Designing and evaluating a web-based self-management site for patients with type 2 diabetes--systematic website development and study protocol.
BACKGROUND
Given that patients provide the majority of their own diabetes care, patient self-management training has increasingly become recognized as an important strategy with which to improve quality of care. However, participation in self management programs is low. In addition, the efficacy of current behavioural interventions wanes over time, reducing the impact of self-management interventions on patient health. Web-based interventions have the potential to bridge the gaps in diabetes care and self-management.


METHODS
Our objective is to improve self-efficacy, quality of life, self-care, blood pressure, cholesterol and glycemic control and promote exercise in people with type 2 diabetes through the rigorous development and use of a web-based patient self-management intervention. This study consists of five phases: (1) intervention development; (2) feasibility testing; (3) usability testing; (4) intervention refinement; and (5) intervention evaluation using mixed methods. We will employ evidence-based strategies and tools, using a theoretical framework of self-efficacy, then elicit user feedback through focus groups and individual user testing sessions. Using iterative redesign the intervention will be refined. Once finalized, the impact of the website on patient self-efficacy, quality of life, self-care, HbA1c, LDL-cholesterol, blood pressure and weight will be assessed through a non-randomized observational cohort study using repeated measures modeling and individual interviews.


CONCLUSIONS
Increasing use of the World Wide Web by consumers for health information and ongoing revolutions in social media are strong indicators that users are primed to welcome a new era of technology in health care. However, their full potential is hindered by limited knowledge regarding their effectiveness, poor usability, and high attrition rates. Our development and research agenda aims to address these limitations by improving usability, identifying characteristics associated with website use and attrition, and developing strategies to sustain patient use in order to maximize clinical outcomes.
Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada. yuca@smh.ca
Catherine H
CH
Yu
Janet
J
Parsons
Muhammad
M
Mamdani
Gerald
G
Lebovic
Baiju R
BR
Shah
Onil
O
Bhattacharyya
Andreas
A
Laupacis
Sharon E
SE
Straus
D002170:Canada; D008076:Cholesterol, HDL / Q000097:blood; D002985:Clinical Protocols; D054626:Consumer Health Information; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000517:prevention & control* / Q000628:therapy; D019317:Evidence-Based Medicine / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D017144:Focus Groups; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D020407:Internet / Q000458:organization & administration*; D008297:Male; D008491:Medical Informatics Applications; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000592:standards; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D036301:Qualitative Research; D011788:Quality of Life; D012107:Research Design; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy; D012959:Socioeconomic Factors; D014584:User-Computer Interface
D008076:Cholesterol, HDL; D006442:Glycated Hemoglobin