Background China has the largest number of cases of diabetes with a high rate of uncontrolled blood sugar. Many studies show that family members’ involvement is related to better glycemic control. However, there is a significant problem with low participation of family members. The widespread use of WeChat provides an opportunity for family members to support their diabetic loved ones in their type 2 diabetes self-management practices. The main aim of this study is to examine the effectiveness of a family-based intervention via WeChat. Methods A parallel, two-group, randomized controlled trial will be conducted in the central urban area of Jiading district in Shanghai, China. A total of 222 type 2 diabetics will be randomly divided into an intervention group or a control group using a 1:1 ratio. Patients in the intervention group will receive the usual care, and their family will get education in diabetes control and the importance of family support by subscribing to the WeChat public account. Both the patients and the family members will be followed up at 12 months after the intervention commences. Data collection is scheduled at baseline, 6-months, and 12-months. Discussion Family involvement based on WeChat may generate ongoing support for type 2 diabetic patients and improve these patients’ health outcomes. A successful outcome of this study may also provide inspiration for other efforts to provide health education via WeChat. Trial registration ChiCTR1900020736 . Registered 15 January 2019. Electronic supplementary material The online version of this article (10.1186/s12889-019-6702-8) contains supplementary material, which is available to authorized users.
Background Intervention based on family support and risk perception can enhance type 2 diabetes mellitus (T2DM) patients’ self-care activities. In addition, eHealth education is considered to improve family members’ support for patients with T2DM. However, there is little evidence from rigorously designed studies on the effectiveness of an intervention combining these approaches. Objective This randomized controlled trial (RCT) aimed to assess the effectiveness of an eHealth family-based health education intervention for patients with T2DM to improve their glucose control, risk perception, and self-care behaviors. Methods This single-center, 2-parallel-group RCT was conducted between 2019 and 2020. Overall, 228 patients were recruited from Jiading District, Shanghai, and randomly divided into intervention and control groups. The intervention group received an eHealth family intervention based on community management via WeChat, whereas the control group received usual care. The primary outcome was the glycated hemoglobin (HbA1c) level of the patients with T2DM, and the secondary outcomes were self-management behavior (general and specific diet, exercise, blood sugar testing, foot care, and smoking), risk perception (risk knowledge, personal control, worry, optimism bias, and personal risk), and family support (supportive and nonsupportive behaviors). A 2-tailed paired-sample t test was used to compare the participants at baseline and follow-up within the control and intervention groups. An analysis of covariance was used to measure the intervention effect. Results In total, 225 patients with T2DM were followed up for 1 year. After intervention, they had significantly lower HbA1c values (β=–.69, 95% CI –0.99 to –0.39; P<.001). They also had improved general diet (β=.60, 95% CI 0.20 to 1.00; P=.003), special diet (β=.71, 95% CI 0.34 to 1.09; P<.001), blood sugar testing (β=.50, 95% CI 0.02 to 0.98; P=.04), foot care (β=1.82, 95% CI 1.23 to 2.42; P<.001), risk knowledge (β=.89, 95% CI 0.55 to 1.24; P<.001), personal control (β=.22, 95% CI 0.12 to 0.32; P<.001), worry (β=.24, 95% CI 0.10 to 0.39; P=.001), optimism bias (β=.26, 95% CI 0.09 to 0.43; P=.003), and supportive behaviors (β=5.52, 95% CI 4.03 to 7.01; P<.001). Conclusions The eHealth family-based intervention improved glucose control and self-care activities among patients with T2DM by aiding the implementation of interventions to improve T2DM risk perceptions among family members. The intervention is generalizable for patients with T2DM using health management systems in community health centers. Trial Registration Chinese Clinical Trial Registry ChiCTR1900020736; https://www.chictr.org.cn/showprojen.aspx?proj=31214
BACKGROUND Intervention based on family support and risk perception can enhance type 2 diabetes mellitus (T2DM) patients’ self-care activities. In addition, eHealth education is considered to improve family members’ support for patients with T2DM. However, there is little evidence from rigorously designed studies on the effectiveness of an intervention combining these approaches. OBJECTIVE This randomized controlled trial (RCT) aimed to assess the effectiveness of an eHealth family-based health education intervention for patients with T2DM to improve their glucose control, risk perception, and self-care behaviors. METHODS This single-center, 2-parallel-group RCT was conducted between 2019 and 2020. Overall, 228 patients were recruited from Jiading District, Shanghai, and randomly divided into intervention and control groups. The intervention group received an eHealth family intervention based on community management via WeChat, whereas the control group received usual care. The primary outcome was the glycated hemoglobin (HbA<sub>1c</sub>) level of the patients with T2DM, and the secondary outcomes were self-management behavior (general and specific diet, exercise, blood sugar testing, foot care, and smoking), risk perception (risk knowledge, personal control, worry, optimism bias, and personal risk), and family support (supportive and nonsupportive behaviors). A 2-tailed paired-sample <i>t</i> test was used to compare the participants at baseline and follow-up within the control and intervention groups. An analysis of covariance was used to measure the intervention effect. RESULTS In total, 225 patients with T2DM were followed up for 1 year. After intervention, they had significantly lower HbA<sub>1c</sub> values (β=–.69, 95% CI –0.99 to –0.39; <i>P</i><.001). They also had improved general diet (β=.60, 95% CI 0.20 to 1.00; <i>P</i>=.003), special diet (β=.71, 95% CI 0.34 to 1.09; <i>P</i><.001), blood sugar testing (β=.50, 95% CI 0.02 to 0.98; <i>P</i>=.04), foot care (β=1.82, 95% CI 1.23 to 2.42; <i>P</i><.001), risk knowledge (β=.89, 95% CI 0.55 to 1.24; <i>P</i><.001), personal control (β=.22, 95% CI 0.12 to 0.32; <i>P</i><.001), worry (β=.24, 95% CI 0.10 to 0.39; <i>P</i>=.001), optimism bias (β=.26, 95% CI 0.09 to 0.43; <i>P</i>=.003), and supportive behaviors (β=5.52, 95% CI 4.03 to 7.01; <i>P</i><.001). CONCLUSIONS The eHealth family-based intervention improved glucose control and self-care activities among patients with T2DM by aiding the implementation of interventions to improve T2DM risk perceptions among family members. The intervention is generalizable for patients with T2DM using health management systems in community health centers. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR1900020736; https://www.chictr.org.cn/showprojen.aspx?proj=31214
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