C-C2-05: Primary Care Web-Based Lifestyle Intervention for Type 2 Diabetes: Randomized Controlled Trial to Improve Knowledge and Self-Care

Abstract

over 15,000 children ages 4-8 had at least one height and one weight recorded in the EHR at the same visit with BMI> 85th % for age, sex. 11,276 physician letters were mailed: 9,954 opt in letters over 13-months (Cohorts 1-3) and1,322 opt out letters in 2-months (Cohort 4). Of the 170 families screened, 58/107 (54%) identified opt in letters as recruitment source; 49/63 (78%) families in Cohort 4 reported opt out letters introduced them to the study. Fifty-six families gave written informed consent and/or assent and were randomized to one of two groups -Group Family Behavior Modification (FBM) or Enhanced Information Mailing (EIM) group. Three FBM and two EIM families dropped before treatment started. Conclusions: Physician letters to parents of eligible children identified in the EHR were the most successful recruitment strategies for the primary care obesity prevention study. Opt-out physician letters shortened recruitment time and doubled the number of participants recruited for the final cohort. Background: Rapidly growing numbers of Type 2 Diabetics (T2D) in the US continues to escalate need for evidence-based primary care interventions to reduce complications and costs. Limited time, information, and lack of revenue for chronic disease management create gaps between national guidelines and primary care for diabetes. Methods: Of the over 20,000 diabetics were identified in Geisinger EPIC ® EHR, 3166 T2D with diagnosis on problem list or ICD-9 code had HgA1c>8.0%. Physician letters or emails were sent to invite them to call to Opt OUT if they did not want more information. After a 10 day period, staff called 1932 eligible T2D to invite them to a shared medical primary care visit to participate in a randomized controlled trial comparing a tailored 5-month web-based lifestyle intervention (dLifeG.com) to usual care. 166 Type 2 diabetics gave written informed consent and were randomized 1:2 to control group or intervention group. In <20 minutes with simple computer instructions, T2Ds in intervention group created password protected personalized website to set goals, view weekly lessons, and take interactive quizzes to improve diabetes knowledge and selfmanagement. Weekly emails with lesson topics and links to the dLifeG.com were sent to intervention group participants. At end of study, control group will also have access to website intervention. Results: At midpoint, ~3/4th of the 100 T2 diabetics in intervention group were engaged [defined by the number of site page viewed (0-3090 pages), emails opened (0-100%), and quiz pages consumed (0-578)]. Mid and end of study changes in diabetes knowledge, HgA1c, Blood Pressure, and weight will be discussed. Conclusions: Web-based lifestyle interventions can be employed in primary care to engage a majority of diabetics with HgA1c>8.0 in a self-management lifestyle modification intervention. Importantly, the study also helped identify diabetics who may need additional resources and assistance with chronic disease management.

Assessment of kidney disease knowledge among chronic kidney disease patients in the Kingdom of Saudi Arabia

“…Slowing the progression of CKD is feasible through the control of key risk factors such as high protein and salt consumption, physical inactivity, and smoking tobacco (Wright et al, 2011). There is a growing body of literature highlighting the importance of increasing patients' knowledge of their chronic disease to improve coping strategies and self‐management behaviour (Cavanaugh, 2015; Devraj et al, 2015; Kumela Goro et al, 2019; Rukstalis et al, 2011). Obtaining sufficient knowledge about the disease also enables patients to have a say in their treatment modality and enough time to prepare for its challenges.…”

Chronic disease knowledge and its determinants among chronically ill adults in rural areas of Shanxi Province in China: a cross-sectional study

“…CDs are diseases of long duration and generally slow progression that are largely preventable through the reduction of their main lifestyle risk factors, such as unhealthy diet, physical inactivity, tobacco use, and harmful use of alcohol [ 5 ]. Research shows that increasing the health knowledge of chronically ill and high-risk populations is the most effective way to prevent and delay the onset of CDs [ 6 , 7 ]. The improvement of health knowledge contributes to an increased awareness of health care, which not only helps people know more about diseases and increases their ability for self-care, but also helps them to quit unhealthy behaviours and lead healthy lifestyles.…”