步骤添加：一种基于社会认知理论的个性化移动健康干预措施，以增加 2 型糖尿病患者的身体活动量。

StepAdd: A personalized mHealth intervention based on social cognitive theory to increase physical activity among type 2 diabetes patients.

机构信息

Department of Biomedical Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Planning, Information and Management, The University of Tokyo Hospital, Tokyo, Japan; Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

出版信息

J Biomed Inform. 2023 Sep;145:104481. doi: 10.1016/j.jbi.2023.104481. Epub 2023 Aug 28.

DOI:10.1016/j.jbi.2023.104481

PMID:37648101

Abstract

OBJECTIVE

Investigate the preliminary efficacy and feasibility of a personalized mobile health (mHealth) intervention based on social cognitive theory (SCT) to promote physical activity among type 2 diabetes patients via self-monitoring, goal setting, and automatic feedback.

METHODS

We conducted a pilot study involving 33 type 2 diabetes patients attending Mitsui Memorial Hospital in Japan using a pre-post evaluation design over 12 weeks. Participants measured daily step count, body weight, and blood pressure at home, with the measurements synchronized with the StepAdd application (app) automatically. Participants used the app to review daily results, update personalized step goals, identify individualized barriers to achieving the step goals, find coping strategies to overcome each barrier, and implement these strategies, thereby building effective coping skills to meet the goals. Pharmacists examined the usage of the app and provided coaching on lifestyle modifications. Ultimately, patients established skills to enhance diabetes self-care by using the app.

RESULTS

Daily step count increased dramatically with high statistical significance (p < 0.0001), from a mean of 5436 steps/day to 10,150 steps/day, an 86.7 % increase. HbA1c (p = 0.0001) and BMI (p = 0.0038) also improved. Diabetes self-care in diet, exercise, and foot care as well as self-management behavior, self-regulation, and self-efficacy in achieving daily step goals showed significant improvements. The retention rate of the study was very high, at 97.0 % (n = 32).

CONCLUSIONS

A personalized smartphone-based mHealth intervention based on SCT is feasible and effective at promoting physical activity among type 2 diabetes patients. The methodology of the intervention could be readily applied to other patient populations.

摘要

目的

基于社会认知理论（SCT），调查一种个性化移动健康（mHealth）干预措施在促进 2 型糖尿病患者通过自我监测、目标设定和自动反馈来提高身体活动量方面的初步效果和可行性。

方法

我们采用预前后评估设计，在日本三井纪念医院进行了一项试点研究，共纳入 33 例 2 型糖尿病患者。参与者在家中测量每日步数、体重和血压，测量结果与 StepAdd 应用程序（app）自动同步。参与者使用该应用程序查看每日结果，更新个性化的步数目标，识别实现目标的个性化障碍，找到克服每个障碍的应对策略，并实施这些策略，从而建立有效的应对技能来实现目标。药剂师检查了应用程序的使用情况，并提供了生活方式改变方面的指导。最终，患者通过使用该应用程序建立了提高糖尿病自我护理的技能。

结果

每日步数显著增加，具有统计学意义（p<0.0001），从平均 5436 步/天增加到 10150 步/天，增加了 86.7%。HbA1c（p=0.0001）和 BMI（p=0.0038）也得到了改善。饮食、运动和足部护理方面的糖尿病自我护理以及自我管理行为、自我调节和实现每日目标的自我效能感均显著改善。研究的保留率非常高，为 97.0%（n=32）。