Living Smartly with Diabetes: Using PWP and Mobile PWP for Self-Management

描述（由申请人提供）： 糖尿病是一种代价高昂且具有破坏性的慢性疾病，非裔美国人受到的影响不成比例。协调护理和自我管理可以显著减轻这种疾病的经济和心理负担。最先进的通信和网络技术的使用越来越多地用于改善患者与提供者的沟通、疾病管理和自我护理行为。使用基于互联网的策略的患者门户网站（PWP）提供了电子医疗记录与患者健康记录的集成，以增强患者的结果。智能手机是可以即时访问互联网以获取健康信息的通信设备。PWP与智能手机的集成提供了从提供者到患者的安全和即时消息的实时反馈，以及对健康相关信息的即时访问。 路易斯·斯托克斯健康科学图书馆和霍华德大学医院糖尿病治疗中心（HUH-DTC）都位于霍华德大学，一所历史悠久的黑人学院和大学的校园内。HUH-DTC目前为患者提供糖尿病PWP。在PWP的最初设计中，健康科学图书馆员没有参与。到目前为止，有几个障碍，患者有效地使用PWP，如忘记密码，缺乏使用的PWP教育组件等，这项研究将整合健康科学图书馆员，临床医生和计算机科学家的专业知识，以改善PWP。研究目标是：（1）通过患者和提供者焦点小组消除障碍，改善PWP的使用，（2）在健康科学图书馆员的帮助下，利用焦点小组的反馈重新设计当前的PWP，（3）将智能手机与现有PWP集成，以增强患者/提供者的沟通和健康信息，以及（4）测量患者激活，以改善糖尿病自我治疗。在重新设计的PWP-智能手机干预后，随着血红蛋白A1 c的减少，管理沿着减少。 研究设计是双重的。第一，是实施以患者为中心的糖尿病PWP重新设计，第二，是一项非盲态随机干预平行分配试验。试验参与者将被随机分配到两个行为糖尿病干预组之一：（1）网络智能手机教育PWP，或（2）标准糖尿病护理，可访问PWP，但无智能手机PWP干预。该研究将在HUH-DTC进行。将从HUH-DTC招募210名18岁或以上的非裔美国男性和女性，以获得足够的把握度来检测患者激活的差异，以增强糖尿病自我护理管理。网络活动使用将使用Google Analytics进行监控。拟议的研究将接受霍华德大学机构审查委员会的彻底审查和监督。将有一个安全的套接字层，用于所有电子健康信息的安全性，这将消除电子健康数据的安全漏洞，符合HIPPA关于患者便携性和隐私的规定。

DESCRIPTION (provided by applicant): Diabetes Mellitus is a costly and devastating chronic illness with African Americans disproportionately affected. Coordination of care and self-management can significantly reduce the economic and psychological burden of this disease. The use of state-of-the-art communications and networking technologies are increasingly being used to improve patient-provider communication, disease management, and self-care behavior. Patient web portals (PWPs) using internet-based strategies provide the integration of the electronic medical record with the patient health record for enhanced patient outcomes. Smartphones are communication devices that can provide instant access to the internet for health information. The integration of the PWP with a Smartphone provides real-time feedback for secure and instant messaging from provider to patient and immediate access to health related information. Louis Stokes Health Sciences Library and Howard University Hospital Diabetes Treatment Center (HUH-DTC) are both located on the campus of Howard University, a Historically Black College and University. The HUH- DTC currently provides a diabetes PWP to its patients. In the initial design of the PWP, health science librarians were not involved. To date, there are several barriers in patients effectively using the PWP such as forgotten passwords, lack of use of the PWP educational component, etc. This study will integrate the expertise of health science librarians, clinicians, and computer scientists for an improved PWP. The study goals are to: (1) improve PWP use by removing barriers through patient and provider focus groups, (2) redesign the current PWP using feedback from the focus groups with the assistance of health science librarians, (3) integrate the Smartphone with the existing PWP for enhanced patient/provider communication and health information and (4) measure patient activation for improved diabetes self-management along with reduction in hemoglobin A1c after the redesigned PWP-Smartphone intervention. The study design is two-fold. First, is to implement a patient-centered redesign of the diabetes PWP and the second, is a non-masked randomized interventional parallel assignment trial. Trial participants will be randomized into one of two behavioral diabetes intervention arms: (1) web-enabled Smartphone educational PWP, or (2) standard diabetes care with access to the PWP, but no Smartphone-enabled PWP intervention. The study will take place at the HUH-DTC. A total of 210 African American men and women 18 years or older will be recruited from HUH-DTC to achieve adequate power to detect differences in patient activation for enhanced diabetes self-care management. Web activity use will be monitored using Google Analytics. The proposed study will receive thorough review and oversight from the Institutional Review Board at Howard University. There will be a secure socket layer for security of all electronic health information that will eliminate security breaches of electronic health data meeting HIPPA regulations of patient portability and privacy.