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Multicenter Study
. 2019 Jun 13;29(Suppl 2):393-404.
doi: 10.18865/ed.29.S2.393. eCollection 2019.

Achieving Health Equity with e-Healthystrides©: Patient Perspectives of a Consumer Health Information Technology Application

Priscilla Pemu  1 , Robina Josiah Willock  1 , Ernest Alema-Mensa  2 , Latrice Rollins  3 , Michelle Brown  4 , Bethany Saint Clair  5 , Elizabeth Olorundare  1 , Atuarra McCaslin  6 , Tabia Henry Akintobi  7 , Alexander Quarshie  1 , Elizabeth Ofili  8
Affiliations
Multicenter Study

Achieving Health Equity with e-Healthystrides©: Patient Perspectives of a Consumer Health Information Technology Application

Priscilla Pemu et al. Ethn Dis. .

Abstract

Objective: We describe the implementation, clinical outcomes and participant perspectives for e-Healthystrides©.

Setting: Three independent ambulatory clinics and an historic African American (AA) church.

Participants: Adults with diagnosed diabetes mellitus type 2.

Intervention: e-Healthystrides© health coach facilitated intervention.

Primary outcome: Acquisition of three new self-management behaviors.

Secondary outcomes: Blood pressure, blood glucose, A1c, attrition rate and participant perspectives of e-Healthystrides©.

Methods: A convergent parallel mixed method design was used in both pilot studies.

Results: Two hundred and sixty-four participants, aged ~62±16 years, enrolled. Attrition at 52 weeks varied 50%-90% by site. Low engagement users were defined mainly by anxiety with putting health information online. The primary outcome was achieved in 36% of our participants, with the top 3 self-management behaviors acquired being: reducing risk (24.5%); healthy eating (23.7%); and monitoring (16.4%). Problem solving had the lowest rate of achievement (.91%). Blood pressure improved significantly at all sites at 12 weeks and at clinics A,B,C at 52 weeks. Blood glucose improved at 12 weeks: clinic A (P=.0001), B (P=.003), C (P=.001) and D (P=.03); but, at 52 weeks, only clinics A (P=<.0001) and B (P=.0001). Participants felt empowered by features of e-Healthystrides©. Engagement with health coaches and peers was highly valued.

Conclusions: e-Healthystrides© is effective for self-management behavior change. Participants showed the best success with healthy coping, healthy eating, and monitoring behaviors. They felt empowered by access to health information and valued interaction with coaches and peers. Our findings support strong relational/social network strategy with a role for coaches as guides (apomediaries) who facilitate skill acquisition using technology.

Keywords: Diabetes; Health Information Technology; Self-Management.

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Conflict of interest statement

Competing Interests: None declared.

Figures

Figure 1.
Figure 1.. Timeline of study activities
CPN, Community Physicians Network
Figure 2.
Figure 2.. Kaplan-Meier attrition curves comparing attrition rates between study groups across time
A, Clinic A; B, Clinic B; C, Clinic C; D, Clinic D
Figure 3.
Figure 3.. Website usage patterns by user type: mean time spent per logon viewing DSME curriculum chapters
DSME, diabetes self-management education
Figure 4.
Figure 4.. Website usage patterns by user type: mean time spent per logon viewing clinical trend data
HbA1C, glycosylated hemoglobin
Figure 5.
Figure 5.. Website usage patterns by user type: mean time spent per logon viewing/setting up AADE 7 goals
AADE 7, American Association of Diabetes Educators 7
Figure 6.
Figure 6.. Primary outcome: AADE 7 self-management behaviors
AADE 7, American Association of Diabetes Educators 7
See this image and copyright information in PMC

References

    1. Health Disparities CDC. and Inequalities Report — United States, 2013. MMWR Suppl. 2013;62(3). https://www.cdc.gov/mmwr/pdf/other/su6203.pdf. Accessed July 6, 2018
    1. Diabetes Prevention Program (DPP) Research Group The Diabetes Prevention Program (DPP): description of lifestyle intervention. Diabetes Care. 2002;25(12):2165-2171. 10.2337/diacare.25.12.2165 - DOI - PMC - PubMed
    1. King P, Peacock I, Donnelly R. The UK prospective diabetes study (UKPDS): clinical and therapeutic implications for type 2 diabetes. Br J Clin Pharmacol. 1999;48(5):643-648. 10.1046/j.1365-2125.1999.00092.x10.1046/j.1365-2125.1999.00092.x - DOI - DOI - PMC - PubMed
    1. Magwood GS, Zapka J, Jenkins C. A review of systematic reviews evaluating diabetes interventions: focus on quality of life and disparities. Diabetes Educ. 2008;34(2):242-265. 10.1177/0145721708316551 - DOI - PMC - PubMed
    1. Forsyth R, Maddock CA, Iedema RAM, Lassere M. Patient perceptions of carrying their own health information: approaches towards responsibility and playing an active role in their own health - implications for a patient-held health file. Health Expect. 2010;13(4):416-426. 10.1111/j.1369-7625.2010.00593.x10.1111/j.1369-7625.2010.00593.x - DOI - DOI - PMC - PubMed

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