Community-Based Intelligent Blood Glucose Management for Older Adults With Type 2 Diabetes Based on the Health Belief Model: Randomized Controlled Trial.
{"title":"Community-Based Intelligent Blood Glucose Management for Older Adults With Type 2 Diabetes Based on the Health Belief Model: Randomized Controlled Trial.","authors":"Anqi Zhang, Jinsong Wang, Xiaojuan Wan, Ziyi Zhang, Shuhan Zhao, Shuo Bai, Yamin Miao, Shuang Yang, Xue Jiang","doi":"10.2196/60227","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The number of older patients with type 2 diabetes (T2D) is increasing, and effective self-management is crucial for controlling disease progression and its complications.</p><p><strong>Objective: </strong>We designed a home telemedicine intervention that combines telemedicine with health education based on the Health Belief Model (HBM). This study evaluated its effectiveness on self-management in older patients with T2D.</p><p><strong>Methods: </strong>Between March and April 2022, we recruited 198 community-dwelling patients with T2D aged 65 years and older. Patients were randomly assigned to either a control group, which received a conventional diabetes management program, or an intervention group, which received a home telemedicine intervention with a health education program based on the HBM. The intervention lasted 6 months. The primary outcome measured was glycosylated hemoglobin (HbA1c); secondary outcomes included diabetes self-management capacity, self-efficacy, and health beliefs. We collected outcome metrics at baseline, 3 months, and 6 months. Generalized estimating equations were used to compare changes in outcomes.</p><p><strong>Results: </strong>A total of 96.5% (191/198) of patients completed the study. From baseline to 6 months, HbA1c decreased by mean -0.99% (95% CI -1.60% to -0.60%) in the intervention group and mean -0.42% (95% CI -0.90% to 0.90%) in the control group. The intervention group experienced a significantly greater reduction of 0.42% compared to the control group (95% CI 0.12%-0.73%). Furthermore, compared to the control group, the intervention group showed significant improvements in diabetes self-management skills (mean 5.88, 95% CI 4.98-6.79), self-efficacy (mean 9.40, 95% CI 8.15-10.66), and health beliefs (mean 19.54, 95% CI 17.71-21.36) at both 3 and 6 months.</p><p><strong>Conclusions: </strong>Home telemedicine interventions incorporating health education based on the HBM can provide significant benefits for community-dwelling older patients with T2D, potentially offering new avenues for chronic disease prevention and management. However, future large-scale studies are required to further assess their effectiveness and feasibility.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e60227"},"PeriodicalIF":6.2000,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199844/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JMIR mHealth and uHealth","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2196/60227","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The number of older patients with type 2 diabetes (T2D) is increasing, and effective self-management is crucial for controlling disease progression and its complications.
Objective: We designed a home telemedicine intervention that combines telemedicine with health education based on the Health Belief Model (HBM). This study evaluated its effectiveness on self-management in older patients with T2D.
Methods: Between March and April 2022, we recruited 198 community-dwelling patients with T2D aged 65 years and older. Patients were randomly assigned to either a control group, which received a conventional diabetes management program, or an intervention group, which received a home telemedicine intervention with a health education program based on the HBM. The intervention lasted 6 months. The primary outcome measured was glycosylated hemoglobin (HbA1c); secondary outcomes included diabetes self-management capacity, self-efficacy, and health beliefs. We collected outcome metrics at baseline, 3 months, and 6 months. Generalized estimating equations were used to compare changes in outcomes.
Results: A total of 96.5% (191/198) of patients completed the study. From baseline to 6 months, HbA1c decreased by mean -0.99% (95% CI -1.60% to -0.60%) in the intervention group and mean -0.42% (95% CI -0.90% to 0.90%) in the control group. The intervention group experienced a significantly greater reduction of 0.42% compared to the control group (95% CI 0.12%-0.73%). Furthermore, compared to the control group, the intervention group showed significant improvements in diabetes self-management skills (mean 5.88, 95% CI 4.98-6.79), self-efficacy (mean 9.40, 95% CI 8.15-10.66), and health beliefs (mean 19.54, 95% CI 17.71-21.36) at both 3 and 6 months.
Conclusions: Home telemedicine interventions incorporating health education based on the HBM can provide significant benefits for community-dwelling older patients with T2D, potentially offering new avenues for chronic disease prevention and management. However, future large-scale studies are required to further assess their effectiveness and feasibility.
背景：老年2型糖尿病（T2D）患者数量不断增加，有效的自我管理对于控制疾病进展及其并发症至关重要。目的：设计基于健康信念模型（HBM）的远程医疗与健康教育相结合的家庭远程医疗干预。本研究评估其对老年T2D患者自我管理的有效性。方法：2022年3月至4月，我们招募了198名65岁及以上的社区居住T2D患者。患者被随机分配到对照组，接受传统的糖尿病管理计划，或干预组，接受基于HBM的家庭远程医疗干预和健康教育计划。干预持续6个月。测量的主要终点是糖化血红蛋白（HbA1c）；次要结局包括糖尿病自我管理能力、自我效能和健康信念。我们在基线、3个月和6个月收集结果指标。使用广义估计方程来比较结果的变化。结果：96.5%（191/198）的患者完成了研究。从基线到6个月，干预组HbA1c平均下降-0.99% (95% CI -1.60%至-0.60%)，对照组平均下降-0.42% （95% CI -0.90%至0.90%）。与对照组相比，干预组显著降低0.42% （95% CI 0.12%-0.73%）。此外，与对照组相比，干预组在糖尿病自我管理技能（平均5.88,95% CI 4.98-6.79）、自我效能（平均9.40,95% CI 8.15-10.66）和健康信念（平均19.54,95% CI 17.71-21.36）方面均在3个月和6个月时均有显著改善。结论：结合基于HBM的健康教育的家庭远程医疗干预可以为社区居住的老年T2D患者提供显著的益处，可能为慢性疾病的预防和管理提供新的途径。然而，未来的大规模研究需要进一步评估其有效性和可行性。
期刊介绍：
JMIR mHealth and uHealth (JMU, ISSN 2291-5222) is a spin-off journal of JMIR, the leading eHealth journal (Impact Factor 2016: 5.175). JMIR mHealth and uHealth is indexed in PubMed, PubMed Central, and Science Citation Index Expanded (SCIE), and in June 2017 received a stunning inaugural Impact Factor of 4.636.
The journal focusses on health and biomedical applications in mobile and tablet computing, pervasive and ubiquitous computing, wearable computing and domotics.
JMIR mHealth and uHealth publishes since 2013 and was the first mhealth journal in Pubmed. It publishes even faster and has a broader scope with including papers which are more technical or more formative/developmental than what would be published in the Journal of Medical Internet Research.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
