Project Summary: This proposal addresses the growing public health problem of diabetes, a disease that affects the ability of the body to process sugars from foods. For the patient, diabetes and its complications such as reduced vision and pain can seriously affect quality of life and the ability to function day-to-day. The course of diabetes can be changed dramatically with lifestyle changes, such as healthy eating and increasing physical activity. However, traditional approaches (face-to-face counseling in clinics, individual visits with a diabetes educator, or group classes) are not sufficient to improve health in patients with diabetes. The overall goal of this proposal is to enhance the supports and resources available to patients with diabetes to assist them to achieve their health goals. We will develop and evaluate an innovative program that uses nurse health coaching; motivational interviewing techniques; and wireless sensor and mobile health (mHealth) technology. The program is based on input from patient, provider, and technology experts as to how best to address the healthcare needs of persons living with diabetes and improve their health and wellness.
Specific Aims: This study aims to:
- Partner with stakeholders (patients and providers) to revise and finalize the proposed intervention elements (nurse coaching, wireless sensor technology, and mHealth framework and relevant outcomes).
- Evaluate the feasibility and usefulness of integrating patient-generated goals and sensor data into an mHealth dashboard linked back into primary care practice.
- Evaluate the effectiveness of the P2E2T2 program on diabetes management as measured by the following outcomes prioritized by patients in preliminary studies: quality of life, self-efficacy, readiness to change, and clinically relevant indicators.
Relevance: The focus of this proposal is to attend to patient voice regarding what is needed from the healthcare team and from technology to optimally support patients to succeed in reaching self-identified health goals to better manage their diabetes. Diabetes management is ultimately in the hands of the patient, who is an expert on their own circumstances, motivations, and beliefs. Together, healthcare providers and technology can provide support, education, and coaching to assist patients to meet their goals. We anticipate iterative design of the program as we regularly involve our patient, provider, and technical expert stakeholders throughout the project. Current electronic health record structure is focused on recording medical problems and the prescriptions providers generate, with no place to capture health goals set by the patient. We believe a fundamental shift is needed to not only include the patient in their care plan, but to highlight to the healthcare team through the electronic integration of an mHealth dashboard, those areas that the patient identifies as holding the highest level of importance.
Other Clinical Interventions
Other Health Services Interventions
Incentives for Behavior Change
Training and Education Interventions