Technology-Assisted Self-Monitoring of Lifestyle Behaviors and Health Indicators in Diabetes: Qualitative Study.
Technology-Assisted Self-Monitoring of Lifestyle Behaviors and Health Indicators in Diabetes: Qualitative Study.
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DOI：
10.2196/21183
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发表时间：
2020-08-28
期刊：
影响因子：
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通讯作者：
Wang, Jing
中科院分区：
文献类型：
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作者：
Du, Yan;Dennis, Brittany;Wang, Jing
背景：自我监测是糖尿病和肥胖症患者成功改变行为的关键，使用传统的基于纸张的自我监测方法可能既耗时又费力。目的：本研究旨在探讨超重或肥胖成人2型糖尿病患者在使用技术辅助的生活方式行为和健康指标自我监测时的体验。方法：对干预组为期6个月的三组随机临床试验（对照组、纸质日记组和技术辅助自我监测组）的定性数据进行分析。干预组的研究参与者使用LoseIt！在行为生活方式干预开始后的第6周（n=10）和第6个月（n=9）分别进行半结构化小组讨论。所有的小组访谈都被录音并逐字记录下来。两位训练有素的专业人员采用主题分析和比较分析相结合的方法，对转录进行独立编码，然后分别讨论并总结为期6周和6个月的讨论的共同主题。结果：样本（n=10）主要包括非裔美国人参与者（n=7）和女性参与者（n=8），平均年龄为59.4岁。出现了以下八个主题：(1)技术辅助自我监测的感知效益；(2)感知易用性（例如，障碍：技术困难和缺乏自律；促进因素：来自家人、朋友和项目的帮助）；(3)利用技术辅助的自我监控；(4)促进健康生活方式行为（例如，可视化和意识到卡路里的输入/消耗）；(5)积极改变生活方式；(6)参与健康生活方式行为的障碍（如事件影响）；(7)学习曲线；(8)监控数据共享。前六个主题在6周和6个月时间点共享，但这些主题中的代码并不完全相同，并且在两个时间点之间略有不同。这些差异为参与者在参与生活方式干预时使用技术进行自我监控和随后的行为生活方式改变的想法和看法的演变提供了见解。从6周和6个月的数据中得出的结果有助于描绘出参与者的舒适度和技术与知识的整合情况，并澄清了参与者的态度、困难、行为过程和修改，以及整个研究过程中所经历的健康指标。结论：尽管存在一些障碍，但参与者能够识别各种个人和外部的促进因素来适应和参与技术辅助的自我监测，结论是技术辅助的自我监测方法对积极的生活方式改变是有益的、安全的和可行的。在未来的研究中，在调查使用技术辅助自我监测的有效性时，需要考虑这些患者的观点，在临床实践中，在推荐技术辅助的生活方式行为和健康指标自我监测以改善健康结果时，也需要考虑这些患者的观点。
BACKGROUND: Self-monitoring is key to successful behavior change in diabetes and obesity, and the use of traditional paper-based methods of self-monitoring may be time-consuming and burdensome.OBJECTIVE: This study aimed to explore participant experiences while using technology-assisted self-monitoring of lifestyle behaviors and health indicators among overweight or obese adults with type 2 diabetes.METHODS: Qualitative data collected from the intervention group of a 6-month, three-arm (control, paper diary, and technology-assisted self-monitoring groups) randomized clinical trial were analyzed. Study participants in the intervention group monitored their diet, exercise, and weight using the LoseIt! app, and their blood glucose levels using a glucometer and the Diabetes Connect app. Semistructured group discussions were conducted at 6 weeks (n=10) from the initiation of the behavioral lifestyle intervention and again at 6 months (n=9). All group interviews were audiotaped and transcribed verbatim. Using a combination of thematic and comparative analysis approaches, two trained professionals coded the transcriptions independently and then discussed and concluded common themes for the 6-week and 6-month discussions separately.RESULTS: The sample (n=10), which primarily involved African American participants (n=7) and female participants (n=8), had a mean age of 59.4 years. The following eight themes emerged: (1) perceived benefits of technology-assisted self-monitoring; (2) perceived ease of use (eg, barriers: technical difficulties and lack of self-discipline; facilitators: help from family, friends, and the program); (3) use of technology-assisted self-monitoring; (4) facilitators of engaging in healthy lifestyle behaviors (eg, visualization and awareness of calorie input/expenditure); (5) positive lifestyle change; (6) barriers of engaging in healthy lifestyle behaviors (eg, event influence); (7) learning curve; and (8) monitored data sharing. The first six of these themes were shared between the 6-week and 6-month timepoints, but the codes within these themes were not all the same and differed slightly between the two timepoints. These differences provide insights into the evolution of participant thoughts and perceptions on using technology for self-monitoring and subsequent behavioral lifestyle changes while participating in lifestyle interventions. The findings from the 6-week and 6-month data helped to paint a picture of participant comfort and the integration of technology and knowledge overtime, and clarified participant attitudes, difficulties, behavioral processes, and modifications, as well as health indicators that were experienced throughout the study.CONCLUSIONS: Although there were some barriers, participants were able to identify various individual and external facilitators to adjust to and engage in technology-assisted self-monitoring, and it was concluded that the technology-assisted self-monitoring approach was beneficial, safe, and feasible to use for positive lifestyle change. These patient perspectives need to be considered in future research studies when investigating the effectiveness of using technology-assisted self-monitoring, as well as in clinical practice when recommending technology-assisted self-monitoring of lifestyle behaviors and health indicators to improve health outcomes.