Development, Roessinghsbleekweg 33B, 7522 AH Enschede, The Netherlands.,Biomedical Signal and Systems Group, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands
| | - Lex van Velsen
- Roessingh Research and Development, Roessinghsbleekweg 33B, 7522 AH Enschede, The Netherlands.,Biomedical Signal and Systems Group, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands
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Bilgin A, Muz G, Yuce GE. The effect of motivational interviewing on metabolic control and psychosocial variables in individuals diagnosed with diabetes: Systematic review and meta-analysis. PATIENT EDUCATION AND COUNSELING 2022; 105:2806-2823. [PMID: 35501227 DOI: 10.1016/j.pec.2022.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 04/03/2022] [Accepted: 04/12/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The current study aimed to analyze the effects of motivational interviewing (MI) on metabolic and psychosocial variables among individuals with diabetes. METHODS Four databases were searched between 2000 and 2021 years. Randomized controlled studies were included. The standardized mean differences were determined. The heterogeneity was analyzed using the I2 test. The methodological quality was evaluated independently by three researchers. RESULTS This meta-analysis included 16 studies. Glycated hemoglobin, postprandial plasma glucose (PG), systolic blood pressure (BP) significantly decreased after MI. There are no significant effects of MI on fasting PG, body mass index, diastolic BP, total cholesterol, high-density lipoprotein, low-density lipoprotein and triglyceride. MI had an overall significant impact on depression, emotional distress, and self-efficacy. Only four studies had 7 points based on the Modified Jadad Scale. The Egger's test showed no evidence of publication bias. CONCLUSION MI effectively reduced glycated hemoglobin, postprandial plasma glucose, systolic blood pressure, depressive symptoms, emotional distress, and increased self-efficacy. PRACTICE IMPLICATIONS This meta-analysis showed that MI was effective at improving metabolic control and psychosocial variables. MI should be considered a complementary treatment for people diagnosed with diabetes. Future studies should be structured as long-term studies with higher methodological quality.
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Affiliation(s)
- Aylin Bilgin
- Hacettepe University, Faculty of Nursing, Internal Medicine Nursing Department, Ankara, Turkey
| | - Gamze Muz
- Nevsehir Haci Bektas Veli University, Department of Internal Medicine Nursing, Nevsehir, Turkey.
| | - Gulyeter Erdogan Yuce
- Aksaray University, Department of Emergency Assistance and Disaster Management, Aksaray, Turkey
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Baricchi M, Vellone E, Caruso R, Arrigoni C, Dellafiore F, Ghizzardi G, Pedroni C, Pucciarelli G, Alvaro R, Iovino P. Technology-Delivered Motivational Interviewing to Improve Health Outcomes in Patients with Chronic Conditions. A Systematic Review of the Literature. Eur J Cardiovasc Nurs 2022; 22:227-235. [PMID: 35943381 DOI: 10.1093/eurjcn/zvac071] [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: 02/08/2022] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 11/15/2022]
Abstract
AIM Provide an overview of remote Motivational Interviewing (MI) interventions for chronically-ill patients, and understand their degree of effectiveness on different health outcomes. METHODS AND RESULTS A systematic review with meta-analysis was conducted using the following databases: PubMed, CINAHL, PsychInfo, and Web of Science. Eligibility criteria included studies that administered remote MI alone or in combination with other remote approaches. A narrative synthesis and two meta-analyses were performed. Fifteen studies met the inclusion criteria. MI administration almost exclusively occurred by telephone and individual sessions. Eight studies reported treatment fidelity aspects, and four declared adopting a theoretical framework. Most targeted outcomes were therapeutic adherence, physical activity, depression, quality of life, and mortality. Risk of bias varied markedly, with the largest source resulting from selection process and intervention performance. The two meta-analyses indicated a significant effect of MI on depression (Standardized Mean Difference = -0.20, 95%CI: -0.34, -0.05, Z = 2.73, p = 0.006, I2 = 0%), and no effect of MI on glycosylated hemoglobin (Mean Difference = -0.02, 95%CI: -0.48, 0.45), p = 0.94, I2 = 84%). CONCLUSION Remote MI can be a promising approach for improving depression in chronic disease patients. However, studies are inconclusive due to risks of bias, heterogeneity, and lack of reporting of interventionist's training, treatment fidelity, and theoretical frameworks' use. More studies with solid designs are needed to inform clinical decision-making and research.
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Harenberg S, Sforzo GA, Edman J. A Rubric to Assess the Design and Intervention Quality of Randomized Controlled Trials in Health and Wellness Coaching. Am J Lifestyle Med 2022. [DOI: 10.1177/15598276221117089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective To collect health and wellness coaching (HWC) literature related to treatment of obesity and Type 2 Diabetes (T2D) for systematic assessment using a novel rubric. Data Source Pubmed, CINAHL, and PsychInfo Study Inclusion and Exclusion Given 282 articles retrieved, only randomized and controlled trials meeting a HWC criteria-based definition were included; studies with intervention <4 months or <4 sessions were excluded. Data Extraction Rubric assessment required details of two theoretical frameworks (i.e., study design and HWC intervention design) be extracted from each included paper. Data Synthesis Data were derived from a 28-item rubric querying items such as sampling characteristics, statistical methods, coach characteristics, HWC strategy, and intervention fidelity. Results 29 articles were reviewed. Inter-rater rubric scoring yielded high intraclass correlation (r = .85). Rubric assessment of HWC literature resulted in moderate scores (56.7%), with study design scoring higher than intervention design; within intervention design, T2D studies scored higher than obesity. Conclusions A novel research design rubric is presented and successfully applied to assess HWC research related to treatment of obesity and T2D. Most studies reported beneficial clinical findings; however, rubric results revealed moderate scores for study and intervention design. Implications for future HWC research are discussed.
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Affiliation(s)
- Sebastian Harenberg
- Department of Human Kinetics, St Francis Xavier University, Antigonish, NS, Canada (SH); Exercise & Sport Sciences, Ithaca College, Ithaca, NY, USA (GAS); and Edman Wellness Services, Media, PA, USA (JE)
| | - Gary A. Sforzo
- Department of Human Kinetics, St Francis Xavier University, Antigonish, NS, Canada (SH); Exercise & Sport Sciences, Ithaca College, Ithaca, NY, USA (GAS); and Edman Wellness Services, Media, PA, USA (JE)
| | - Joel Edman
- Department of Human Kinetics, St Francis Xavier University, Antigonish, NS, Canada (SH); Exercise & Sport Sciences, Ithaca College, Ithaca, NY, USA (GAS); and Edman Wellness Services, Media, PA, USA (JE)
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Gohil S, Majd Z, Sheneman JC, Abughosh SM. Interventions to improve medication adherence in inflammatory bowel disease: A systematic review. PATIENT EDUCATION AND COUNSELING 2022; 105:1731-1742. [PMID: 34736829 DOI: 10.1016/j.pec.2021.10.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To summarize existing literature examining interventions to enhance medication adherence and their effectiveness in enhancing care for inflammatory bowel disease (IBD) patients. METHODS This review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. PubMed and Embase were searched for studies from June 2014 to Dec 2020. Only the studies published in English were included. RESULTS Our systematic literature search identified 488 published articles. Seventeen studies with a total of 7073 patients were included. Out of seventeen different interventions, five were classified as educational, eight as multicomponent, three as behavioral and one as cognitive behavioral. Adherence was measured using patient self-report, administrative/pharmacy claims data, and electronic monitoring devices/pill dispensing systems. Twelve out of seventeen interventions showed a statistically significant improvement in medication adherence including three educational, seven multicomponent, one behavioral and one cognitive behavioral intervention. CONCLUSIONS Multicomponent interventions demonstrated the greatest success in IBD patients in promoting medication adherence. Future research should focus on a multidisciplinary approach to design multicomponent interventions to optimize treatment adherence and enhance long-term clinical outcomes. PRACTICE IMPLICATIONS While stand-alone strategies have demonstrated effectiveness in improving adherence, better outcomes may be achieved by combining multiple strategies.
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Affiliation(s)
- Shrey Gohil
- Department of Pharmaceutical Health Outcomes and Policy, University of Houston, College of Pharmacy, Houston, TX, USA
| | - Zahra Majd
- Department of Pharmaceutical Health Outcomes and Policy, University of Houston, College of Pharmacy, Houston, TX, USA
| | | | - Susan M Abughosh
- Department of Pharmaceutical Health Outcomes and Policy, University of Houston, College of Pharmacy, Houston, TX, USA
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McDaniel CC, Kavookjian J, Whitley HP. Telehealth delivery of motivational interviewing for diabetes management: A systematic review of randomized controlled trials. PATIENT EDUCATION AND COUNSELING 2022; 105:805-820. [PMID: 34366228 PMCID: PMC8912910 DOI: 10.1016/j.pec.2021.07.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 07/15/2021] [Accepted: 07/22/2021] [Indexed: 05/09/2023]
Abstract
OBJECTIVES The objective of this systematic review was to explore and report the evidence and gaps in the literature for randomized controlled trials (RCTs) studying the effects of motivational interviewing (MI)-based telehealth interventions on outcomes among persons with diabetes (PWD) or prediabetes. METHODS Following a modified Cochrane approach, we searched Pubmed, CENTRAL, CINAHL, PsycINFO, and Clinicaltrials.gov. Included studies were RCTs published in English before March 25, 2021 evaluating MI-based telehealth on outcomes for adults with diabetes or prediabetes. RESULTS A total of 21 retained articles captured results for 6436 PWD. Among the most commonly investigated outcomes, 60% of articles documented A1C reductions (ranging from<1% to>3%), 56% documented systolic blood pressure reductions, 57% documented diabetes self-efficacy/empowerment improvements, and 40% documented physical activity improvements. Conversely, diastolic blood pressure, lipid panels, body mass index, depressive symptoms, and quality of life were frequently measured outcomes, where MI-based telehealth yielded minor effects (<30% of articles demonstrating improvements). CONCLUSIONS MI-based telehealth seems most effective for improving A1C, systolic blood pressure, diabetes self-efficacy, and physical activity behaviors. Variability in outcome assessment and intervention heterogeneity were key challenges impeding comparisons across retained articles. PRACTICE IMPLICATIONS MI-based telehealth interventions demonstrate promising results for improving outcomes in PWD.
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Affiliation(s)
- Cassidi C McDaniel
- Department of Health Outcomes Research and Policy, Auburn University Harrison School of Pharmacy, Auburn, AL, USA.
| | - Jan Kavookjian
- Department of Health Outcomes Research and Policy, Auburn University Harrison School of Pharmacy, Auburn, AL, USA
| | - Heather P Whitley
- Department of Pharmacy Practice, Auburn University Harrison School of Pharmacy, Auburn, AL, USA
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Stephen C, Halcomb E, Fernandez R, McInnes S, Batterham M, Zwar N. Nurse-led interventions to manage hypertension in general practice: A systematic review and meta-analysis. J Adv Nurs 2022; 78:1281-1293. [PMID: 35244944 DOI: 10.1111/jan.15159] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 01/08/2023]
Abstract
To evaluate the impact of general practice nurse-led interventions for blood pressure control and cardiovascular disease risk factor reduction in patients with hypertension. Systematic review and meta-analysis of randomized control trials. CINAHL, Medline and Scopus databases were searched to identify peer-reviewed studies published between 2000 and 2021. A systematic review of randomized control trials was conducted using a structured search strategy. The Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used to appraise study quality. Meta-analysis and narrative synthesis were performed to determine the effectiveness of the included interventions. Eleven trials comprising of 4454 participants were included in the review. Meta-analysis showed significant reductions in both systolic and diastolic blood pressure in trials with 6 months or less follow-up. Improvements were also demonstrated in reducing blood lipids, physical activity, general lifestyle measures and medication adherence. Evidence for dietary improvements and reduction in alcohol and smoking rates was inconclusive. Nurse-led interventions for patients with hypertension are heterogeneous in terms of the nature of the intervention and outcomes measured. However, nurse-led interventions in general practice demonstrate significant potential to improve blood pressure and support cardiovascular disease risk factor reduction. Future research should be directed towards elucidating the successful elements of these interventions, evaluating cost-effectiveness and exploring translation into usual care. This review provides evidence that nurses in general practice could enhance current hypertension management through nurse-led interventions.
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Affiliation(s)
- Catherine Stephen
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Illawarra Health & Medical Research Institute, Wollongong, New South Wales, Australia
| | - Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Illawarra Health & Medical Research Institute, Wollongong, New South Wales, Australia
| | - Ritin Fernandez
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Illawarra Health & Medical Research Institute, Wollongong, New South Wales, Australia.,Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, Sydney, New South Wales, Australia
| | - Susan McInnes
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Illawarra Health & Medical Research Institute, Wollongong, New South Wales, Australia
| | - Marijka Batterham
- Statistical Consulting Centre, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Nick Zwar
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia
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Aubeeluck E, Al-Arkee S, Finlay K, Jalal Z. The impact of pharmacy care and motivational interviewing on improving medication adherence in patients with cardiovascular diseases: A systematic review of randomised controlled trials. Int J Clin Pract 2021; 75:e14457. [PMID: 34105858 DOI: 10.1111/ijcp.14457] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 05/09/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is prevalent worldwide, and for many patients, non-adherence to medication remains a problem. Motivational interviewing is a behavioural, communication strategy used as an intervention aimed to improve health outcomes. AIMS This systematic review sought to investigate the effect of motivational interviewing delivered as part of pharmacy care on medication adherence, and the effect this has on clinical outcomes. These included systolic and diastolic blood pressure, haemoglobin A1C, lipid profiles and cardiovascular risk scores. METHOD A systematic review was conducted in six databases: PubMed Central UK, Cochrane Library, CINAHL (EBSCO), PsycINFO, EMBASE and MEDLINE from the inception of motivational interviewing in 1983 to November 2020. Randomised controlled trials (RCTs) that assessed motivational interviewing as part of pharmacy care interventions were selected. The Cochrane risk of bias tool was used to assess the risk of bias for each included study. This review was registered with PROSPERO (registration number CRD42020222954). RESULTS A total of eight RCTs met the inclusion criteria. Five out of eight studies demonstrated medication adherence significantly improved following motivational interviewing interventions. One study showed a significant improvement for systolic blood pressure change by 7.2 mmHg (95% CI 1.6-12.8 mmHg); this reduction was observed in patients whose baseline blood pressure was above their target blood pressure. No statistically significant effect was seen across other clinical outcomes. CONCLUSION Motivational interviewing could be an effective behavioural strategy to enhance medication adherence in patients with CVD. Although the evidence is promising thus far, further research is required to explore the impact of motivational interviewing on clinical outcomes as well as the feasibility of implementing motivational interviewing interventions within existing pharmacy care services.
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Affiliation(s)
- Eshanee Aubeeluck
- School of Pharmacy, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Shahd Al-Arkee
- School of Pharmacy, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Katherine Finlay
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Zahraa Jalal
- School of Pharmacy, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
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Bennett V, Southard ME, Monsen KA. Evaluation of Evidence-Based Interventions for the Nurse Coach Scope of Practice Within the Omaha System Guidelines Corpus. J Holist Nurs 2021; 40:219-226. [PMID: 34636677 DOI: 10.1177/08980101211045550] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to examine nurse coach scope of practice in relation to existing evidence-based guideline interventions using the Omaha System. The majority of interventions were within scope for nurse coach practice, and problem, category, and target terms showed differential nurse coach practice applicability across interventions. The Omaha System terminology was aligned with nurse coach practice in that both represent and employ comprehensive and holistic perspectives. This study provides a platform for multiple initiatives in nurse coach quality and documentation and provides a methodology for examining the Omaha System guidelines and interventions for other interprofessional roles.
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14
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Rosa WE, Levoy K, Battista V, Dahlin C, Thaxton C, Greer K. Using the Nurse Coaching Process to Support Bereaved Staff During the COVID-19 Crisis. J Hosp Palliat Nurs 2021; 23:403-405. [PMID: 34081631 PMCID: PMC8410627 DOI: 10.1097/njh.0000000000000773] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Nurses are confronting a number of negative mental health consequences owing to high burdens of grief during COVID-19. Despite increased vaccination efforts and lower hospitalization and mortality rates, the long-term effects of mass bereavement are certain to impact nurses for years to come. The nurse coaching process is an evidence-based strategy that nurse leaders can use to assist staff in mitigating negative mental health outcomes associated with bereavement. The End-of-Life Nursing Education Consortium brought together a team of palliative nursing experts early in the pandemic to create resources to support nurses across settings and promote nurse well-being. This article shares a timely resource for health systems and nursing administration that leverages the nurse coaching process to support bereaved staff in a safe and therapeutic environment.
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15
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Stan DL, Cutshall SM, Adams TF, Ghosh K, Clark MM, Wieneke KC, Kebede EB, Donelan Dunlap BJ, Ruddy KJ, Hazelton JK, Butts AM, Jenkins SM, Croghan IT, Bauer BA. Wellness Coaching: An Intervention to Increase Healthy Behavior in Breast Cancer Survivors. Clin J Oncol Nurs 2021; 24:305-315. [PMID: 32441691 DOI: 10.1188/20.cjon.305-315] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Regular physical activity after breast cancer diagnosis improves survival rates and quality of life (QOL). However, breast cancer survivors rarely meet guidelines for recommended levels of physical activity. Wellness coaching interventions (WCIs) have improved exercise and health behaviors in other patient populations. OBJECTIVES This study assessed the feasibility and effectiveness of WCIs for increasing physical activity in breast cancer survivors; secondary measures included changes in dietary habits, weight, and QOL. METHODS 20 obese or overweight breast cancer survivors who recently completed active breast cancer treatment were recruited into a single-arm, 12-week WCI pilot feasibility study. The intervention was comprised of one in-person wellness coaching visit followed by four telephone calls over 12 weeks and 12 weekly emails containing wellness recommendations. FINDINGS Significant improvements from pre- to postintervention were seen in physical activity level, dietary habits, and in some aspects of QOL. Forty percent of participants achieved the 3% postintervention weight-loss goal, but this was not sustained at 30 weeks.
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16
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Challenges of conducting a remote behavioral weight loss study: Lessons learned and a practical guide. Contemp Clin Trials 2021; 108:106522. [PMID: 34352387 DOI: 10.1016/j.cct.2021.106522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 07/26/2021] [Accepted: 07/29/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To describe challenges and lessons learned in conducting a remote behavioral weight loss trial. METHODS The Personal Diet Study is an ongoing randomized clinical trial which aims to compare two mobile health (mHealth) weight loss approaches, standardized diet vs. personalized feedback, on glycemic response. Over a six-month period, participants attended dietitian-led group meetings via remote videoconferencing and were encouraged to self-monitor dietary intake using a smartphone app. Descriptive statistics were used to report adherence to counseling sessions and self-monitoring. Challenges were tracked during weekly project meetings. RESULTS Challenges in connecting to and engaging in the videoconferencing sessions were noted. To address these issues, we provided a step-by-step user manual and video tutorials regarding use of WebEx, encouraged alternative means to join sessions, and sent reminder emails/texts about the WebEx sessions and asking participants to join sessions early. Self-monitoring app-related issue included inability to find specific foods in the app database. To overcome this, the study team incorporated commonly consumed foods as "favorites" in the app database, provided a manual and video tutorials regarding use of the app and checked the self-monitoring app dashboard weekly to identify nonadherent participants and intervened as appropriate. Among 135 participants included in the analysis, the median attendance rate for the 14 remote sessions was 85.7% (IQR: 64.3%-92.9%). CONCLUSIONS Experience and lessons shared in this report may provide critical and timely guidance to other behavioral researchers and interventionists seeking to adapt behavioral counseling programs for remote delivery in the age of COVID-19.
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17
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Chan CB, Popeski N, Hassanabad MF, Sigal RJ, O'Connell P, Sargious P. Use of Virtual Care for Glycemic Management in People With Types 1 and 2 Diabetes and Diabetes in Pregnancy: A Rapid Review. Can J Diabetes 2021; 45:677-688.e2. [PMID: 34045146 DOI: 10.1016/j.jcjd.2021.02.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/18/2021] [Accepted: 02/28/2021] [Indexed: 11/26/2022]
Abstract
Our objective in this study was to answer the main research question: In patients with diabetes, does virtual care vs face-to-face care provide different clinical, patient and practitioner experience or quality outcomes? Articles (2012 to 2020) describing interventions using virtual care with the capability for 2-way, individualized interactions compared with usual care were included. Studies involving any patients with diabetes and outcomes of glycated hemoglobin (A1C), quality of care and/or patient or health-care practitioner experience were included. Systematic reviews, randomized controlled studies, quasi-experimental trials, implementation trials, observational studies and qualitative analyses were reviewed. MEDLINE and McMaster Health Evidence databases searched in June 2020 identified 59 articles. Virtual care, in particular telemonitoring, combined with a means of 2-way communications provided improvement in A1C similar or superior to usual care, with the strongest evidence for type 2 diabetes. Virtual care was generally acceptable to patients, who expressed satisfaction with their care. Health-care providers recognized benefits but raised issues of technical support, workflow and compensation.
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Affiliation(s)
- Catherine B Chan
- Diabetes, Obesity and Nutrition Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada; Department of Agricultural, Food and Nutritional Sciences, Li Ka Shing Centre for Health Innovation Research, University of Alberta, Edmonton, Alberta, Canada; Department of Physiology, University of Alberta, Edmonton, Alberta, Canada.
| | - Naomi Popeski
- Diabetes, Obesity and Nutrition Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Mortaza Fatehi Hassanabad
- Calvin, Phoebe and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada; Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ronald J Sigal
- Diabetes, Obesity and Nutrition Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Department of Cardiac Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Petra O'Connell
- Diabetes, Obesity and Nutrition Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada
| | - Peter Sargious
- Diabetes, Obesity and Nutrition Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada; Department of Medicine, Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada
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18
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Eberle C, Stichling S. Clinical Improvements by Telemedicine Interventions Managing Type 1 and Type 2 Diabetes: Systematic Meta-review. J Med Internet Res 2021; 23:e23244. [PMID: 33605889 PMCID: PMC7935656 DOI: 10.2196/23244] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/16/2020] [Accepted: 10/28/2020] [Indexed: 02/06/2023] Open
Abstract
Background Diabetes mellitus (DM) is one of the world’s greatest health threats with rising prevalence. Global digitalization leads to new digital approaches in diabetes management, such as telemedical interventions. Telemedicine, which is the use of information and communication technologies, may provide medical services over spatial distances to improve clinical patient outcomes by increasing access to diabetes care and medical information. Objective This study aims to examine whether telemedical interventions effectively improve diabetes control using studies that pooled patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), and whether the benefits are greater in patients diagnosed with T2DM than in those diagnosed with T1DM. We analyzed the primary outcome glycated hemoglobin A1c (HbA1c) and the secondary outcomes fasting blood glucose (FBG), blood pressure (BP), body weight, BMI, quality of life (QoL), cost, and time saving. Methods Publications were systematically identified by searching Cochrane Library, MEDLINE via PubMed, Web of Science Core Collection, Embase, and CINAHL databases for studies published between January 2008 and April 2020, considering systematic reviews (SRs), meta-analyses (MAs), randomized controlled trials (RCTs), and clinical trials (CTs). Study quality was assessed using the A Measurement Tool to Assess Systematic Reviews, Effective Public Health Practice Project, and National Institute for Health and Care Excellence qualitative checklist. We organized the trials by communication technologies in real-time video or audio interventions, asynchronous interventions, and combined interventions (synchronous and asynchronous communication). Results From 1116 unique citations, we identified 31 eligible studies (n=15 high, n=14 moderate, n=1 weak, and n=1 critically low quality). We selected 21 SRs and MAs, 8 RCTs, 1 non-RCT, and 1 qualitative study. Of the 10 trials, 3 were categorized as real-time video, 1 as real-time video and audio, 4 as asynchronous, and 2 as combined intervention. Significant decline in HbA1c levels based on pooled T1DM and T2DM patients data ranged from −0.22% weighted mean difference (WMD; 95% CI −0.28 to −0.15; P<.001) to −0.64% mean difference (95% CI −1.01 to −0.26; P<.001). The intervention effect on lowering HbA1c values might be significantly smaller for patients with T1DM than for patients with T2DM. Evidence on the impact on BP, body weight, FBG, cost effectiveness, and time saving was smaller compared with HbA1c but indicated potential in some publications. Conclusions Telemedical interventions might be clinically effective in improving diabetes control overall, and they might significantly improve HbA1c concentrations. Patients with T2DM could benefit more than patients with T1DM regarding lowering HbA1c levels. Further studies with longer duration and larger cohorts are necessary.
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Affiliation(s)
- Claudia Eberle
- Medicine with specialization in Internal Medicine and General Medicine, Hochschule Fulda - University of Applied Sciences, Fulda, Germany
| | - Stefanie Stichling
- Medicine with specialization in Internal Medicine and General Medicine, Hochschule Fulda - University of Applied Sciences, Fulda, Germany
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19
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Opipari-Arrigan L, Dykes DMH, Saeed SA, Thakkar S, Burns L, Chini BA, McPhail GL, Eslick I, Margolis PA, Kaplan HC. Technology-Enabled Health Care Collaboration in Pediatric Chronic Illness: Pre-Post Interventional Study for Feasibility, Acceptability, and Clinical Impact of an Electronic Health Record-Linked Platform for Patient-Clinician Partnership. JMIR Mhealth Uhealth 2020; 8:e11968. [PMID: 33242014 PMCID: PMC7728534 DOI: 10.2196/11968] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 06/08/2020] [Accepted: 09/01/2020] [Indexed: 01/19/2023] Open
Abstract
Background Mobile health (mHealth) technology has the potential to support the Chronic Care Model’s vision of closed feedback loops and patient-clinician partnerships. Objective This study aims to evaluate the feasibility, acceptability, and short-term impact of an electronic health record–linked mHealth platform (Orchestra) supporting patient and clinician collaboration through real-time, bidirectional data sharing. Methods We conducted a 6-month prospective, pre-post, proof-of-concept study of Orchestra among patients and parents in the Cincinnati Children’s Hospital inflammatory bowel disease (IBD) and cystic fibrosis (CF) clinics. Participants and clinicians used Orchestra during and between visits to complete and view patient-reported outcome (PRO) measures and previsit plans. Surveys completed at baseline and at 3- and 6-month follow-up visits plus data from the platform were used to assess outcomes including PRO completion rates, weekly platform use, disease self-efficacy, and impact on care. Analyses included descriptive statistics; pre-post comparisons; Pearson correlations; and, if applicable, effect sizes. Results We enrolled 92 participants (CF: n=52 and IBD: n=40), and 73% (67/92) completed the study. Average PRO completion was 61%, and average weekly platform use was 80%. Participants reported improvement in self-efficacy from baseline to 6 months (7.90 to 8.44; P=.006). At 6 months, most participants reported that the platform was useful (36/40, 90%) and had a positive impact on their care, including improved visit quality (33/40, 83%), visit collaboration (35/40, 88%), and visit preparation (31/40, 78%). PRO completion was positively associated with multiple indicators of care impact at 3 and 6 months. Conclusions Use of an mHealth tool to support closed feedback loops through real-time data sharing and patient-clinician collaboration is feasible and shows indications of acceptability and promise as a strategy for improving pediatric chronic illness management.
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Affiliation(s)
- Lisa Opipari-Arrigan
- Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.,Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | | | - Shehzad A Saeed
- Gastroenterology and Nutrition, Dayton Children's Hospital, Dayton, OH, United States.,Gastroenterology and Nutrition, Wright State University, Dayton, OH, United States
| | - Sunny Thakkar
- Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Lisa Burns
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.,Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Barbara A Chini
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.,Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Gary L McPhail
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.,Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Ian Eslick
- Vital Labs, Inc, San Francisco, CA, United States
| | - Peter A Margolis
- Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Heather C Kaplan
- Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.,Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinatti, OH, United States
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20
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Batsis JA, McClure AC, Weintraub AB, Sette D, Rotenberg S, Stevens CJ, Gilbert-Diamond D, Kotz DF, Bartels SJ, Cook SB, Rothstein RI. Barriers and facilitators in implementing a pilot, pragmatic, telemedicine-delivered healthy lifestyle program for obesity management in a rural, academic obesity clinic. Implement Sci Commun 2020; 1:83. [PMID: 33015640 PMCID: PMC7526351 DOI: 10.1186/s43058-020-00075-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 09/17/2020] [Indexed: 12/19/2022] Open
Abstract
PURPOSE Few evidence-based strategies are specifically tailored for disparity populations such as rural adults. Two-way video-conferencing using telemedicine can potentially surmount geographic barriers that impede participation in high-intensity treatment programs offering frequent visits to clinic facilities. We aimed to understand barriers and facilitators of implementing a telemedicine-delivered tertiary-care, rural academic weight-loss program for the management of obesity. METHODS A single-arm study of a 16-week, weight-loss pilot evaluated barriers and facilitators to program participation and exploratory measures of program adoption and staff confidence in implementation and intervention delivery. A program was delivered using video-conferencing within an existing clinical infrastructure. Elements of Consolidated Framework for Implementation Research (CFIR) provided a basis for assessing intervention characteristics, inner and outer settings, and individual characteristics using surveys and semi-structured interviews. We evaluated elements of the RE-AIM model (reach, adoption) to assess staff barriers to success for future scalability. FINDINGS There were 27 patients and 8 staff completing measures. Using CFIR, the intervention was valuable from a patient participant standpoint; staff equally had positive feelings about using telemedicine as useful for patient care. The RE-AIM framework demonstrated limited reach but willingness to adopt was above average. A significant barrier limiting sustainability was physical space for intervention delivery and privacy and dedicated resources for staff. Scheduling stressors were also a challenge in its implementation. CONCLUSIONS The need to engage staff, enhance organizational culture, and increase reach are major factors for rural health obesity clinics to enhance sustainability of using telemedicine for the management of obesity. TRIAL REGISTRATION Clinicaltrials.gov NCT03309787. Registered on 16 October 2017.
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Affiliation(s)
- John A. Batsis
- Division of Geriatric Medicine, Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Auden C. McClure
- Geisel School of Medicine at Dartmouth and The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, NH USA
- Dartmouth Weight & Wellness Center, Lebanon, NH USA
| | | | - Diane Sette
- Dartmouth Weight & Wellness Center, Lebanon, NH USA
| | - Sivan Rotenberg
- Dartmouth Weight & Wellness Center, Lebanon, NH USA
- Department of Psychiatry, Dartmouth-Hitchcock, Lebanon, NH USA
| | - Courtney J. Stevens
- Dartmouth Weight & Wellness Center, Lebanon, NH USA
- Department of Psychiatry, Dartmouth-Hitchcock, Lebanon, NH USA
- Dartmouth Centers for Health and Aging, Dartmouth College, Hanover, NH USA
| | - Diane Gilbert-Diamond
- Geisel School of Medicine at Dartmouth and The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, NH USA
- Dartmouth Weight & Wellness Center, Lebanon, NH USA
- Department of Epidemiology, Dartmouth College, Hanover, NH USA
| | - David F. Kotz
- Department of Computer Science, Dartmouth College, Hanover, NH USA
| | | | | | - Richard I. Rothstein
- Geisel School of Medicine at Dartmouth and The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, NH USA
- Dartmouth Weight & Wellness Center, Lebanon, NH USA
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21
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Fornasini S, Dianti M, Bacchiega A, Forti S, Conforti D. Using Geocaching to Promote Active Aging: Qualitative Study. J Med Internet Res 2020; 22:e15339. [PMID: 32525486 PMCID: PMC7317631 DOI: 10.2196/15339] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 01/30/2020] [Accepted: 02/22/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Over the past few years, the development of technologies supporting active aging has been increasing. Among the activities that promote physical exercise by using technologies is geocaching-a treasure hunt of sorts in which participants use a receiver GPS to hide or find real or virtual objects. Although this activity is particularly suited to the promotion of healthy lifestyles in older people, geocaching remains to be unexplored in this area. OBJECTIVE This study aimed to investigate the effectiveness of activities combining geocaching and self-tracking technologies to promote active aging, evaluate the usability of technologies, and explore the ways in which technologies have been integrated in the organizational context under examination to determine the user experience of participants. METHODS A group of individuals aged 65 years and older (N=14) attending a senior center managed by a social cooperative was involved in the study. Some of them created the geocaching contents, and others, split into 2 teams, participated in the game. Each participant was given a pedometer bracelet and the geocaching app. The steps taken by individual participants along with the number of caches found by each group translated into team scores. RESULTS The main results of the study were as follows: (1) activities in favor of active aging that involve the use of new technologies can foster the participation of elderly people; in particular, adding gamification to self-tracking can be a valid strategy to promote physical exercise among the elderly; (2) for this to happen, involvement of older people firsthand is crucial, and there must be a focus on their active involvement and empowerment in every phase of the project; and (3) the mediation of conflicts and competition that arise from the gamification could only take place because of the strong support of the organization in the form of social workers. CONCLUSIONS The results show that promoting active aging through technologies requires more effort than simply using these tools; it requires a wider process that involves an articulated organizational network with heterogeneous actors, technologies, and relations.
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Affiliation(s)
- Silvia Fornasini
- Fondazione Bruno Kessler, Trento, Italy
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
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22
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Young HM, Miyamoto S, Dharmar M, Tang-Feldman Y. Nurse Coaching and Mobile Health Compared With Usual Care to Improve Diabetes Self-Efficacy for Persons With Type 2 Diabetes: Randomized Controlled Trial. JMIR Mhealth Uhealth 2020; 8:e16665. [PMID: 32130184 PMCID: PMC7076411 DOI: 10.2196/16665] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 12/11/2019] [Accepted: 12/15/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Type 2 diabetes is a growing public health problem amenable to prevention and health promotion. As healthy behaviors have an impact on disease outcomes, approaches to support and sustain diabetes self-management are vital. OBJECTIVE This study aimed to evaluate the effectiveness of a nurse coaching program using motivational interviewing paired with mobile health (mHealth) technology on diabetes self-efficacy and self-management for persons with type 2 diabetes. METHODS This randomized controlled trial compared usual care with an intervention that entailed nurse health coaching and mHealth technology to track patient-generated health data and integrate these data into an electronic health record. The inclusion criteria were as follows: (1) enrolled at 1 of 3 primary care clinics, (2) aged 18 years or above, (3) living with type 2 diabetes, and (4) English-speaking. We collected outcome measures at baseline, 3 months, and 9 months. The primary outcome was diabetes self-efficacy; secondary outcomes were depressive symptoms, perceived stress, physical functioning, and emotional distress and anxiety. Linear regression mixed modeling estimated the population trends and individual differences in change. RESULTS We enrolled 319 participants; 287 participants completed the study (155 control and 132 intervention). The participants in the intervention group had significant improvements in diabetes self-efficacy (Diabetes Empowerment Scale, 0.34; 95% CI -0.15,0.53; P<.01) and a decrease in depressive symptoms compared with usual care at 3 months (Patient Health Questionnaire-9; 0.89; 95% CI 0.01-1.77; P=.05), with no differences in the other outcomes. The differences in self-efficacy and depression scores between the 2 arms at 9 months were not sustained. The participants in the intervention group demonstrated a significant increase in physical activity (from 23,770 steps per week to 39,167 steps per week at 3 months and 32,601 per week at 9 months). CONCLUSIONS We demonstrated the short-term effectiveness of this intervention; however, by 9 months, although physical activity remained above the baseline, the improvements in self-efficacy were not sustained. Further research should evaluate the minimum dose of coaching required to continue progress after active intervention and the potential of technology to provide effective ongoing automated reinforcement for behavior change. TRIAL REGISTRATION ClinicalTrials.gov NCT02672176; https://clinicaltrials.gov/ct2/show/NCT02672176.
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Affiliation(s)
- Heather M Young
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, United States
| | - Sheridan Miyamoto
- College of Nursing, The Pennsylvania State University, University Park, PA, United States
| | - Madan Dharmar
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, United States
| | - Yajarayma Tang-Feldman
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, United States
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23
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Liu F, Jiang Y, Xu G, Ding Z. Effectiveness of Telemedicine Intervention for Chronic Obstructive Pulmonary Disease in China: A Systematic Review and Meta-Analysis. Telemed J E Health 2020; 26:1075-1092. [PMID: 32069170 DOI: 10.1089/tmj.2019.0215] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: Telemedicine market in China has been rapidly developing. However, no systematic review has been published in China. Details of the implementation of telemedicine interventions in the chronic obstructive pulmonary disease (COPD) in China have not been described, and the effectiveness of telemedicine interventions is still unclear. Therefore, in this review, we describe the implementation details of telemedicine intervention in China and access the efficacy of telemedicine. Materials and Methods: A literature search was conducted in Embase, Cochrane Library, PubMed, China National Knowledge Infrastructure (CNKI), Wan Fang Data, and China Science and Technology Journal Database by July 9, 2018. Results: A total number of 24 studies were meta-analyzed. There are many differences during the implementation of telemedicine in China. Quality of life in the group of the telemedicine intervention was better than that in the control group (mean difference = -4.93 [95% confidence interval; CI -6.86 to -3.01], p < 0.00001), but the heterogeneity is high (I2 = 86%, p = 0.0001). The rates of hospitalization were lower than those in the control group (odds ratio = 0.24 [95% CI 0.20-0.29], p < 0.00001), and the heterogeneity was low (I2 = 25%, p = 0.14). Conclusion: The implementation of telemedicine in China has not yet been standardized. Nonetheless, results of our review indicated that telemedicine in China can improve the quality of life and reduce the rates of hospitalization in COPD patients.
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Affiliation(s)
- Fenglan Liu
- Research Office of Chronic Disease Management and Rehabilitation, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Yuyu Jiang
- Research Office of Chronic Disease Management and Rehabilitation, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Guangqing Xu
- Huishan District Rehabilitation Hospital, Wuxi, China.,Huishan Qianzhou District Community Health Service Center, Wuxi, China
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24
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Vilme H, Duke NN, Muiruri C, Wordlaw L, Skinner AC. Using Telehealth to Disseminate Primary, Secondary, and Tertiary CVD Interventions to Rural Populations. Curr Hypertens Rep 2019; 21:92. [PMID: 31701257 DOI: 10.1007/s11906-019-0998-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE OF REVIEW This study aims to review the evidence on telehealth interventions in rural communities that use primary, secondary, or tertiary strategies for the prevention and management of cardiovascular disease (CVD). RECENT FINDINGS Studies focused on the reduction of CVD risk factors and mitigation of disease progression among rural populations using telehealth are limited in number but appear to be increasing in the last 5 years. These studies suggest primary-, secondary-, and tertiary-level interventions can impact CVD risk and management. The current review found more studies addressing primary CVD intervention strategies, although the evidence for efficacy at all intervention levels is in the early stages. Leveraging prevention strategies via telehealth may be an effective vehicle to facilitate improved CVD outcomes among populations traditionally marginalized by geographic location.
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Affiliation(s)
- Helene Vilme
- Department of Population Health Sciences, Duke University School of Medicine, 215 Morris St., Suite 210, Durham, NC, 27701, USA.
| | - Naomi N Duke
- Internal Medicine, Pediatrics, Adolescent Medicine, Division of Primary Care, Department of Pediatrics, Duke University, Durham, NC, USA
| | - Charles Muiruri
- Department of Population Health Sciences, Duke University School of Medicine, 215 Morris St., Suite 210, Durham, NC, 27701, USA.,Kilimanjaro Christian Medical University College, Moshi, Tanzania.,Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - LaShawn Wordlaw
- Department of Public Health Education, North Carolina Central University, Durham, NC, USA
| | - Asheley C Skinner
- Department of Population Health Sciences, Duke University School of Medicine, 215 Morris St., Suite 210, Durham, NC, 27701, USA
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25
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Miyamoto S, Henderson S, Fazio S, Saconi B, Thiede E, Greenwood DA, Young HM. Empowering Diabetes Self-Management Through Technology and Nurse Health Coaching. DIABETES EDUCATOR 2019; 45:586-595. [DOI: 10.1177/0145721719879421] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Purpose This research explores the impact of mobile health (mHealth) technology and nurse health coaching on views of diabetes self-management (DSM) for persons living with diabetes. Methods Three focus groups (N = 24) were conducted with individuals living with type 2 diabetes who participated in a nurse health coaching and mHealth technology intervention study. Qualitative thematic analysis was used to identify overarching themes in each group. Results Major themes identified following intervention participation included enhanced perspectives about living with diabetes, increased awareness of how health behaviors influence DSM, improved support, and increased ownership of DSM. Conclusions The themes identified suggest that the mHealth technology and health coaching intervention together may have had an empowering effect on participants’ DSM. These results suggest that providing nurse health coaching with mHealth technology may help individuals ameliorate some of the challenges of living with and managing diabetes.
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Affiliation(s)
- Sheridan Miyamoto
- College of Nursing, The Pennsylvania State University, University Park, Pennsylvania
| | - Stuart Henderson
- Clinical and Translational Science Center, School of Health Evaluation, University of California Davis, Sacramento, California
| | - Sarina Fazio
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, California
- University of California Davis Medical Center, Sacramento, California
| | - Bruno Saconi
- College of Nursing, The Pennsylvania State University, University Park, Pennsylvania
| | - Elizabeth Thiede
- College of Nursing, The Pennsylvania State University, University Park, Pennsylvania
| | | | - Heather M. Young
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, California
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Badowski DM, Rossler KL, Gill-Gembala L(T. Telehealth Simulation With Motivational Interviewing: Impact on Learning and Practice. J Nurs Educ 2019; 58:221-224. [DOI: 10.3928/01484834-20190321-06] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 01/09/2019] [Indexed: 11/20/2022]
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Delaney C, Bark L. The Experience of Holistic Nurse Coaching for Patients With Chronic Conditions. J Holist Nurs 2019; 37:225-237. [DOI: 10.1177/0898010119837109] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose: The purpose of this study was to explore and describe the lived experience of adults with chronic conditions receiving holistic nurse coaching. Method: A qualitative phenomenological research design was used for this study. A purposive sample of 15 patients with varied chronic conditions participated. Institutional review board approval was obtained from the participating university prior to data collection. The patients’ stories of their experiences with holistic nurse coaching were analyzed using Colaizzi’s method of phenomenological analysis. Findings: Eight theme clusters emerged when the formulated meanings were organized into the following categories: (1) Seeking Guidance to Navigate Life’s Challenges, (2) Entering a Safe Sacred Place, (3) Feeling Empowered and Accountable, (4) Developing Strategies to Access Different Ways of Knowing, (5) Finding the Answers Within, (6) Making Healthy Behavioral Changes, (7) Forming a New Caring Relationship with Self, and (8) Transforming to a Brand-New Approach to Life. Conclusions: Findings from this study provide insight into experiences of holistic nurse coaching for patients with chronic conditions. Further research is needed to examine the influence of holistic nurse coaching on health outcomes related to chronic conditions such as quality of life, patient empowerment, and targeted metrics related to specific chronic conditions.
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Yang S, Jiang Q, Li H. The role of telenursing in the management of diabetes:A systematic review and meta‐analysis. Public Health Nurs 2019; 36:575-586. [PMID: 30883888 DOI: 10.1111/phn.12603] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 01/30/2019] [Accepted: 02/14/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Sa Yang
- Department of Nursing Henan Provincial People's Hospital, People's Hospital of Zhengzhou University Zhengzhou China
| | - Qiuhuan Jiang
- Department of Nursing Henan Provincial People's Hospital, People's Hospital of Zhengzhou University Zhengzhou China
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Borries TM, Dunbar A, Bhukhen A, Rismany J, Kilham J, Feinn R, Meehan TP. The impact of telemedicine on patient self-management processes and clinical outcomes for patients with Types I or II Diabetes Mellitus in the United States: A scoping review. Diabetes Metab Syndr 2019; 13:1353-1357. [PMID: 31336491 DOI: 10.1016/j.dsx.2019.02.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 02/04/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The objective of this scoping review was to identify peer-reviewed medical literature on the use of telemedicine in patients with Types I or II DM in the United States, assess its impact on self-management processes and clinical outcomes of care, and to delineate research gaps. METHODS We utilized a structured scoping review protocol to conduct this research. We searched the published medical literature utilizing two databases, PubMed and CINHAL, and we included all original research articles published prior to July 20th, 2018. Using a 4-step systematic approach, we identified, reviewed, extracted and summarized data from all relevant studies. RESULTS We identified 47 articles overall. Telemedicine impact was reported as positive in articles addressing the following components of patient self-management: adherence to blood glucose monitoring, day-to-day decision-making related to self-care, and adherence with medications. The most commonly reported clinical outcome was HbA1c level. Few or no studies evaluated impact on long term clinical outcomes such as blindness, amputation, cardiovascular events, development of chronic kidney disease, or mortality. DISCUSSION This scoping review provides important information about studies conducted in the United States evaluating the impact of telemedicine on patient self-management and on clinical outcomes in patients with DM. CONCLUSIONS Results suggest that telemedicine has a positive impact on self-management processes and on HbA1c levels. However, future evaluative reviews are necessary to confirm and quantitate the impact of telemedicine on self-management processes and primary studies are necessary to evaluate its impact on long term clinical outcomes.
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Affiliation(s)
- Trevor M Borries
- Quinnipiac University Frank H. Netter MD School of Medicine, North Haven, CT, USA.
| | - Ashley Dunbar
- Quinnipiac University Frank H. Netter MD School of Medicine, North Haven, CT, USA.
| | - Arti Bhukhen
- Quinnipiac University Frank H. Netter MD School of Medicine, North Haven, CT, USA.
| | - Joshua Rismany
- Quinnipiac University Frank H. Netter MD School of Medicine, North Haven, CT, USA.
| | - Jessica Kilham
- Quinnipiac University Frank H. Netter MD School of Medicine, North Haven, CT, USA.
| | - Richard Feinn
- Quinnipiac University Frank H. Netter MD School of Medicine, North Haven, CT, USA.
| | - Thomas P Meehan
- Quinnipiac University Frank H. Netter MD School of Medicine, North Haven, CT, USA; Connecticut Center for Primary Care, Farmington, CT, USA.
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Binning J, Woodburn J, Bus SA, Barn R. Motivational interviewing to improve adherence behaviours for the prevention of diabetic foot ulceration. Diabetes Metab Res Rev 2019; 35:e3105. [PMID: 30513132 DOI: 10.1002/dmrr.3105] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/01/2018] [Accepted: 11/18/2018] [Indexed: 11/06/2022]
Abstract
Diabetic foot ulceration is a major complication associated with high morbidity. Little evidence exists on which interventions are effective at preventing ulceration. Participants who are adherent to self-care behaviours have significantly better outcomes. Motivational interviewing is an intervention that has been used successfully for conditions where adherence is important, such as reduction of obesity and HbA1c levels. A systematic review was conducted to determine whether motivational interviewing is effective at improving adherence for the prevention of Diabetic Foot Ulceration. Electronic searches were run without date or language restrictions in MEDLINE (viaEBSCOhost), CINAHL (viaEBSCOhost), ProQuest (Health and Medical Collection, Nursing and Allied Health Database, PsycINFO, Psychology, PsychArticles), AMED, EMBASE, Cochrane Central Register of Controlled Trials, ScienceDirect, and Web of Science Core Collections. Papers were included if participants had or were at risk of diabetic foot ulceration. Studies required motivational interviewing or a motivational approach as the sole intervention or as a component. Randomised controlled trials and quasi-experimental studies were included if ulceration and/or at least one behavioural outcome was measured before and after the intervention. Five studies met the inclusion criteria. Heterogeneity prevented the pooling of data. One study used motivational interviewing as the sole intervention. This study found a short-term positive effect on footwear adherence. The remaining four studies had a motivational component within their interventions. Two of these studies showed the intervention to be effective but both were at a high risk of bias. This review demonstrates an evidence gap. More research is needed.
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Affiliation(s)
- Jodi Binning
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Jim Woodburn
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Sicco A Bus
- Department of Rehabilitation, Academic Medical Center, Amsterdam Movement Sciences, University of Amsterdam, The Netherlands
| | - Ruth Barn
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
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Results of a national survey of certified nurse coaches with implications for advanced practice nurses. J Am Assoc Nurse Pract 2019; 30:251-261. [PMID: 29757841 DOI: 10.1097/jxx.0000000000000041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE Evidence suggests that nurse-coaching can improve health outcomes, but application of this skill is not well understood. The purpose of this study is to describe the practices of nurse coaches including their work settings, clients/health conditions, motivations behind becoming certified as coaches, and the personal benefits experienced by nurse coaches. METHODS A cross-sectional online survey was emailed to certified nurse coaches (n = 315); 164 completed the survey, including 68 (41.5%) advanced practice nurses. CONCLUSIONS The most frequent conditions seen by coaches included the following: anxiety/stress (n = 39, 27.1%), cardiometabolic conditions (n = 24, 16.7%), and pain (n = 20, 13.9%). Coaching varied in frequency, method (individual versus group), and mode (in-person, by phone, or electronically). Participants became coaches to gain skills for enhancing their practice, deliver care that fits with their values and philosophy, meet personal needs (starting a private practice and improve their own self-care), attain credentials/validation, and empower others. The majority agreed/strongly agreed that since becoming a nurse coach, their own interpersonal relationships (80.3%), health/health behaviors (84.8%), and job satisfaction (70.7%) improved. IMPLICATIONS FOR PRACTICE Nurse practitioners may be strategically situated to provide coaching and have the knowledge and skills needed to intervene with medically complex, at-risk populations.
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Fazio S, Edwards J, Miyamoto S, Henderson S, Dharmar M, Young HM. More than A1C: Types of success among adults with type-2 diabetes participating in a technology-enabled nurse coaching intervention. PATIENT EDUCATION AND COUNSELING 2019; 102:106-112. [PMID: 30172572 PMCID: PMC6289853 DOI: 10.1016/j.pec.2018.08.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 08/17/2018] [Accepted: 08/22/2018] [Indexed: 05/07/2023]
Abstract
OBJECTIVE Success in diabetes research and self-management is often defined as a significant decrease in glycated hemoglobin (A1C). The aim of this article is to explore different types of successes experienced by adults with type-2 diabetes participating in a health technology and nurse coaching clinical trial. METHODS A qualitative analysis was conducted using surveys and documentation from motivational interview-based coaching sessions between study nurses and intervention participants. RESULTS Of the 132 cases reviewed, types of success predominantly fell into five categories: 1) change in health behaviors; 2) change in mindset or awareness; 3) change in engagement with healthcare resources; 4) change in physical or emotional health; and 5) change in health indicators. CONCLUSION Experiences of success in diabetes are more varied than traditional A1C-based outcome models. Our findings suggest coaching and technology can assist patients to achieve a range of successes in diabetes management through goal setting, health tracking, resolving barriers, and aligning goals with factors that impact change. PRACTICE IMPLICATIONS While A1C reduction is a critical factor in decreasing risk of diabetes-related complications, when healthcare professionals focus on A1C as the main indicator of diabetes management success, important changes in individuals' health and well-being may be overlooked or undervalued.
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Affiliation(s)
- Sarina Fazio
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, USA; UC Davis Medical Center, UC Davis Health.
| | - Jennifer Edwards
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, USA.
| | - Sheridan Miyamoto
- College of Nursing, The Pennsylvania State University, University Park, USA.
| | - Stuart Henderson
- Schools of Health Evaluation, Clinical and Translational Science Center, University of California Davis, Sacramento, USA.
| | - Madan Dharmar
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, USA; Department of Pediatrics, School of Medicine, Betty Irene Moore School of Nursing University of California, Davis, Sacramento, USA.
| | - Heather M Young
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, USA.
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Ruggiano N, Brown EL, Li J, Scaccianoce M. Rural Dementia Caregivers and Technology: What Is the Evidence? Res Gerontol Nurs 2018; 11:216-224. [PMID: 30036405 DOI: 10.3928/19404921-20180628-04] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 04/17/2018] [Indexed: 11/20/2022]
Abstract
Caregivers of adults with dementia often experience burden and depression as a result of their intensive caregiving activities. Dementia caregivers in rural communities experience additional barriers of large distances from health care providers and/or limited numbers of health care providers, which may further exacerbate burden. Technology has been identified as a platform for reducing dementia caregiver burden and stress, although the extent to which technologically based interventions have been tested with rural dementia caregivers is unknown. The current study involved a systematic review of technologically based interventions to assess the geography of sample populations, scope of interventions, and study outcomes. Of 8,348 articles identified and screened, 30 articles met eligibility guidelines. The current review found that few studies identified their sample population as living in rural communities. In addition, studies were more likely to report improved psychosocial outcomes of intervention groups, with few reporting positive effects on caregiving skills/self-efficacy. Implications for future research are discussed. [Res Gerontol Nurs. 2018; 11(4):216-224.].
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Werbrouck A, Swinnen E, Kerckhofs E, Buyl R, Beckwée D, De Wit L. How to empower patients? A systematic review and meta-analysis. Transl Behav Med 2018; 8:660-674. [DOI: 10.1093/tbm/iby064] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- Amber Werbrouck
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Rehabilitation Research (RERE), Vrije Universiteit Brussel, Brussel, Belgium
| | - Eva Swinnen
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Rehabilitation Research (RERE), Vrije Universiteit Brussel, Brussel, Belgium
| | - Eric Kerckhofs
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Rehabilitation Research (RERE), Vrije Universiteit Brussel, Brussel, Belgium
| | - Ronald Buyl
- Department of Biostatistics and Medical Informatics, Vrije Universiteit Brussel, Brussel, Belgium
| | - David Beckwée
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Rehabilitation Research (RERE), Vrije Universiteit Brussel, Brussel, Belgium
- Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
| | - Liesbet De Wit
- Department of Public Health, Vrije Universiteit Brussel, Brussel, Belgium
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Williams AM, Liu PJ, Muir KW, Waxman EL. Behavioral economics and diabetic eye exams. Prev Med 2018; 112:76-87. [PMID: 29626555 DOI: 10.1016/j.ypmed.2018.04.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 03/09/2018] [Accepted: 04/02/2018] [Indexed: 01/09/2023]
Abstract
Diabetic retinopathy is a common microvascular complication of diabetes mellitus and is the leading cause of new blindness among working-age adults in the United States. Timely intervention to prevent vision loss is possible with early detection by regular eye examinations. Unfortunately, adherence to recommended annual diabetic eye exams is poor. Public health interventions have targeted traditional barriers to care, such as cost and transportation, with limited success. Behavioral economics provides an additional framework of concepts and tools to understand low screening rates and to promote regular diabetic eye exams for populations at risk. In particular, behavioral economics outlines biases and heuristics that affect decision-making and underlie pervasive barriers to care, such as not viewing diabetic eye exams as a priority or perceiving oneself as too healthy to need an examination. In this review, we examine the literature on the use of behavioral economics interventions to promote regular diabetic eye exams. From the results of the included studies, we outline how concepts from behavioral economics can improve eye examination rates. In particular, the default bias, present bias, and self-serving bias play a significant role in precluding regular diabetic eye examinations. Potential tools to mitigate these biases include leveraging default options, using reminder messages, providing behavioral coaching, applying commitment contracts, offering financial incentives, and personalizing health messages. When combined with traditional public health campaigns, insights from behavioral economics can improve understanding of pervasive barriers to care and offer additional strategies to promote regular preventive eye care for patients with diabetes.
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Affiliation(s)
- Andrew M Williams
- Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
| | - Peggy J Liu
- Department of Marketing and Business Economics, Katz Graduate School of Business, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kelly W Muir
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA; Durham VA Medical Center, Health Services Research and Development, Durham, NC, USA
| | - Evan L Waxman
- Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Bashir A, Bastola DR. Perspectives of Nurses Toward Telehealth Efficacy and Quality of Health Care: Pilot Study. JMIR Med Inform 2018; 6:e35. [PMID: 29802089 PMCID: PMC5993972 DOI: 10.2196/medinform.9080] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 03/18/2018] [Accepted: 04/05/2018] [Indexed: 11/27/2022] Open
Abstract
Background Telehealth nursing, or the delivery, management, and coordination of nursing care services provided via telecommunications technology, is one of the methods of delivering health care to patients in the United States. It is important to assess the service quality of the involved health professionals as well as the telehealth nursing process. The focus of this study is the innovative model of telehealth care delivery by nurses for managing patients with chronic disease while they are living in their own residence. Objective The primary objective of this pilot study was to examine whether telehealth technology impacts the perceived level of internal service quality delivered by nurses within a telehealth organization. To address this research goal, the notion of telehealth nursing service quality (TNSQ) is empirically tested and validated with a survey instrument. Methods Data were collected from nurses belonging to a home care agency based on interview questions inquiring about facilitators and inhibitors to TNSQ. A survey to measure TNSQ based on the SERVQUAL instrument was completed by adjusting descriptions of the original instrument to suit the context. Follow-up interviews were conducted to validate questions on the revised instrument. Results The findings of this survey research were positive, based on mean differences between expectations and perceptions of TNSQ. This indicates satisfaction with TNSQ and shows that the quality of the service is higher than what the respondents expect. The Wilcoxon signed-rank test using the P value for the test, which is .35, did not show a statistically significant change between the median differences of perception and expectation. The total number of respondents was 13. Results indicate that overall perceived service quality is a positive value (0.05332). This means the perceptions of the level of service are slightly higher than what they expect, indicating there is satisfaction with TNSQ. Conclusions The responses to the interview questions and data gathered from the survey showed overall satisfaction with TNSQ. The SERVQUAL instrument was a good framework to assess TNSQ. In a nutshell, the study highlighted how the telehealth process provides daily monitoring of patient health, leading to the benefits of immediate feedback for patients, family, and caregivers as well as convenience of scheduling.
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Affiliation(s)
- Ayisha Bashir
- Department of Clinical and Translational Science, Creighton University, Omaha, NE, United States
| | - Dhundy R Bastola
- School of Interdisciplinary Informatics, Information Science and Technology, University of Nebraska, Omaha, NE, United States
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Miyamoto S, Dharmar M, Fazio S, Tang-Feldman Y, Young HM. mHealth Technology and Nurse Health Coaching to Improve Health in Diabetes: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2018; 7:e45. [PMID: 29449200 PMCID: PMC5832903 DOI: 10.2196/resprot.9168] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 01/03/2018] [Accepted: 01/06/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Chronic diseases, including diabetes mellitus, are the leading cause of mortality and disability in the United States. Current solutions focus primarily on diagnosis and pharmacological treatment, yet there is increasing evidence that patient-centered models of care are more successful in improving and addressing chronic disease outcomes. OBJECTIVE The objective of this clinical trial is to evaluate the impact of a mobile health (mHealth) enabled nurse health coaching intervention on self-efficacy among adults with type-2 diabetes mellitus. METHODS A randomized controlled trial was conducted at an academic health system in Northern California. A total of 300 participants with type-2 diabetes were scheduled to be enrolled through three primary care clinics. Participants were randomized to either usual care or intervention. All participants received training on use of the health system patient portal. Participants in the intervention arm received six scheduled health-coaching telephone calls with a registered nurse and were provided with an activity tracker and mobile application that integrated data into the electronic health record (EHR) to track their daily activity and health behavior decisions. All participants completed a baseline survey and follow-up surveys at 3 and 9 months. Primary and secondary outcomes include diabetes self-efficacy, hemoglobin A1c (HbA1c), and quality of life measures. RESULTS Data collection for this trial, funded by the Patient-Centered Outcomes Research Institute, will be completed by December 2017. Results from the trial will be available mid-2018. CONCLUSIONS This protocol details a patient-centered intervention using nurse health coaching, mHealth technologies, and integration of patient-generated data into the EHR. The aim of the intervention is to enhance self-efficacy and health outcomes by providing participants with a mechanism to track daily activity by offering coaching support to set reasonable and attainable health goals, and by creating a complete feedback loop by bringing patient-generated data into the EHR. TRIAL REGISTRATION ClinicalTrials.gov NCT02672176; https://clinicaltrials.gov/ct2/show/NCT02672176 (Archived by WebCite at http://www.webcitation.org/6xEQXe1M5).
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Affiliation(s)
- Sheridan Miyamoto
- College of Nursing, The Pennsylvania State University, University Park, PA, United States
| | - Madan Dharmar
- Department of Pediatrics, University of California Davis, Sacramento, CA, United States
| | - Sarina Fazio
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, United States
| | - Yajarayma Tang-Feldman
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, United States
| | - Heather M Young
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, United States
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Lawrenson JG, Graham‐Rowe E, Lorencatto F, Burr J, Bunce C, Francis JJ, Aluko P, Rice S, Vale L, Peto T, Presseau J, Ivers N, Grimshaw JM. Interventions to increase attendance for diabetic retinopathy screening. Cochrane Database Syst Rev 2018; 1:CD012054. [PMID: 29333660 PMCID: PMC6491139 DOI: 10.1002/14651858.cd012054.pub2] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Despite evidence supporting the effectiveness of diabetic retinopathy screening (DRS) in reducing the risk of sight loss, attendance for screening is consistently below recommended levels. OBJECTIVES The primary objective of the review was to assess the effectiveness of quality improvement (QI) interventions that seek to increase attendance for DRS in people with type 1 and type 2 diabetes.Secondary objectives were:To use validated taxonomies of QI intervention strategies and behaviour change techniques (BCTs) to code the description of interventions in the included studies and determine whether interventions that include particular QI strategies or component BCTs are more effective in increasing screening attendance;To explore heterogeneity in effect size within and between studies to identify potential explanatory factors for variability in effect size;To explore differential effects in subgroups to provide information on how equity of screening attendance could be improved;To critically appraise and summarise current evidence on the resource use, costs and cost effectiveness. SEARCH METHODS We searched the Cochrane Library, MEDLINE, Embase, PsycINFO, Web of Science, ProQuest Family Health, OpenGrey, the ISRCTN, ClinicalTrials.gov, and the WHO ICTRP to identify randomised controlled trials (RCTs) that were designed to improve attendance for DRS or were evaluating general quality improvement (QI) strategies for diabetes care and reported the effect of the intervention on DRS attendance. We searched the resources on 13 February 2017. We did not use any date or language restrictions in the searches. SELECTION CRITERIA We included RCTs that compared any QI intervention to usual care or a more intensive (stepped) intervention versus a less intensive intervention. DATA COLLECTION AND ANALYSIS We coded the QI strategy using a modification of the taxonomy developed by Cochrane Effective Practice and Organisation of Care (EPOC) and BCTs using the BCT Taxonomy version 1 (BCTTv1). We used Place of residence, Race/ethnicity/culture/language, Occupation, Gender/sex, Religion, Education, Socioeconomic status, and Social capital (PROGRESS) elements to describe the characteristics of participants in the included studies that could have an impact on equity of access to health services.Two review authors independently extracted data. One review author entered the data into Review Manager 5 and a second review author checked them. Two review authors independently assessed risks of bias in the included studies and extracted data. We rated certainty of evidence using GRADE. MAIN RESULTS We included 66 RCTs conducted predominantly (62%) in the USA. Overall we judged the trials to be at low or unclear risk of bias. QI strategies were multifaceted and targeted patients, healthcare professionals or healthcare systems. Fifty-six studies (329,164 participants) compared intervention versus usual care (median duration of follow-up 12 months). Overall, DRS attendance increased by 12% (risk difference (RD) 0.12, 95% confidence interval (CI) 0.10 to 0.14; low-certainty evidence) compared with usual care, with substantial heterogeneity in effect size. Both DRS-targeted (RD 0.17, 95% CI 0.11 to 0.22) and general QI interventions (RD 0.12, 95% CI 0.09 to 0.15) were effective, particularly where baseline DRS attendance was low. All BCT combinations were associated with significant improvements, particularly in those with poor attendance. We found higher effect estimates in subgroup analyses for the BCTs 'goal setting (outcome)' (RD 0.26, 95% CI 0.16 to 0.36) and 'feedback on outcomes of behaviour' (RD 0.22, 95% CI 0.15 to 0.29) in interventions targeting patients, and 'restructuring the social environment' (RD 0.19, 95% CI 0.12 to 0.26) and 'credible source' (RD 0.16, 95% CI 0.08 to 0.24) in interventions targeting healthcare professionals.Ten studies (23,715 participants) compared a more intensive (stepped) intervention versus a less intensive intervention. In these studies DRS attendance increased by 5% (RD 0.05, 95% CI 0.02 to 0.09; moderate-certainty evidence).Fourteen studies reporting any QI intervention compared to usual care included economic outcomes. However, only five of these were full economic evaluations. Overall, we found that there is insufficient evidence to draw robust conclusions about the relative cost effectiveness of the interventions compared to each other or against usual care.With the exception of gender and ethnicity, the characteristics of participants were poorly described in terms of PROGRESS elements. Seventeen studies (25.8%) were conducted in disadvantaged populations. No studies were carried out in low- or middle-income countries. AUTHORS' CONCLUSIONS The results of this review provide evidence that QI interventions targeting patients, healthcare professionals or the healthcare system are associated with meaningful improvements in DRS attendance compared to usual care. There was no statistically significant difference between interventions specifically aimed at DRS and those which were part of a general QI strategy for improving diabetes care. This is a significant finding, due to the additional benefits of general QI interventions in terms of improving glycaemic control, vascular risk management and screening for other microvascular complications. It is likely that further (but smaller) improvements in DRS attendance can also be achieved by increasing the intensity of a particular QI component or adding further components.
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Affiliation(s)
- John G Lawrenson
- City University of LondonCentre for Applied Vision Research, School of Health SciencesNorthampton SquareLondonUKEC1V 0HB
| | - Ella Graham‐Rowe
- City University LondonSchool of Health Sciences, Centre for Health Services ResearchNorthampton SquareLondonUKEC1V 0HB
| | - Fabiana Lorencatto
- City University LondonSchool of Health Sciences, Centre for Health Services ResearchNorthampton SquareLondonUKEC1V 0HB
| | - Jennifer Burr
- University of St AndrewsSchool of Medicine, Medical and Biological Sciences BuildingFifeUKKY16 9TF
| | - Catey Bunce
- Kings College LondonDepartment of Primary Care & Public Health Sciences4th Floor, Addison HouseGuy's CampusLondonUKSE1 1UL
| | - Jillian J Francis
- City University LondonSchool of Health Sciences, Centre for Health Services ResearchNorthampton SquareLondonUKEC1V 0HB
| | - Patricia Aluko
- Newcastle UniversityNational Institute for Health Research (NIHR) Innovation ObservatoryTimes Central offices, 4th Floor, GallowgateNewcastle upon TyneUKNE1 4BF
| | - Stephen Rice
- Newcastle UniversityInstitute of Health & SocietyNewcastle upon TyneUKNE2 4AX
| | - Luke Vale
- Newcastle UniversityInstitute of Health & SocietyNewcastle upon TyneUKNE2 4AX
| | - Tunde Peto
- Queen's University BelfastCentre for Public HealthBelfastUKBT12 6BA
| | - Justin Presseau
- Ottawa Hospital Research InstituteClinical Epidemiology Program501 Smyth RoadOttawaOntarioCanadaK1H 8L6
| | - Noah Ivers
- Women's College HospitalDepartment of Family and Community Medicine76 Grenville StreetTorontoONCanadaM5S 1B2
| | - Jeremy M Grimshaw
- Ottawa Hospital Research InstituteClinical Epidemiology Program501 Smyth RoadOttawaOntarioCanadaK1H 8L6
- University of OttawaDepartment of MedicineOttawaONCanada
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Swartz MC, Lewis ZH, Swartz MD, Martinez E, Lyons EJ. Brief Report: Active Ingredients for Adherence to a Tracker-Based Physical Activity Intervention in Older Adults. J Appl Gerontol 2017; 38:1023-1034. [PMID: 29165029 DOI: 10.1177/0733464817739350] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To identify factors associated with weekly adherence to a 12-week tracker-based activity intervention in older adults. METHOD Using generalized linear mixed models in a secondary analysis ( N = 35), we examined factors associated with weekly adherence (defined as wore the Jawbone Up24 tracker for ≥5 days and completed weekly calls). Factors examined included individual characteristics, gave and received virtual support, achieved step goals, barrier and task self-efficacy, and self-comment. RESULTS Participants' ( Mage = 61.7, SDage = 5.7) adherence changed from 86% (Week 1) to 74% (Week 12). Achieved the previous week's goal (β = 1.13, p = .01) and received virtual support (β = 0.01, p = .02) significantly increased the odds of weekly adherence. DISCUSSION Achieved step goals and received virtual support were associated with improved adherence to our tracker-based activity intervention, which has promising potential to be translated into the clinical setting to promote active lifestyles.
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Affiliation(s)
- Maria C Swartz
- 1 The University of Texas Medical Branch, Galveston, USA
| | - Zakkoyya H Lewis
- 1 The University of Texas Medical Branch, Galveston, USA.,2 Beachbody LLC, Santa Monica, CA, USA
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Ramelet AS, Fonjallaz B, Rio L, Zoni S, Ballabeni P, Rapin J, Gueniat C, Hofer M. Impact of a nurse led telephone intervention on satisfaction and health outcomes of children with inflammatory rheumatic diseases and their families: a crossover randomized clinical trial. BMC Pediatr 2017; 17:168. [PMID: 28716081 PMCID: PMC5513092 DOI: 10.1186/s12887-017-0926-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 07/10/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Children suffering from rheumatic disease are faced with multidimensional challenges that affect their quality of life and family dynamics. Symptom management and monitoring of the course of the disease over time are important to minimize disability and pain. Poor disease control and anticipation of the need for treatment changes may be prompted by specialist medical follow-up and regular nurse-led consultations with the patient and families, in which information and support is provided. The purpose of this study was to evaluate the impact of a nurse-led telephone intervention or Telenursing (TN) compared to standard care (SC) on satisfaction and health outcomes of children with inflammatory rheumatic diseases and their parents. METHODS A multicentered, randomized, longitudinal, crossover trial was conducted with pediatrics outpatients newly diagnosed with inflammatory rheumatic diseases. Participants were randomly assigned to two groups TN and SC for 12 months and crossed-over for the following 12 months. TN consisted of providing individualized affective support, health information and aid to decision making. Satisfaction (primary outcome) and health outcomes were assessed with the Client Satisfaction Questionnaire-8 and the Juvenile Arthritis Multidimensional Assessment Report, respectively. A mixed effect model, including a group x time interaction, was performed for each outcome. RESULTS Satisfaction was significantly higher when receiving TN (OR = 7.7, 95% CI: 1.8-33.6). Morning stiffness (OR = 3.2, 95% CI: 0.97-7.15) and pain (OR = 2.64, 95% CI: 0.97-7.15) were lower in the TN group. For both outcomes a carry-over effect was observed with a higher impact of TN during the 12 first months of the study. The other outcomes did not show any significant improvements between groups. CONCLUSION TN had a positive impact on satisfaction and on morning stiffness and pain of children with inflammatory rheumatic diseases and their families. This highlights the importance of support by specialist nurses in improving satisfaction and symptom management for children with inflammatory rheumatisms and their families. TRIAL REGISTRATION ClinicalTrial.gov identifier: NCT01511341 (December 1st, 2012).
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Affiliation(s)
- Anne-Sylvie Ramelet
- Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne, University Hospital of Lausanne, Rte de la Corniche 10, 1011, Lausanne, Switzerland. .,Pediatric Medico-chirurgical Department of University Hospital of Lausanne, CHUV, Rue du Bugnon 21, 1011, Lausanne, Switzerland.
| | - Béatrice Fonjallaz
- Geneva League for Rheumatology, La ligue Genevoise contre le Rhumatisme, Rue Merle d'Aubigné 22, 1207, Geneva, Switzerland
| | - Laura Rio
- Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne, University Hospital of Lausanne, Rte de la Corniche 10, 1011, Lausanne, Switzerland
| | - Sandra Zoni
- Pediatric Medico-chirurgical Department of University Hospital of Lausanne, CHUV, Rue du Bugnon 21, 1011, Lausanne, Switzerland
| | - Pierluigi Ballabeni
- Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne, University Hospital of Lausanne, Rte de la Corniche 10, 1011, Lausanne, Switzerland
| | - Joachim Rapin
- Pediatric Medico-chirurgical Department of University Hospital of Lausanne, CHUV, Rue du Bugnon 21, 1011, Lausanne, Switzerland
| | - Christophe Gueniat
- Haute Ecole de Santé Vaud (HESAV), University of Applied Sciences and Arts Western Switzerland, Rte de la Corniche 10, 1011, Lausanne, Switzerland
| | - Michaël Hofer
- Pediatric Medico-chirurgical Department of University Hospital of Lausanne, CHUV, Rue du Bugnon 21, 1011, Lausanne, Switzerland
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Guo Y, Albright D. The effectiveness of telehealth on self-management for older adults with a chronic condition: A comprehensive narrative review of the literature. J Telemed Telecare 2017; 24:392-403. [DOI: 10.1177/1357633x17706285] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Given the rapid global growth of older adults with chronic condition(s), the present study explored the effects of telehealth technologies on self-management among older adults with chronic condition(s). Methods Clinical trial studies on telehealth self-management for older adults with chronic condition(s) published in peer reviewed journals were reviewed systematically. In addition, the potential biases were assessed for included studies. Results This review identified 31 articles regarding the effectiveness of telehealth technologies on self-management among older adults. Discussion According to the findings of the present study, telehealth technologies have shown effectiveness on improving self-care skills, improving self-monitoring behaviours and improving clinical outcomes among older adults with chronic condition(s) in different settings. Using telehealth technologies is an advisable intervention for promoting older patients’ self-management. However, it is critical to consider racial diversity and culture-related health behaviour differences when using telehealth technologies.
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Affiliation(s)
- Yuqi Guo
- University of Alabama, Tuscaloosa, AL, USA
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Javanmardifard S, Ghodsbin F, Kaviani MJ, Jahanbin I. The effect of telenursing on self-efficacy in patients with non-alcoholic fatty liver disease: a randomized controlled clinical trial. GASTROENTEROLOGY AND HEPATOLOGY FROM BED TO BENCH 2017; 10:263-271. [PMID: 29379590 PMCID: PMC5758733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM This study aimed to assess the effect of telenursing on nutritional behavior and physical activity self-efficacy in patients with non-alcoholic fatty liver disease (NAFLD). BACKGROUND NAFLD is the most common liver disorder, which has a chronic course. Therefore, routine monitoring of these patients by medical staff helps them actively participate in the healing process and promote their self-efficacy. METHODS In this randomized controlled clinical trial, 60 patients were chosen through convenience sampling among patients with NAFLD. After obtaining written informed consents, the participants were randomly divided into an intervention and a control group (each containing 30 subjects). The participants received diet consultation individually and were taught how to perform physical activities. Telephone intervention was conducted in the intervention group for 12 weeks. The study questionnaires were completed by the participants before and after the intervention. The data were analyzed using the SPSS statistical software. RESULTS Based on the results, the mean score of nutritional behavior and physical activity self-efficacy increased in the study groups after the intervention. This increase was statistically significant only in the intervention group. Additionally, the two groups were significantly different regarding the mean scores of nutritional behavior and physical activity self-efficacy. CONCLUSION Telenursing could improve self-efficacy and physical activity in patients with NAFLD.
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Affiliation(s)
- Sorur Javanmardifard
- School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fariba Ghodsbin
- Community Based Psychiatric Care Research Center, Shiraz Geriatric Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Javad Kaviani
- Gastroenterohepatology Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Iran Jahanbin
- Department of Community Health Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Muñoz K, Kibbe K, Preston E, Caballero A, Nelson L, White K, Twohig M. Paediatric hearing aid management: a demonstration project for using virtual visits to enhance parent support. Int J Audiol 2016; 56:77-84. [DOI: 10.1080/14992027.2016.1226521] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Karen Muñoz
- Department of Communicative Disorders and Deaf Education, Utah State University, Logan, UT, USA,
- National Center for Hearing Assessment and Management, Utah State University, Logan, UT, USA, and
| | - Kristin Kibbe
- Department of Communicative Disorders and Deaf Education, Utah State University, Logan, UT, USA,
| | - Elizabeth Preston
- Department of Communicative Disorders and Deaf Education, Utah State University, Logan, UT, USA,
| | - Ana Caballero
- Department of Communicative Disorders and Deaf Education, Utah State University, Logan, UT, USA,
| | - Lauri Nelson
- Department of Communicative Disorders and Deaf Education, Utah State University, Logan, UT, USA,
| | - Karl White
- National Center for Hearing Assessment and Management, Utah State University, Logan, UT, USA, and
- Department of Psychology, Utah State University, Logan, UT, USA
| | - Michael Twohig
- Department of Psychology, Utah State University, Logan, UT, USA
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Laderman M, Mate K. Community health workers for patients with medical and behavioral health needs – Challenges and opportunities. Healthcare (Basel) 2016; 4:145-7. [DOI: 10.1016/j.hjdsi.2015.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 07/16/2015] [Accepted: 07/27/2015] [Indexed: 11/25/2022] Open
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Mochari-Greenberger H, Vue L, Luka A, Peters A, Pande RL. A Tele-Behavioral Health Intervention to Reduce Depression, Anxiety, and Stress and Improve Diabetes Self-Management. Telemed J E Health 2016; 22:624-30. [DOI: 10.1089/tmj.2015.0231] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Lee Vue
- AbilTo, Inc., New York, New York
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Baron JS, Hirani SP, Newman SP. Investigating the behavioural effects of a mobile-phone based home telehealth intervention in people with insulin-requiring diabetes: Results of a randomized controlled trial with patient interviews. J Telemed Telecare 2016; 23:503-512. [DOI: 10.1177/1357633x16655911] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Introduction Evidence supporting home telehealth effects on clinical outcomes in diabetes is available, yet mechanisms of action for these improvements remain poorly understood. Behavioural change is one plausible explanation. This study investigated the behavioural effects of a mobile-phone based home telehealth (MTH) intervention in people with diabetes. It was hypothesized that MTH would improve self-efficacy, illness beliefs, and diabetes self-care. Methods A randomized controlled trial compared standard care to standard care supplemented with MTH (self-monitoring, data transmission, graphical and nurse-initiated feedback, educational calls). Self-report measures of self-efficacy, illness beliefs, and self-care were repeated at baseline, three months, and nine months. MTH effects were based on the group by time interactions in hierarchical linear models and effect sizes with 95% confidence intervals (CIs). Interviews with MTH participants explored the perceived effects of MTH on diabetes self-management. Results Eighty-one participants were randomized to the intervention ( n = 45) and standard care ( n = 36). Significant group by time effects were observed for five out of seven self-efficacy subscales. Effect sizes were large, particularly at nine months. Interaction effects for illness beliefs and self-care were non-significant, but effect sizes and confidence intervals suggested MTH may positively affect diet and exercise. In interviews, MTH was associated with increased awareness, motivation, and a greater sense of security. Improved self-monitoring and diet were reported by some participants. Discussion MTH empowers people with diabetes to manage their condition and may influence self-care. Future MTH research would benefit from investigating behavioural mechanisms and determining patient profiles predictive of greater behavioural effectiveness.
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Affiliation(s)
- Justine Sita Baron
- Institute of Cardiovascular Science, University College London, United Kingdom; Ottawa Hospital Research Institute, Ontario, Canada
| | | | - Stanton Peter Newman
- Centre for Health Services Research, School of Health Sciences, City University London, UK
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Amante DJ, Thompson MJ. The promise of telecommunication tools to 'reach' the disengaged patient with diabetes. Curr Opin Endocrinol Diabetes Obes 2016; 23:111-20. [PMID: 26915036 DOI: 10.1097/med.0000000000000240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW To discuss recent research on the use of telecommunication technologies to improve care for disengaged patients with diabetes. RECENT FINDINGS It is established that patients who are disengaged with their healthcare have worse health outcomes. Reasons for disengagement vary but could be because of difficulties accessing or affording care or not possessing the skills or tools required to manage their disease. New patient-facing technologies are being used to improve communication and coordination of care for patients with diabetes. Early results show improvements in health outcomes. Utilizing these technologies to reach patient groups susceptible for disengagement has begun to demonstrate improvement. SUMMARY Research over the past year has continued to demonstrate the promise of using telecommunication tools to assist patients in the management of diabetes. Although a few studies looked specifically at disengaged patients, efforts to utilize appropriate technological interventions targeting specific groups of patients are needed.
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Affiliation(s)
- Daniel J Amante
- aDivision of Health Informatics and Implementation Science, Department of Quantitative Health SciencesbClinical and Population Health Research PhD Program, Graduate School of Biomedical SciencescDiabetes Center of Excellence, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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Miyamoto SW, Henderson S, Young HM, Pande A, Han JJ. Tracking Health Data Is Not Enough: A Qualitative Exploration of the Role of Healthcare Partnerships and mHealth Technology to Promote Physical Activity and to Sustain Behavior Change. JMIR Mhealth Uhealth 2016; 4:e5. [PMID: 26792225 PMCID: PMC4758807 DOI: 10.2196/mhealth.4814] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 08/31/2015] [Accepted: 10/18/2015] [Indexed: 11/13/2022] Open
Abstract
Background Despite the recent explosion of the mobile health (mHealth) industry and consumer acquisition of mHealth tools such as wearable sensors and applications (apps), limited information is known about how this technology can sustain health behavior change and be integrated into health care. Objective The objective of the study was to understand potential users’ views of mHealth technology, the role this technology may have in promoting individual activity goals aimed at improving health, and the value of integrating mHealth technology with traditional health care. Methods Four focus groups were conducted with adults interested in sharing their views on how mHealth technology could support wellness programs and improve health. Participants (n=30) were enrolled from an employee population at an academic health institution. Qualitative thematic analysis was used to code transcripts and identify overarching themes. Results Our findings suggest that tracking health data alone may result in heightened awareness of daily activity, yet may not be sufficient to sustain use of mHealth technology and apps, which often have low reuse rates. Participants suggested that context, meaning, and health care partnerships need to be incorporated to engage and retain users. In addition to these findings, drivers for mHealth technology previously identified in the literature, including integration and control of health data were confirmed in this study. Conclusions This study explores ways that mHealth technologies may be used to not only track data, but to encourage sustained engagement to achieve individual health goals. Implications of these findings include recommendations for mHealth technology design and health care partnership models to sustain motivation and engagement, allowing individuals to achieve meaningful behavior change.
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Affiliation(s)
- Sheridan W Miyamoto
- College of Nursing, The Pennsylvania State University, University Park, CA, United States.
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Quinn CC, Khokhar B, Weed K, Barr E, Gruber-Baldini AL. Older Adult Self-Efficacy Study of Mobile Phone Diabetes Management. Diabetes Technol Ther 2015; 17:455-61. [PMID: 25692373 PMCID: PMC4808269 DOI: 10.1089/dia.2014.0341] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The purpose of this study was to evaluate participant self-efficacy and use of a mobile phone diabetes health intervention for older adults during a 4-week period. Participants included seven adults (mean age, 70.3 years) with type 2 diabetes cared for by community-based primary care physicians. Participants entered blood glucose data into a mobile phone and personalized patient Internet Web portal. Based on blood glucose values, participants received automatic messages and educational information to self-manage their diabetes. Study measures included prior mobile phone/Internet use, the Stanford Self-Efficacy for Diabetes Scale, the Stanford Energy/Fatigue Scale, the Short Form-36, the Patient Health Questionnaire-9 (depression), the Patient Reported Diabetes Symptom Scale, the Diabetes Stages of Change measure, and a summary of mobile system use. Participants had high self-efficacy and high readiness and confidence in their ability to monitor changes to control their diabetes. Participants demonstrated ability to use the mobile intervention and communicate with diabetes educators.
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Affiliation(s)
- Charlene C. Quinn
- Division of Gerontology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Bilal Khokhar
- Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland
| | - Kelly Weed
- Division of Gerontology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Erik Barr
- Division of Gerontology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Ann L. Gruber-Baldini
- Division of Gerontology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
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