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Personalized Digital Health Solutions to Increasing Diabetes-Related Knowledge and Behavioral Outcomes: Results from
Marcia Ory1,2, Christi H Esquivel1, Gang Han3,4
1Center for Community Health and Aging, School of Public Health, Texas A&M University, 212 Adriance Lab Rd, College Station, US.
Background:
The prevalence of diabetes in the US necessitates investigations into how to better enable adults with type 2 diabetes to manage their health using easy to access and personally adaptable technologies. The ubiquity of digital content further justifies the need to consider the impact of different digital intervention modalities in diabetes self-care activities.
Objective:
The purpose of this study is to compare the impact of two digital diabetes self-care education programs delivered separately, and in combination, to adults with type 2 diabetes across various settings in Texas.
Methods:
We conducted a randomized control trial (RCT) in Texas with 188 adults with T2DM to assess whether two different interventions alone (vMMWD or TBES) or in combination (vMMWD followed by TBES) improved multiple outcomes associated with diabetes self-management. We employed several estimation techniques including generalized estimating equations (GEE), to account for multiple factors simultaneously.
Results:
All three digital intervention modalities led to significant improvements (p<.05) in diabetes-related confidence, distress, and self-care behaviors, with significant effects from baseline through 6 months and supported by moderate to strong effect sizes for the total population (ranging from .446 to .827 at 3 months and .538 to .888 at 6 months). No statistically significant superiority was observed among the intervention modalities. Higher self-care behaviors were significantly associated with higher baseline confidence and lower distress. Those in the most disadvantaged positions (less education, less financial stability, and no health insurance) showed significantly larger improvement in selfcare behaviors.
Conclusions:
Given the benefits associated with the current study's interventions, we suggest future work to further develop digital content that can be tailored to individuals with T2DM to help them manage their chronic condition(s) in a cost-effective manner.
Clinicaltrial:
This trial was registered at ClinicalTrials.gov under ID number NCT06370494.
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