Twelve-month outcomes of an Internet-based diabetes self-management support program
Twelve-month outcomes of an Internet-based diabetes self-management support program
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DOI：
10.1016/j.pec.2011.07.024
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发表时间：
2012-04-01
影响因子：
3.5
通讯作者：
Ritzwoller, Debra
中科院分区：
文献类型：
--
作者：
Glasgow, Russell E.;Kurz, Deanna;Ritzwoller, Debra
目的：基于互联网的程序提供了实用的，具有成本效益的慢性疾病自我管理programmes.Methods的潜力：我们报告12个月的结果，基于互联网的糖尿病自我管理程序，有和没有额外的支持，相比，加强常规护理在3臂实际随机试验。患者（n = 463）被随机分组：77.3%完成了12个月的随访。主要结果是健康饮食，体育活动和药物服用等健康行为的变化。次要结果是血红蛋白A1 c，体重指数，血脂，血压，和psychosocial factors.Results：互联网条件改善健康行为显着与常规护理超过12个月的时间（D效应大小= 0.09 - 0.16）。所有情况在生物学和心理社会学结果上均有适度改善。拉丁美洲人，识字率较低，心血管疾病风险较高的患者改善了尽可能多的其他participator.Conclusions：互联网干预符合潜在的广泛的公共卫生影响的范围和可行性标准。然而，12个月的影响幅度很小，这表明需要不同或更密集的方法来支持长期结果。研究是必要的，以了解干预和维护过程和下游outcome.Practice影响之间的联系：自动化自我管理干预措施应量身定制，并整合到初级保健;维护病人的自我管理，可以通过链接到社区资源。出版社：Elsevier爱尔兰Ltd.
Objective: Internet-based programs offer potential for practical, cost-effective chronic illness self-management programs.Methods: We report 12-month results of an Internet-based diabetes self-management program, with and without additional support, compared to enhanced usual care in a 3-arm practical randomized trial. Patients (n = 463) were randomized: 77.3% completed 12-month follow-up. Primary outcomes were changes in health behaviors of healthy eating, physical activity, and medication taking. Secondary outcomes were hemoglobin A1c, body mass index, lipids, blood pressure, and psychosocial factors.Results: Internet conditions improved health behaviors significantly vs. usual care over the 12-month period (d for effect size = .09-.16). All conditions improved moderately on biological and psychosocial outcomes. Latinos, lower literacy, and higher cardiovascular disease risk patients improved as much as other participants.Conclusions: The Internet intervention meets the reach and feasibility criteria for a potentially broad public health impact. However, 12-month magnitude of effects was small, suggesting that different or more intensive approaches are necessary to support long-term outcomes. Research is needed to understand the linkages between intervention and maintenance processes and downstream outcomes.Practice implications: Automated self-management interventions should be tailored and integrated into primary care; maintenance of patient self-management can be enhanced through links to community resources. Published by Elsevier Ireland Ltd.