title: D-WISE: Diabetes Web-Centric Information and Support Environment: conceptual specification and proposed evaluation.
abstract: OBJECTIVE
  To develop and evaluate Diabetes Web-Centric Information and Support Environment (D-WISE) that offers 1) a computerized decision-support system to assist physicians to A) use the Canadian Diabetes Association clinical practice guidelines (CDA CPGs) to recommend evidence-informed interventions; B) offer a computerized readiness assessment strategy to help physicians administer behaviour-change strategies to help patients adhere to disease self-management programs; and 2) a patient-specific diabetes self-management application, accessible through smart mobile devices, that offers behaviour-change interventions to engage patients in self-management.
  
  
  METHODS
  The above-mentioned objectives were pursued through a knowledge management approach that involved 1) Translation of paper-based CDA CPGs and behaviour-change models as computerized decision-support tools that will assist physicians to offer evidence-informed and personalized diabetes management and behaviour-change strategies; 2) Engagement of patients in their diabetes care by generating a diabetes self-management program that takes into account their preferences, challenges and needs; 3) Empowering patients to self-manage their condition by providing them with personalized educational and motivational messages through a mobile self-management application. The theoretical foundation of our research is grounded in behaviour-change models and healthcare knowledge management. We used 1) knowledge modelling to computerize the paper-based CDA CPGs and behaviour-change models, in particular, the behaviour-change strategy elements of A) readiness-to-change assessments; B) motivation-enhancement interventions categorized along the lines of patients' being ready, ambivalent or not ready; and C) self-efficacy enhancement. The CDA CPGs and the behaviour-change models are modelled and computerized in terms of A) a diabetes management ontology that serves as the knowledge resource for all the services offered by D-WISE; B) decision support services that use logic-based reasoning algorithms to utilize the knowledge encoded within the diabetes management ontology to assist physicians by recommending patient-specific diabetes-management interventions and behaviour-change strategies; C) a mobile diabetes self-management application to engage and educate diabetes patients to self-manage their condition in a home-based setting while working in concert with their family physicians.
  
  
  RESULTS
  We have been successful in creating and conducting a usability assessment of the physician decision support tool. These results will be published once the patient self- management application has been evaluated.
  
  
  CONCLUSIONS
  D-WISE will be evaluated through pilot studies measuring 1) the usability of the e-Health interventions; and 2) the impact of the interventions on patients' behaviour changes and diabetes control.
authors.affiliation: Medical Informatics Program, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. Electronic address: Samina.Abidi@Dal.ca.
authors.forename: Samina
authors.initials: S
authors.lastname: Abidi
authors.affiliation: CDHA Behaviour-Change Institute, QEII Health Sciences Center, Halifax, Nova Scotia, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Vallis
authors.affiliation: NICHE Research Group, Faculty of Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Syed Sibte
authors.initials: SS
authors.lastname: Raza Abidi
authors.affiliation: Department of Family Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Helena
authors.initials: H
authors.lastname: Piccinini-Vallis
authors.affiliation: Division of Endocrinology and Metabolism, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Syed Ali
authors.initials: SA
authors.lastname: Imran
mesh_terms: D022126:Access to Information; D002170:Canada; D003661:Decision Support Techniques; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000628:therapy; D055317:Evidence-Based Practice; D005260:Female; D006801:Humans; D020407:Internet / Q000191:economics / Q000706:statistics & numerical data*; D008297:Male; D010353:Patient Education as Topic / Q000191:economics / Q000458:organization & administration*; D040242:Risk Reduction Behavior; D012648:Self Care / Q000191:economics / Q000523:psychology; D012944:Social Support; D012984:Software; D017216:Telemedicine / Q000191:economics / Q000706:statistics & numerical data*
keywords: aide à la décision clinique; behaviour change; changement du comportement; clinical decision support; diabetes self-management; healthcare knowledge modeling; modélisation des connaissances en matière de soins de santé; prise en charge autonome du diabète