Brief Digital Solutions in Behavior Change Interventions for Type 2 Diabetes Mellitus: A Literature Review

Abstract

Introduction With the advent of the COVID-19 pandemic, health systems increasingly look to digital health solutions to provide support for self-management to people with type 2 diabetes (T2D). This review aimed to assess brief digital behavior change solutions (i.e., solutions that require limited engagement or contact) for T2D, including use of behavior change techniques (BCTs) and their impact on self-care and glycemic control. Methods A review was conducted by searching Embase and gray literature using a predefined search strategy to identify randomized controlled trials (RCT) published between January 1, 2015, and March 21, 2021. BCTs were coded using an internationally established BCT taxonomy v1 (BCTTv1). Results Out of 1426 articles identified, 10 RCTs were included in qualitative synthesis. Of these, six reported significant improvements in primary outcome(s), including improved patient engagement, glycemic control, self-efficacy, and physical activity. Interventions as short as 12 min were found to be effective, and users’ ability to control their preferences was noted as conducive to engagement. Almost three quarters of BCTs targeted by interventions were under the hierarchical clusters of “Feedback and monitoring,” “Goals and planning,” and “Shaping knowledge.” Interventions that targeted fewer BCTs were at least as effective as interventions that were more comprehensive in their goals. Discussion Digital behavior change solutions can successfully improve T2D self-care support and outcomes in a variety of populations including patients with low incomes, limited educational attainment, or living in rural areas. Easy-to-use interventions tailored to patient needs may be as effective as lengthy, complex, and more generalized interventions. Conclusions Brief digital solutions can improve clinical and behavioral outcomes while reducing patient burden, fitting more easily in patients’ lives and potentially improving usability. As T2D patients increasingly expect access to self-care assistance between face-to-face encounters, digital support tools will play a greater role in effective diabetes management programs. Supplementary Information The online version contains supplementary material available at 10.1007/s13300-022-01244-w.

A Randomised Control Trial to Explore the Impact and Efficacy of the Healum Collaborative Care Planning Software and App on Condition Management in the Type 2 Diabetes Mellitus Population in NHS Primary Care

“…A strength of this research conducted is the fact that it was a real-world study, where practice nurses delivered the intervention in an everyday practice setting, which is rare for digital health studies in T2D [ 22 ]. The sample size was based on a power calculation which estimated a requirement to screen 450 patients to give 390 patients participating, at a power of 83.6% to see a difference between intervention + usual care group ( p < 0.05).…”

Understanding how self‐management education and support programmes for type 2 diabetes are expected to change behaviour: A document analysis of two programmes

“…A documentary analysis of programme materials was conducted in line with the methods employed in previous research to examine the active ingredients and expected MoAs of interventions. [17][18][19][20][21][22][23][24] Materials were sourced and selected for review and analysis in collaboration with relevant stakeholders, including programme managers and diabetes educators, to ensure that documents providing more detailed information on the content of the programmes were included in the analysis. The selected materials included the following (see Appendix S2 for an outline of the included documents):…”

“…[17][18][19][20] Previous reviews have primarily focused on digitally delivered interventions when examining the active ingredients of self-management interventions for type 2 diabetes. [21][22][23][24] However, limited attention has been paid to the active components of widely delivered in-person DSMES programmes. The complexity and heterogeneity of these interventions and the common poor reporting of intervention content have hindered the identification of their most effective components.…”

“…Notably, providers often provided limited information about the rationale for the selection of theories and constructs that informed programme's design, and the links between theoretical constructs and BCTs 17–20 . Previous reviews have primarily focused on digitally delivered interventions when examining the active ingredients of self‐management interventions for type 2 diabetes 21–24 . However, limited attention has been paid to the active components of widely delivered in‐person DSMES programmes.…”

Comprehensive Network Analysis Reveals the Targets and Potential Multitarget Drugs of Type 2 Diabetes Mellitus

“…As a result, the high incidence and mortality dramatically increased, placing a huge burden on the health care system [ 2 ]. The main categories of diabetes include type 1 diabetes (T1DM), type 2 diabetes mellitus (T2DM), gestational diabetes, and other less common types, such as monogenic diabetes syndrome, pancreatic exocrine diseases, and diabetes caused by drugs or chemicals [ 3 ]. Among them, T2DM is the most common type of diabetes, accounting for 90% of all diabetic patients [ 4 ].…”