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Engagement in a diabetes self-management website: usage patterns and generalizability of program use
Russell E Glasgow1, Steven M Christiansen, Deanna Kurz
1Institute for Health Research, Kaiser Permanente, Denver, CO, USA. russg@re-aim.net
Journal of Medical Internet Research
|March 5, 2011
Summary
Adults with diabetes frequently used an internet-based program for self-management, but engagement declined over time. Website use, particularly self-monitoring, was linked to improved healthy eating and exercise behaviors.
Area of Science:
- Digital Health Interventions
- Behavioral Science
- Diabetes Self-Management
Background:
- eHealth interventions show promise for diabetes self-management.
- A critical factor is sustained user engagement for behavior change.
Purpose of the Study:
- To assess website engagement indices in an internet-based diabetes intervention.
- To identify participant characteristics associated with engagement.
- To examine the relationship between website use and health outcomes.
Main Methods:
- A randomized controlled trial (RCT) compared website-only versus website plus human support.
- Engagement metrics included log-ins, component visits, self-monitoring entries, and time on site.
- Outcomes assessed were exercise, healthy eating, medication adherence, BMI, and cardiovascular risk factors.
Main Results:
- Website usage decreased over 4 months, with 70% visiting weekly initially, dropping to 47%.
- Self-monitoring engagement correlated with improved healthy eating (r=0.20) and reduced dietary fat (r=-0.31).
- Exercise engagement also showed a positive correlation (r=0.20), but medication adherence did not.
Conclusions:
- Participants engaged with key website features, but overall engagement waned over time.
- Engagement patterns were consistent across diverse participants, suggesting broad applicability of online interventions.
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