Russell E. Glasgow|Steven M. Christiansen|Deanna Kurz|Diane K. King|Tim Woolley|Andrew J. Faber|Paul A. Estabrooks|Lisa A. Strycker|Deborah J. Toobert|Jennifer M. Dickman
Engagement in a Diabetes Self-management Website: Usage Patterns and Generalizability of Program Use
Kaiser Permanente|InterVision Media (United States)|Kaiser Permanente|Kaiser Permanente|InterVision Media (United States)|Kaiser Permanente|Virginia Tech|Oregon Research Institute|Oregon Research Institute|Kaiser Permanente
increased access internet availability efficacious ehealth interventions offer great promise assisting adults diabetes change maintain health behaviors key concern whether levels engagement internet programs sufficient promote sustain behavior changethis paper used automated data ongoing internetbased diabetes selfmanagement intervention study calculate various indices website engagement multimedia website involved goal setting action planning selfmonitoring well offering features ask expert enhance healthy eating physical activity medication adherence also investigated participant characteristics associated website engagement relationship website use 4month behavioral health outcomeswe report participants randomized controlled trial rct randomized receive 1 website alone n 137 2 website plus human support n 133 included additional phone calls group meetings website available english spanish included features enhance engagement user experience number engagement variables calculated participant including number logins number website components visited least twice number days entering selfmonitoring data number visits action plan section time website key outcomes included exercise healthy eating medication adherence well body mass index bmi biological variables related cardiovascular disease riskof 270 intervention participants average age 60 average bmi 349 kgm 130 48 female 62 23 selfreported latino ethnicity number participant visits website 4 months ranged 1 119 mean 28 visits median 18 usage decreased 70 participants visiting least weekly first 6 weeks 47 weeks 7 16 significant differences website website plus support conditions engagement variables total 75 participants entered selfmonitoring data least per week exercise action plan pages visited often medication taking healthy eating pages mean 43 visits vs 28 20 respectively p 001 spearman nonparametric correlations indicated significant associations patient characteristics summary website engagement variables key factors ethnicity baseline computer use age health literacy education related use partial correlations indicated engagement especially selfmonitoring consistently related improvement healthy eating r 20 p 04 reduction dietary fat r 31 p 001 also significant correlation selfmonitoring improvement exercise r 20 p 033 medication takingparticipants visited website fairly often used theoretically important sections engagement decreased 4 months usage rates patterns similar wide range participants encouraging implications potential reach online interventionsnct00987285 httpclinicaltrialsgovshownct00987285 archived webcite httpwwwwebcitationorg5vpe4rhtv