How Do Mobile Phone Diabetes Programs Drive Behavior Change? Evidence From a Mixed Methods Observational Cohort Study
How Do Mobile Phone Diabetes Programs Drive Behavior Change? Evidence From a Mixed Methods Observational Cohort Study
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DOI：
10.1177/0145721714551992
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发表时间：
2014-11-01
影响因子：
3.9
通讯作者：
Peek, Monica E.
中科院分区：
文献类型：
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作者：
Nundy, Shantanu;Mishra, Anjuli;Peek, Monica E.
目的本研究的目的是调查一种理论驱动的，基于移动电话的干预，结合自动短信和远程护理，使用一个自动的，互动的短信系统。方法采用混合方法进行观察性队列研究。研究参与者是芝加哥大学健康计划（UCHP）的成员，他们大多居住在工薪阶层的城市非洲裔美国人社区。调查分别在基线、干预中3个月和干预后6个月进行，以检验干预与自我效能、社会支持、健康信念和自我保健的改善有关的假设。此外，对14名参与者进行了深入的个人访谈，然后使用恒定比较法进行分析，以识别受干预影响的新行为构形。结果干预与自我护理（服药、血糖监测、足部护理、运动和健康饮食）的6个领域中的5个领域的改善以及自我效能、社会支持和健康信念（感知控制）的1项或多项措施的改善有关。定性地说，参与者报告说，知识、态度和所有权也受到了该计划的影响。这些发现被用来构建一个新的行为模型。本研究的发现挑战了手机在很大程度上通过提醒影响行为改变的普遍假设，并支持了行为驱动的移动健康干预可以解决与持续行为改变相关的多种行为途径的观点。
PurposeThe purpose of this study was to investigate the behavioral effects of a theory-driven, mobile phone-based intervention that combines automated text messaging and remote nursing, using an automated, interactive text messaging system.MethodsThis was a mixed methods observational cohort study. Study participants were members of the University of Chicago Health Plan (UCHP) who largely reside in a working-class, urban African American community. Surveys were conducted at baseline, 3 months (mid-intervention), and 6 months (postintervention) to test the hypothesis that the intervention would be associated with improvements in self-efficacy, social support, health beliefs, and self-care. In addition, in-depth individual interviews were conducted with 14 participants and then analyzed using the constant comparative method to identify new behavioral constructs affected by the intervention.ResultsThe intervention was associated with improvements in 5 of 6 domains of self-care (medication taking, glucose monitoring, foot care, exercise, and healthy eating) and improvements in 1 or more measures of self-efficacy, social support, and health beliefs (perceived control). Qualitatively, participants reported that knowledge, attitudes, and ownership were also affected by the program. Together these findings were used to construct a new behavioral model.ConclusionsThis study's findings challenge the prevailing assumption that mobile phones largely affect behavior change through reminders and support the idea that behaviorally driven mobile health interventions can address multiple behavioral pathways associated with sustained behavior change.