Interactive Media for Diabetes Self-Management: Issues in Maximizing Public Health Impact

• Published in: Medical decision making 2010-11, Vol.30 (6), p.745-758
• Main Author: Glasgow, Russell E.
• Format: Article
• Language: English
• Subjects: Cooperative Behavior; Decision Making; Decision Support Techniques; Diabetes Mellitus - drug therapy; Diabetes Mellitus - prevention & control; Health Behavior; Health Education; Humans; Patient Education as Topic - methods; Patient-Centered Care; Peer Group; Public Health - methods; Self Care - methods
• ISSN: 0272-989X; 1552-681X
• DOI: 10.1177/0272989X10385845

Background . Diabetes self-management presents a series of challenging tasks, and primary care, where the majority of cases of adult diabetes are treated, is hard-pressed to address these issues given competing demands. This article discusses how interactive media (IM) can be used to support diabetes self-management. Methods . Following a brief review of the literature, the 5 As framework for enhancing the effectiveness of health behavior counseling and the RE-AIM model for estimating and enhancing public health impact are used to frame discussion of the strengths and limitations of IM for diabetes shared decision making and self-management support. Results . Data and lessons learned from a series of randomized trials of IM for diabetes self-management education are summarized around 2 key issues. The first is enhancing patient engagement in decision making and includes enhancing user experience and engagement, improving quality of care, and promoting collaborative action planning and follow-up. The second is getting such resources into place and sustaining them in real-world primary care settings and involves enhancing participation at patient, clinician, and health care system levels and enhancing the generalizability of results. Conclusions . Key opportunities for IM to support diabetes self-management include assessment of information for shared decision making, assistance with problem-solving self-management challenges, and provision of follow-up support. A key current challenge is the linkage of IM supports to the rest of the patient’s care, and collection of cost-effectiveness data is a key need for future research.