DEMOCRATIZING DISCOVERY HEALTH WITH N=Me

Abstract

Health 360x is a mobile health application and social platform that integrates self-monitoring and decision support for preventive health. We studied 240 diabetic patients in primary care practices and a church community in metropolitan Atlanta. Health coaches were trained on the Health 360x curriculum, which was adapted from the American Association of Diabetes Educators. Participants worked with the health coaches to set goals for diabetes self-management. The intervention included weekly coaching for 12 weeks and online peer networking. Outcome variables included blood pressure, physical activity, and blood glucose that showed significant improvement at 12 weeks and 12 months compared to baseline. Focus group testing revealed that references for empowerment and engagement were associated with positive clinical outcomes. Barriers to adoption and use of the technology were inability to use the internet and concern about privacy and security of health data. Future efforts will integrate a multidisciplinary training dashboard with considerable attention to education on security features including data encryption and sign-on verification.

Fig. 1

The Health 360x ecosystem mediates patient-centered behavior intervention, with spheres of influence beginning with the patient, family and social networks, health coaching, and the health system.

Fig. 2

Health 360x features. Sample screen shots display color-coded systolic and diastolic blood pressure. Graph displays self-monitored blood pressure measurements over 3 months. This data can be shared with the clinician and/or health coach at the point of care.

Fig. 3

Systolic blood pressure (mm Hg) at baseline, and after 12 weeks of intervention. Data at 52 weeks show long-term follow-up without interval health coaching. P values vs. baseline. Abbreviations: BBAME, Big Bethel AME Church; CPN, Community Physicians Network; CPN A, Practice A; CPN B, Practice B; CPN C, Practice C.

Fig. 4

Fasting blood glucose (mg/dl) at baseline, and after 12 weeks of intervention. Data at 52 weeks show long-term follow-up without interval health coaching. P value vs. baseline. Abbreviations: BBAME, Big Bethel AME Church; CPN, Community Physicians Network; CPN A, Practice A; CPN B, Practice B; CPN C, Practice C; ns, not significant.

Fig. 5

Physical activity (miles/day walked) at baseline, and after 12 weeks of intervention. Data at 52 weeks show long-term follow-up without interval health coaching. P value vs. baseline. Abbreviations: BBAME, Big Bethel AME Church; CPN, Community Physicians Network; CPN A, Practice A; CPN B, Practice B;CPN C, Practice C; ns, not significant.