Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2012 Apr;87(1):81-92.
doi: 10.1016/j.pec.2011.07.024. Epub 2011 Sep 15.

Twelve-month outcomes of an Internet-based diabetes self-management support program

Russell E Glasgow  1 , Deanna Kurz, Diane King, Jennifer M Dickman, Andrew J Faber, Eve Halterman, Tim Woolley, Deborah J Toobert, Lisa A Strycker, Paul A Estabrooks, Diego Osuna, Debra Ritzwoller
Affiliations
Randomized Controlled Trial

Twelve-month outcomes of an Internet-based diabetes self-management support program

Russell E Glasgow et al. Patient Educ Couns. 2012 Apr.

Abstract

Objective: Internet-based programs offer potential for practical, cost-effective chronic illness self-management programs.

Methods: We report 12-month results of an Internet-based diabetes self-management program, with and without additional support, compared to enhanced usual care in a 3-arm practical randomized trial. Patients (n=463) were randomized: 77.3% completed 12-month follow-up. Primary outcomes were changes in health behaviors of healthy eating, physical activity, and medication taking. Secondary outcomes were hemoglobin A1c, body mass index, lipids, blood pressure, and psychosocial factors.

Results: Internet conditions improved health behaviors significantly vs. usual care over the 12-month period (d for effect size=.09-.16). All conditions improved moderately on biological and psychosocial outcomes. Latinos, lower literacy, and higher cardiovascular disease risk patients improved as much as other participants.

Conclusions: The Internet intervention meets the reach and feasibility criteria for a potentially broad public health impact. However, 12-month magnitude of effects was small, suggesting that different or more intensive approaches are necessary to support long-term outcomes. Research is needed to understand the linkages between intervention and maintenance processes and downstream outcomes.

Practice implications: Automated self-management interventions should be tailored and integrated into primary care; maintenance of patient self-management can be enhanced through links to community resources.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow diagram of My Path/Mi Camino participation and retention results
See this image and copyright information in PMC

References

    1. Cowie CC, Rust KF, Ford ES, Eberhardt MS, Byrd-Holt DD, Li C, et al. Full accounting of diabetes and pre-diabetes in the U.S. population in 1988–1994 and 2005–2006. Diabetes Care. 2009;32(2):287–294. - PMC - PubMed
    1. Schillinger D, Handley M, Wang F, Hammer H. Effects of self-management support on structure, process, and outcomes among vulnerable patients with diabetes: a three-arm practical clinical trial. Diabetes Care. 2009;32(4):559–566. - PMC - PubMed
    1. Thoolen B, de Ridder D, Bensing J, Gorter K, Rutten G. Who participates in diabetes self-management interventions? Issues of recruitment and retention. Diabetes Educ. 2007 May/Jun;33:465–474. PMID 17570877. - PubMed
    1. Kroeze W, Werkman A, Brug J. A systematic review of randomized trials on the effectiveness of computer-tailored education on physical activity and dietary behaviors. Ann Behav Med. 2006;31(3):205–223. - PubMed
    1. Norris SL, Lau J, Smith SJ, Schmid CH, Engelgau MM. Self-management education for adults with type 2 diabetes: A meta-analysis on the effect on glycemic control. Diabetes Care. 2002;25:1159–1171. - PubMed

Publication types

MeSH terms

Substances