@Article{info:doi/10.2196/14024,
author="Chiu, Ching-Ju
and Yu, Yung-Chen
and Du, Ye-Fong
and Yang, Yi-Ching
and Chen, Jou-Yin
and Wong, Li-Ping
and Tanasugarn, Chanuantong",
title="Comparing a Social and Communication App, Telephone Intervention, and Usual Care for Diabetes Self-Management: 3-Arm Quasiexperimental Evaluation Study",
journal="JMIR Mhealth Uhealth",
year="2020",
month="Jun",
day="2",
volume="8",
number="6",
pages="e14024",
keywords="diabetes; self-management; depression symptoms; distress; middle-aged and older adults",
abstract="Background: Many technology-assisted innovations have been used to manage disease. However, most of these innovations are not broadly used by older adults due to their cost. Additionally, disease management through technology-assisted innovations has not been compared with other interventions. Objective: In this study, we tested the employment of a free and widely used social and communication app to help older adults with diabetes manage their distress and glycemic control. We also compared the effectiveness of the app with 2 other methods, namely telephone and conventional health education, and determined which subgroup experiences the most effects within each intervention. Methods: Adults aged ≥50 years with type 2 diabetes were recruited from Southern Taiwan (N=231) and were allocated to different 3-month interventions. Informed consent was obtained at the Ministry of Science and Technology and approved by the National Cheng Kung University Hospital Institutional Review Board (No. A-ER-102-425). Results: Participants in the mobile-based group had significant reductions in hemoglobin A1c compared with the telephone-based and usual care groups (mean changes of --0.4{\%}, 0.1{\%}, and 0.03{\%}, respectively; P=.02). Diabetes-specific distress decreased to a greater extent in the mobile-based group compared to the other 2 groups (mean changes of --5.16, --3.49, and --2.44, respectively, P=.02). Subgroup analyses further revealed that the effects on reducing blood glucose levels in the social and communication app groups were especially evident in patients with lower distress scores, and diabetes-related distress was especially evident in participants who were younger than 60 years or had higher educational levels. Conclusions: The findings of this study inform more flexible use of social and communication apps with in-person diabetes education and counselling. ",
issn="2291-5222",
doi="10.2196/14024",
url="https://mhealth.jmir.org/2020/6/e14024",
url="https://doi.org/10.2196/14024",
url="http://www.ncbi.nlm.nih.gov/pubmed/32484448"
}