Health Impact of a Mobile-Delivered Diabetes Intervention to Control Blood Pressure in Older Adults

Koren S. Goodman PhD, MSEd , Elizabeth Locke PhD
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Abstract

Introduction

Patient education is an effective modality to reinforce self-care practices for chronic disease management. The purpose of this study was twofold: (1) to assess the health impact of a phone-delivered diabetes intervention and (2) to identify predictors of telehealth message use among adults aged 18–65 years with diabetes in a primary care setting using the Technology Acceptance Model theoretical framework.

Methods

A pretest–posttest experimental study design was employed. Participants were randomized to receive 7 weeks of telehealth self-care messages or to the routine care group. Outcome measures included (1) telehealth use among patients who received weekly telehealth messages, (2) self-care behavior management derived from the Behavior Score Instrument, and (3) clinical outcomes measures.

Results

The study team enrolled 150 patients, and of these, 138 (aged 18–65 years) completed the study. Participants aged 53±9.6 (mean±SD) years were mainly females (n=93; 76%), and the majority received government-sponsored health insurance (n=75; 54%). Age was a strong predictor of telehealth use (p<0.001). Among patients who received telehealth messages, systolic and diastolic blood pressure measures (140/78 mmHg vs 134/74 mmHg) were statistically significant at follow-up (p=0.001 and p=0.007, respectively).

Conclusions

Digital support tools can play a valuable role in supporting lifestyle modification changes and reinforcing good diabetes self-care practices in older adults. Providing accessible tools and resources empowers adults to take an active role in their own health.

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移动糖尿病干预对控制老年人血压的健康影响
导言:患者教育是加强慢性病管理自我护理实践的有效方式。本研究有两个目的:(1) 评估电话糖尿病干预对健康的影响;(2) 利用技术接受模型理论框架,确定在初级保健环境中 18-65 岁成人糖尿病患者使用远程保健信息的预测因素。参与者被随机分配到接受 7 周远程保健自我护理信息或常规护理组。结果测量包括:(1)每周接收远程保健信息的患者的远程保健使用情况;(2)根据行为评分工具得出的自我保健行为管理情况;以及(3)临床结果测量。参与者的年龄为 53±9.6(平均值±SD)岁,以女性为主(93 人;76%),大多数人参加了政府资助的医疗保险(75 人;54%)。年龄是使用远程保健的一个重要预测因素(p<0.001)。在接受远程保健信息的患者中,收缩压和舒张压测量值(140/78 mmHg vs 134/74 mmHg)在随访时具有统计学意义(分别为 p=0.001 和 p=0.007)。提供易于使用的工具和资源可以增强成年人的能力,使他们在自身健康方面发挥积极作用。
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AJPM focus
AJPM focus Health, Public Health and Health Policy
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