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. 2014 Jun 6;16(6):e149.
doi: 10.2196/jmir.3180.

Smartphone-enabled health coach intervention for people with diabetes from a modest socioeconomic strata community: single-arm longitudinal feasibility study

Noah Wayne  1 , Paul Ritvo
Affiliations

Smartphone-enabled health coach intervention for people with diabetes from a modest socioeconomic strata community: single-arm longitudinal feasibility study

Noah Wayne et al. J Med Internet Res. .

Abstract

Background: Lower socioeconomic strata (SES) populations have higher chronic disease risks. Smartphone-based interventions can support adoption of health behaviors that may, in turn, reduce the risks of type 2 diabetes-related complications, overcoming the obstacles that some patients may have with regular clinical contact (eg, shiftwork, travel difficulties, miscommunication).

Objective: The intent of the study was to develop and test a smartphone-assisted intervention that improves behavioral management of type 2 diabetes in an ethnically diverse, lower SES population within an urban community health setting.

Methods: This single-arm pilot study assessed a smartphone application developed with investigator assistance and delivered by health coaches. Participants were recruited from the Black Creek Community Health Centre in Toronto and had minimal prior experience with smartphones.

Results: A total of 21 subjects consented and 19 participants completed the 6-month trial; 12 had baseline glycosylated hemoglobin (HbA1c) levels >7.0% and these subjects demonstrated a mean reduction of 0.43% (SD 0.63) (P<.05) with minimal changes in medication.

Conclusions: This project supported the feasibility of smartphone-based health coaching for individuals from lower SES with minimal prior smartphone experience.

Keywords: diabetes mellitus; health coaching; telehealth; type 2.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Software improvement cycle. Feedback loop conveys user experience and smartphone software redesign.
Figure 2
Figure 2
Exercise Tracker is designed to easily track multiple exercise modalities. Users can log duration of exercise, rate perceived intensity (light, moderate, vigorous), and enter additional text comments.
Figure 3
Figure 3
Food Tracker automatically triggers the smartphone’s camera, enabling photo capture of meals. Users can subjectively rate food portion (small, moderate, large), source (home-made, packaged, restaurant served), and healthiness (not so healthy, moderately healthy, very healthy).
Figure 4
Figure 4
Satisfaction survey: at a customizable timeframe (usually 20 minutes), the program prompts for reports on satiety level (not enough, just right, too full).
Figure 5
Figure 5
Blood Glucose Tracker: Clients enter blood glucose level and comments on readings.
Figure 6
Figure 6
Mood Tracker: Clients enter “How They Feel” using a simple 5-pt scale: I feel (great, very good, good, bad, very bad) and comment on entry, which is time-stamped.
Figure 7
Figure 7
Weight Tracker: Clients enter weight and enter comments on the reading.
Figure 8
Figure 8
Pain Tracker: Clients can enter subjective pain ratings using a 5-pt scale: pain level is (none, mild, moderate, severe, very severe).
Figure 9
Figure 9
Blood Pressure Tracker: Clients enter blood pressure including systolic, diastolic, and heart rate and are able to comment on the reading.
Figure 10
Figure 10
Messaging allows for two-way secure messaging between participant and health coach who can selectively promote healthy choices at pivotal times of client decision-making, providing support immediately after healthy behaviors have been logged, and/or addressing questions and/or sending relevant materials.
Figure 11
Figure 11
Reminders: The trackers use employ alarm-type entry reminders, which provide convenient ways to prompt clients to engage in health behaviors like exercise, dietary modifications, stress reduction, and self-reported mood. Reminders can be turned on and off easily by health coach and/or participant.
See this image and copyright information in PMC

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