A Novel User Utility Score for Diabetes Management Using Tailored Mobile Coaching: Secondary Analysis of a Randomized Controlled Trial
Open Access
- 24 February 2021
- journal article
- research article
- Published by JMIR Publications Inc. in JMIR mHealth and uHealth
- Vol. 9 (2), e17573
- https://doi.org/10.2196/17573
Abstract
Background: Mobile health applications have been developed to support diabetes self-management, but their effectiveness could depend on patient engagement. Therefore, patient engagement must be examined through multifactorial tailored behavioral interventions from an individual perspective. Objective: This study aims to evaluate the usefulness of a novel user utility score (UUS) as a tool to measure patient engagement by using a mobile health application for diabetes management. Methods: We conducted a subanalysis of results from a 12-month randomized controlled trial of a tailored mobile coaching (TMC) system among insurance policyholders with type 2 diabetes. UUS was calculated as the sum of the scores for 4 major core components (range 0-8): frequency of self-monitoring blood glucose testing, dietary and exercise records, and message reading rate. We explored the association between UUS for the first 3 months and glycemic control over 12 months. In addition, we investigated the relationship of UUS with blood pressure, lipid profile, and self-report scales assessing diabetes self-management. Results: We divided 72 participants into 2 groups based on UUS for the first 3 months: UUS:0-4 (n=38) and UUS:5-8 (n=34). There was a significant between-group difference in glycated hemoglobin test (HbA1c) levels for the 12-months study period (P=.011). The HbA1c decrement at 12 months in the UUS:5-8 group was greater than that of the UUS:0-4 group [–0.92 (SD 1.24%) vs –0.33 (SD 0.80%); P=.049]. After adjusting for confounding factors, UUS was significantly associated with changes in HbA1c at 3, 6, and 12 months; the regression coefficients were –0.113 (SD 0.040; P=.006), –0.143 (SD 0.045; P=.002), and –0.136 (SD 0.052; P=.011), respectively. Change differences in other health outcomes between the 2 groups were not observed throughout a 12-month follow-up. Conclusions: UUS as a measure of patient engagement was associated with changes in HbA1c over the study period of the TMC system and could be used to predict improved glycemic control in diabetes self-management through mobile health interventions. Trial Registration: ClinicalTrial.gov NCT03033407; https://clinicaltrials.gov/ct2/show/NCT03033407Keywords
This publication has 44 references indexed in Scilit:
- Standards of Medical Care in Diabetes—2019 Abridged for Primary Care ProvidersClinical Diabetes, 2019
- Projection of Diabetes Prevalence in Korean Adults for the Year 2030 Using Risk Factors Identified from National DataDiabetes & Metabolism Journal, 2019
- Digital Health Interventions for Adults With Type 2 Diabetes: Qualitative Study of Patient Perspectives on Diabetes Self-Management Education and SupportJournal of Medical Internet Research, 2018
- Association of Self-Care Behaviors and Quality of Life among Patients with Type 2 Diabetes Mellitus: Chaldoran County, IranDiabetes & Metabolism Journal, 2017
- Trends in Diabetes Incidence in the Last Decade Based on Korean National Health Insurance Claims DataEndocrinology and Metabolism, 2016
- The Economic Costs of Type 2 Diabetes: A Global Systematic ReviewPharmacoEconomics, 2015
- New Approaches to Providing Individualized Diabetes Care in the 21st CenturyCurrent Diabetes Reviews, 2015
- Diabetes Self-management Education and Support in Type 2 Diabetes: A Joint Position Statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and DieteticsDiabetes Care, 2015
- Effect of lifestyle intervention in patients with type 2 diabetes: A meta-analysisMetabolism, 2015
- The prevention and control the type-2 diabetes by changing lifestyle and dietary patternJournal of Education and Health Promotion, 2014