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Randomized Controlled Trial
. 2018 Mar 7;13(3):e0192807.
doi: 10.1371/journal.pone.0192807. eCollection 2018.

Individual differences in regulatory mode moderate the effectiveness of a pilot mHealth trial for diabetes management among older veterans

Michelle Dugas  1   2 , Kenyon Crowley  2   3 , Guodong Gordon Gao  2   4 , Timothy Xu  5 , Ritu Agarwal  2   4 , Arie W Kruglanski  1 , Nanette Steinle  6   7
Affiliations
Randomized Controlled Trial

Individual differences in regulatory mode moderate the effectiveness of a pilot mHealth trial for diabetes management among older veterans

Michelle Dugas et al. PLoS One. .

Abstract

mHealth tools to help people manage chronic illnesses have surged in popularity, but evidence of their effectiveness remains mixed. The aim of this study was to address a gap in the mHealth and health psychology literatures by investigating how individual differences in psychological traits are associated with mHealth effectiveness. Drawing from regulatory mode theory, we tested the role of locomotion and assessment in explaining why mHealth tools are effective for some but not everyone. A 13-week pilot study investigated the effectiveness of an mHealth app in improving health behaviors among older veterans (n = 27) with poorly controlled Type 2 diabetes. We developed a gamified mHealth tool (DiaSocial) aimed at encouraging tracking of glucose control, exercise, nutrition, and medication adherence. Important individual differences in longitudinal trends of adherence, operationalized as points earned for healthy behavior, over the course of the 13-week study period were found. Specifically, low locomotion was associated with unchanging levels of adherence during the course of the study. In contrast, high locomotion was associated with generally stronger adherence although it exhibited a quadratic longitudinal trend. In addition, high assessment was associated with a marginal, positive trend in adherence over time while low assessment was associated with a marginal, negative trend. Next, we examined the relationship between greater adherence and improved clinical outcomes, finding that greater adherence was associated with greater reductions in glycated hemoglobin (HbA1c) levels. Findings from the pilot study suggest that mHealth technologies can help older adults improve their diabetes management, but a "one size fits all" approach may yield suboptimal outcomes.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. CONSORT participant flow diagram.
Fig 2
Fig 2. Observed values of for weekly adherence scores by individual level of locomotion.
Colors represent standardized locomotion scores of participants and lines show average weekly score for low (< 3.67 scale score) and high (> 3.67 scale score) locomotors as defined by a median split.
Fig 3
Fig 3. Observed values of for weekly adherence scores by individual level of assessment.
Colors represent standardized locomotion scores of participants and lines show average weekly score for low (< 2.83 scale score) and high (> 2.83 scale score) assessors as defined by a median split.
Fig 4
Fig 4. Patterns of predicted weekly adherence scores over time at high and low levels of assessment are depicted.
Fig 5
Fig 5. Patterns of predicted weekly adherence scores over time at high and low levels of locomotion are depicted.
Fig 6
Fig 6. Observed values of HbA1C by individual adherence score.
Colors represent standardized total adherence scores of participants and lines show average HbA1C levels for low (< 4954 total score) and high (> 4954 scale score) adherers as defined by a median split.
Fig 7
Fig 7. Change in predicted HbA1C over time as a function of total adherence scores.
See this image and copyright information in PMC

References

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