Exploring the Use of Personal Technology in Type 2 Diabetes Management Among Ethnic Minority Patients: Cross-Sectional Analysis of Survey Data from the Lifestyle Intervention for the Treatment of Diabetes Study (LIFT Diabetes).
Exploring the Use of Personal Technology in Type 2 Diabetes Management Among Ethnic Minority Patients: Cross-Sectional Analysis of Survey Data from the Lifestyle Intervention for the Treatment of Diabetes Study (LIFT Diabetes).
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DOI：
10.2196/diabetes.8934
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发表时间：
2018-02-22
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影响因子：
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通讯作者：
Bertoni AG
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作者：
Claudel SE;Bertoni AG
少数群体的慢性病发病率较高，通常健康状况较差。互联网技术可以提供一种低成本的慢性病持续管理方法，以促进改善少数群体的健康结果。我们研究的目的是评估利用技术的普遍使用作为提供糖尿病咨询的辅助手段的可行性，通过在正在进行的糖尿病干预研究的背景下调查技术使用的相关性。糖尿病治疗的生活方式干预研究（LIFT糖尿病）将260名超重和肥胖的2型糖尿病成人随机分配到2个干预组。在基线时，我们进行了一项调查，评估各种技术的获取和使用情况，并使用描述性统计和逻辑回归分析了响应。样本人群的平均年龄为56岁（SD 11）; 67.3%（175/260）为女性，54.6%（n=142）自认为来自少数民族（n=125，88.0%为黑人; n=6，4.3%为西班牙裔; n=11，7.7%为其他）。少数民族参与者的基线平均体重指数（P= 0.002）和血红蛋白A1 c水平（P= 0.003）较高。少数族裔参与者不太可能拥有家用电脑（106/142，74.7% vs 110/118，93.2%; P<.001），也不太可能在家中使用电子邮件（P=.03）。拥有家用电脑与高收入（P<.001）、高教育程度（P<.001）、全职工作（P=.01）和拥有智能手机（P=.001）相关。在线完成问卷的意愿与较高的收入（P=.001），高等教育（P<.001），全职工作（P=.01）以及家庭使用计算机，互联网和智能手机（P≤.05）相关。在控制人口统计变量和拥有智能手机后，拥有家用电脑的种族差异仍然存在（调整后OR 0.26，95%CI 0.10-0.67; P= 0.01）。在线完成问卷的意愿是由拥有家用电脑驱动的（调整后的OR 3.87，95%CI 1.14-13.2; P=.03）。自认为属于少数群体的成年人比白色成年人更有可能报告获得技术的机会有限。由于拥有一台家用电脑是使用在线工具的意愿的核心，在访问方面的种族差异可能会限制基于网络的干预措施达到这一人群的潜力。ClinicalTrials.gov NCT 01806727; https://clinicaltrials.gov/ct2/show/NCT01806727（由WebCite在http：//www.webcitation.org/6xOq2b7Tv上存档）
Minority populations have higher morbidity from chronic diseases and typically experience worse health outcomes. Internet technology may afford a low-cost method of ongoing chronic disease management to promote improved health outcomes among minority populations. The objective of our study was to assess the feasibility of capitalizing on the pervasive use of technology as a secondary means of delivering diabetic counseling though an investigation of correlates to technology use within the context of an ongoing diabetes intervention study. The Lifestyle Intervention for the Treatment of Diabetes study (LIFT Diabetes) randomly assigned 260 overweight and obese adults with type 2 diabetes mellitus to 2 intervention arms. At baseline, we administered a survey evaluating access to and use of various technologies and analyzed the responses using descriptive statistics and logistic regression. The sample population had a mean age of 56 (SD 11) years; 67.3% (175/260) were female and 54.6% (n=142) self-identified as being from ethnic minority groups (n=125, 88.0% black; n=6, 4.3% Hispanic; and n=11, 7.7% other). Minority participants had higher baseline mean body mass index (P=.002) and hemoglobin A1c levels (P=.003). Minority participants were less likely to have a home computer (106/142, 74.7% vs 110/118, 93.2%; P<.001) and less likely to have email access at home (P=.03). Ownership of a home computer was correlated to higher income (P<.001), higher educational attainment (P<.001), full-time employment (P=.01), and ownership of a smartphone (P=.001). Willingness to complete questionnaires online was correlated to higher income (P=.001), higher education (P<.001), full-time employment (P=.01), and home access to a computer, internet, and smartphone (P≤.05). Racial disparities in having a home computer persisted after controlling for demographic variables and owning a smartphone (adjusted OR 0.26, 95% CI 0.10-0.67; P=.01). Willingness to complete questionnaires online was driven by ownership of a home computer (adjusted OR 3.87, 95% CI 1.14-13.2; P=.03). Adults who self-identified as being part of a minority group were more likely to report limited access to technology than were white adults. As ownership of a home computer is central to a willingness to use online tools, racial disparities in access may limit the potential of Web-based interventions to reach this population. ClinicalTrials.gov NCT01806727; https://clinicaltrials.gov/ct2/show/NCT01806727 (Archived by WebCite at http://www.webcitation.org/6xOq2b7Tv)