Ingrid Müller|Alison Rowsell|Beth Stuart|Victoria Hayter|Paul Little|Kristin Ganahl|Gabriele Müller|Gerardine Doyle|Peter Chang|Courtney R. Lyles|Don Nutbeam|Lucy Yardley
Effects on Engagement and Health Literacy Outcomes of Web-Based Materials Promoting Physical Activity in People With Diabetes: An International Randomized Trial
University of Southampton|University of Southampton|University of Southampton|University of Southampton|University of Southampton|Gesundheit Österreich|University Hospital Carl Gustav Carus|University College Dublin|Taipei Medical University Hospital|Taipei Hospital|San Francisco General Hospital|University of California, San Francisco|University of Sydney|University of Southampton
developing accessible webbased materials support diabetes selfmanagement people lower levels health literacy continuing challengethe objective international study develop webbased intervention promoting physical activity among people type 2 diabetes determine whether audiovisual presentation interactivity quizzes planners tailoring could help overcome digital divide making digital interventions accessible effective people levels health literacy study also aimed determine whether materials improve health literacy outcomes people lower levels health literacy also effective people higher levels health literacyto assess impact interactivity audiovisual features usage engagement health literacy outcomes designed two versions webbased intervention one interactive one plaintext version content promote physical activity people type 2 diabetes randomly assigned participants united kingdom austria germany ireland taiwan either interactive plaintext version intervention english german mandarin intervention usage objectively recorded intervention software selfreport measures taken baseline followup immediately participants viewed intervention included measures health literacy engagement website satisfaction willingness recommend intervention others health literacy outcomes diabetes knowledge enablement attitude perceived behavioral control intention undertake physical activityin total 1041 people took part study 1005 completed health literacy information 268 2667 intermediate low levels health literacy interactive intervention overall produce better outcomes plaintext version participants plaintext intervention group looked significantly sections intervention mean difference 047 95 ci 064 030 p001 lead better outcomes health literacy outcomes including attitudes intentions engage physical activity significantly improved following intervention participants intervention groups improvements similar across higher lower health literacy levels countries participants interactive intervention group acquired diabetes knowledge mean difference 080 95 ci 065094 p001 participants groups reported high levels website satisfaction would recommend website othersfollowing established practice simple clear design presentation using personbased approach intervention development indepth iterative feedback users may important interactivity audiovisual presentations developing accessible digital health interventions improve health literacy outcomesinternational standard randomized controlled trial number isrctn 43587048 httpwwwisrctncomisrctn43587048 archived webcite httpwwwwebcitationorg6nghap9bv