scholarly journals Incorporating Behavioral Trigger Messages Into a Mobile Health App for Chronic Disease Management: Randomized Clinical Feasibility Trial in Diabetes

10.2196/15927 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e15927
Author(s):  
Scott Sittig ◽  
Jing Wang ◽  
Sriram Iyengar ◽  
Sahiti Myneni ◽  
Amy Franklin
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Mobile Health ◽  
Self Efficacy ◽  
Chronic Disease Management ◽  
Text Messages ◽  
Feasibility Trial ◽  
Significant Difference ◽  
Within Subjects ◽  
The Impact

Background Although there is a rise in the use of mobile health (mHealth) tools to support chronic disease management, evidence derived from theory-driven design is lacking. Objective The objective of this study was to determine the impact of an mHealth app that incorporated theory-driven trigger messages. These messages took different forms following the Fogg behavior model (FBM) and targeted self-efficacy, knowledge, and self-care. We assess the feasibility of our app in modifying these behaviors in a pilot study involving individuals with diabetes. Methods The pilot randomized unblinded study comprised two cohorts recruited as employees from within a health care system. In total, 20 patients with type 2 diabetes were recruited for the study and a within-subjects design was utilized. Each participant interacted with an app called capABILITY. capABILITY and its affiliated trigger (text) messages integrate components from social cognitive theory (SCT), FBM, and persuasive technology into the interactive health communications framework. In this within-subjects design, participants interacted with the capABILITY app and received (or did not receive) text messages in alternative blocks. The capABILITY app alone was the control condition along with trigger messages including spark and facilitator messages. A repeated-measures analysis of variance (ANOVA) was used to compare adherence with behavioral measures and engagement with the mobile app across conditions. A paired sample t test was utilized on each health outcome to determine changes related to capABILITY intervention, as well as participants’ classified usage of capABILITY. Results Pre- and postintervention results indicated statistical significance on 3 of the 7 health survey measures (general diet: P=.03; exercise: P=.005; and blood glucose: P=.02). When only analyzing the high and midusers (n=14) of capABILITY, we found a statistically significant difference in both self-efficacy (P=.008) and exercise (P=.01). Although the ANOVA did not reveal any statistically significant differences across groups, there is a trend among spark conditions to respond more quickly (ie, shorter log-in lag) following the receipt of the message. Conclusions Our theory-driven mHealth app appears to be a feasible means of improving self-efficacy and health-related behaviors. Although our sample size is too small to draw conclusions about the differential impact of specific forms of trigger messages, our findings suggest that spark triggers may have the ability to cue engagement in mobile tools. This was demonstrated with the increased use of capABILITY at the beginning and conclusion of the study depending on spark timing. Our results suggest that theory-driven personalization of mobile tools is a viable form of intervention. Trial Registration ClinicalTrials.gov NCT04132089; http://clinicaltrials.gov/ct2/show/NCT004122089

scholarly journals Incorporating Behavioral Trigger Messages Into a Mobile Health App for Chronic Disease Management: Randomized Clinical Feasibility Trial in Diabetes (Preprint)

2019 ◽  
Author(s):  
Scott Sittig ◽  
Jing Wang ◽  
Sriram Iyengar ◽  
Sahiti Myneni ◽  
Amy Franklin
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Mobile Health ◽  
Self Efficacy ◽  
Chronic Disease Management ◽  
Text Messages ◽  
Feasibility Trial ◽  
Significant Difference ◽  
Within Subjects ◽  
The Impact

BACKGROUND Although there is a rise in the use of mobile health (mHealth) tools to support chronic disease management, evidence derived from theory-driven design is lacking. OBJECTIVE The objective of this study was to determine the impact of an mHealth app that incorporated theory-driven trigger messages. These messages took different forms following the Fogg behavior model (FBM) and targeted self-efficacy, knowledge, and self-care. We assess the feasibility of our app in modifying these behaviors in a pilot study involving individuals with diabetes. METHODS The pilot randomized unblinded study comprised two cohorts recruited as employees from within a health care system. In total, 20 patients with type 2 diabetes were recruited for the study and a within-subjects design was utilized. Each participant interacted with an app called capABILITY. capABILITY and its affiliated trigger (text) messages integrate components from social cognitive theory (SCT), FBM, and persuasive technology into the interactive health communications framework. In this within-subjects design, participants interacted with the capABILITY app and received (or did not receive) text messages in alternative blocks. The capABILITY app alone was the control condition along with trigger messages including spark and facilitator messages. A repeated-measures analysis of variance (ANOVA) was used to compare adherence with behavioral measures and engagement with the mobile app across conditions. A paired sample <i>t</i> test was utilized on each health outcome to determine changes related to capABILITY intervention, as well as participants’ classified usage of capABILITY. RESULTS Pre- and postintervention results indicated statistical significance on 3 of the 7 health survey measures (general diet: <i>P</i>=.03; exercise: <i>P</i>=.005; and blood glucose: <i>P</i>=.02). When only analyzing the high and midusers (n=14) of capABILITY, we found a statistically significant difference in both self-efficacy (<i>P</i>=.008) and exercise (<i>P</i>=.01). Although the ANOVA did not reveal any statistically significant differences across groups, there is a trend among spark conditions to respond more quickly (ie, shorter log-in lag) following the receipt of the message. CONCLUSIONS Our theory-driven mHealth app appears to be a feasible means of improving self-efficacy and health-related behaviors. Although our sample size is too small to draw conclusions about the differential impact of specific forms of trigger messages, our findings suggest that spark triggers may have the ability to cue engagement in mobile tools. This was demonstrated with the increased use of capABILITY at the beginning and conclusion of the study depending on spark timing. Our results suggest that theory-driven personalization of mobile tools is a viable form of intervention. CLINICALTRIAL ClinicalTrials.gov NCT04132089; http://clinicaltrials.gov/ct2/show/NCT004122089

Self-management factors associated with quality of life among women with endometriosis: a cross-sectional Australian survey

2020 ◽  
Author(s):  
Rebecca O’Hara ◽  
Heather Rowe ◽  
Jane Fisher
Keyword(s):  
Quality Of Life ◽  
Chronic Disease ◽  
Disease Management ◽  
Self Efficacy ◽  
Chronic Disease Management ◽  
Self Management ◽  
Cross Sectional ◽  
Female Population ◽  
Management Factors

Abstract STUDY QUESTION What self-management factors are associated with quality of life among women with endometriosis? SUMMARY ANSWER Greater self-efficacy was associated with improved physical and mental quality of life. WHAT IS KNOWN ALREADY Women with endometriosis have an impaired quality of life compared to the general female population. However, most studies have investigated quality of life in a hospital or clinic setting rather than a community setting and the association between self-management factors and quality of life have not, to date, been investigated. STUDY DESIGN, SIZE, DURATION A cross-sectional, population-based online survey was performed, which was advertised through women’s, community and endometriosis-specific groups. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 620 women completed the survey for this study. Mental and physical quality of life was assessed using the standardized SF36v2 questionnaire. Self-management factors included self-efficacy, partners in health (active involvement in managing the condition) and performance of self-care activities. Treatment approaches included the use of hormonal treatment, pain medications and complementary therapies and whether the participant had a chronic disease management plan. Hierarchical regression analyses were used to examine whether self-management and treatment factors were associated with quality of life. MAIN RESULTS AND THE ROLE OF CHANCE Both physical and mental quality of life were significantly lower among women with endometriosis compared to the mean scores of the general Australian female population (P &lt; 0.001). Physical quality of life was positively associated with income sufficiency (P &lt; 0.001) and greater self-efficacy (P &lt; 0.001), but negatively associated with age (P &lt; 0.001), pain severity (P &lt; 0.001), use of prescription medications (P &lt; 0.001), having a chronic disease management plan (P &lt; 0.05) and number of self-care activities (P &lt; 0.05). Mental quality of life was positively associated with being older (P &lt; 0.001), partnered (P &lt; 0.001), having a university education (P &lt; 0.05), increasing self-efficacy (P &lt; 0.001) and higher partners in health scores (P &lt; 0.001). LIMITATIONS, REASONS FOR CAUTION Results are derived from a cross-sectional study and can only be interpreted as associations not as causal relationships. The sample was more educated, more likely to speak English and be born in Australia than the general Australian female population of the same age, which may influence the generalizability of these results. WIDER IMPLICATIONS OF THE FINDINGS This study investigated a knowledge gap by investigating quality of life of women with endometriosis in a large community sample. Self-efficacy was significantly associated with both physical and mental quality of life. Supporting women with endometriosis to improve self-efficacy through a structured chronic disease management programme may lead to improvements in this aspect of wellbeing. STUDY FUNDING/COMPETING INTEREST(S) R.O. undertook this research as part of her PhD at Monash University, which was supported by an Australian Government Research Training Program Stipend. J.F. is the Finkel Professor of Global Public Health, which was supported by the Finkel Family Foundation. There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER NA.

Development and Psychometric Evaluation of the Self-Efficacy for Appropriate Medication Use Scale (SEAMS) in Low-Literacy Patients With Chronic Disease

2007 ◽  
Vol 15 (3) ◽  
pp. 203-219 ◽  
Author(s):  
Jessica Risser ◽  
Terry A. Jacobson ◽  
Sunil Kripalani
Keyword(s):  
Chronic Disease ◽  
Medication Adherence ◽  
Disease Management ◽  
Internal Consistency ◽  
Self Efficacy ◽  
Chronic Disease Management ◽  
Medication Use ◽  
Literacy Skills ◽  
The Self ◽  
Low Literacy

Medication nonadherence remains a significant obstacle to achieving improved health outcomes in patients with chronic disease. Self-efficacy, the confidence in one’s ability to perform a given task such as taking one’s medications, is an important determinant of medication adherence, indicating the need for reliable and valid tools for measuring this construct. This study sought to develop a self-efficacy scale for medication adherence in chronic disease management that can be used in patients with a broad range of literacy skills. The Self-efficacy for Appropriate Medication Use (SEAMS) was developed by a multidisciplinary team with expertise in medication adherence and health literacy. Its psychometric properties were evaluated among 436 patients with coronary heart disease and other comorbid conditions. Reliability was evaluated by measuring internal consistency and test-retest reliability. Principal component factor analysis was performed to evaluate the validity of the SEAMS. Reliability and validity analyses were also performed separately among patients with low and higher literacy levels. The final 13-item scale had good internal consistency reliability (Cronbach’s α = 0.89). A two-factor solution was found, explaining 52.3% of the scale’s variance. The scale performed similarly across literacy levels. The SEAMS is a reliable and valid instrument that may provide a valuable assessment of medication self-efficacy in chronic disease management, and appears appropriate for use in patients with low literacy skills.

scholarly journals Impact of COVID-19 on chronic disease management

2021 ◽  
Vol 9 (8) ◽  
pp. 2510
Author(s):  
Srikar Sama ◽  
Alekhya Gajjala
Keyword(s):  
Heart Failure ◽  
Chronic Kidney Disease ◽  
Chronic Disease ◽  
Kidney Disease ◽  
Disease Management ◽  
Chronic Disease Management ◽  
Routine Care ◽  
Review Article ◽  
Potential Impact ◽  
The Impact

Routine care for chronic disease is an ongoing major challenge. We aimed to evaluate the impact of COVID-19 on routine care for chronic diseases. A deeper understanding helps to increase the health system’s resilience and adequately prepare for the next waves of the pandemic. Diabetes, heart failure, chronic kidney disease, and hypertension were the most impacted conditions due to the reduction in access to care. It is important routine care continues in spite of the pandemic, to avoid a rise in non-COVID-19-related morbidity and mortality. This is a review article discussing the potential impact of COVID-19 on chronic disease management.

The Use and Evaluations of IT in Chronic Disease Management

2011 ◽  
pp. 1075-1092
Author(s):  
Julia Adler-Milstein ◽  
Ariel Linden
Keyword(s):  
Information Technology ◽  
Chronic Disease ◽  
Disease Management ◽  
Information Technologies ◽  
Chronic Disease Management ◽  
Program Effectiveness ◽  
Management Program ◽  
Evaluation Strategies ◽  
Broad Array ◽  
The Impact

This chapter describes the broad array of information technologies currently used in programs that manage individuals with chronic diseases and discusses evaluation strategies to assess the impact of implementing programs that incorporate such technologies. More specifically, it describes the three components of a chronic disease management program and then details the technologies commonly used in each component. Three evaluation designs well-suited to measure DM program effectiveness are also discussed. The intent of this chapter is to educate readers on the range of approaches to incorporating information technology into chronic disease management and the most appropriate evaluation designs that will strengthen the understanding of which approaches are most successful.

The Impact of Big Data on Chronic Disease Management

2018 ◽  
Vol 37 (1) ◽  
pp. 90-98 ◽  
Author(s):  
Niharika Bhardwaj ◽  
Bezawit Wodajo ◽  
Anthony Spano ◽  
Symaron Neal ◽  
Alberto Coustasse
Keyword(s):  
Big Data ◽  
Chronic Disease ◽  
Disease Management ◽  
Chronic Disease Management ◽  
The Impact

scholarly journals The CDM-Net Project: The Development, Implementation and Evaluation of a Broadband-Based Network for Managing Chronic Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-7
Author(s):  
Kay Jones ◽  
Trisha Dunning ◽  
Beth Costa ◽  
Kristine Fitzgerald ◽  
Akuh Adaji ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Health Professionals ◽  
Allied Health ◽  
Chronic Disease Management ◽  
Management Service ◽  
Health Providers ◽  
Allied Health Professionals ◽  
Before And After ◽  
The Impact

Background. In Australia most chronic disease management is funded by Medicare Australia through General Practitioner Management Plans (GPMPs) and Team Care Arrangements (TCAs). Identified barriers may be reduced effectively using a broadband-based network known as the Chronic Disease Management Service (CDMS). Aims. To measure the uptake and adherence to CDMS, test CDMS, and assess the adherence of health providers and patients to GPMPs and TCAs generated through CDMS. Methods. A single cohort before and after study. Results. GPMPs and TCAs increased. There was no change to prescribed medicines or psychological quality of life. Attendance at allied health professionals increased, but decreased at pharmacies. Overall satisfaction with CDMS was high among GPs, allied health professionals, and patients. Conclusion. This study demonstrates proof of concept, but replication or continuation of the study is desirable to enable the impact of CDMS on diabetes outcomes to be determined.

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