TY  - JOUR
AU  - Chiu, Ching-Ju
AU  - Yu, Yung-Chen
AU  - Du, Ye-Fong
AU  - Yang, Yi-Ching
AU  - Chen, Jou-Yin
AU  - Wong, Li-Ping
AU  - Tanasugarn, Chanuantong
PY  - 2020
DA  - 2020/6/2
TI  - Comparing a Social and Communication App, Telephone Intervention, and Usual Care for Diabetes Self-Management: 3-Arm Quasiexperimental Evaluation Study
JO  - JMIR Mhealth Uhealth
SP  - e14024
VL  - 8
IS  - 6
KW  - diabetes
KW  - self-management
KW  - depression symptoms
KW  - distress
KW  - middle-aged and older adults
AB  - 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. 
SN  - 2291-5222
UR  - https://mhealth.jmir.org/2020/6/e14024
UR  - https://doi.org/10.2196/14024
UR  - http://www.ncbi.nlm.nih.gov/pubmed/32484448
DO  - 10.2196/14024
ID  - info:doi/10.2196/14024
ER  -