Enhanced Self-Efficacy and Behavioral Changes Among Patients With Diabetes: Cloud-Based Mobile Health Platform and Mobile App Service

• Published in: JMIR diabetes 2019-05, Vol.4 (2), p.e11017-e11017
• Main Authors: Chao, Dyna Yp, Lin, Tom My, Ma, Wen-Ya
• Format: Article
• Language: English
• Subjects: Application programming interface; Behavior; Behavior modification; Body mass index; Chronic illnesses; Diabetes; Dimensional analysis; Disease management; Education; Expenditures; Health literacy; Health promotion; Heart attacks; Hemoglobin; Information technology; Internet of Things; Intervention; Knowledge management; Lifestyles; Original Paper; Patient-centered care; Patients; Personal health; Self-efficacy
• ISSN: 2371-4379; 2371-4379
• DOI: 10.2196/11017

The prevalence of chronic disease is increasing rapidly. Health promotion models have shifted toward patient-centered care and self-efficacy. Devices and mobile app in the Internet of Things (IoT) have become critical self-management tools for collecting and analyzing personal data to improve individual health outcomes. However, the precise effects of Web-based interventions on self-efficacy and the related motivation factors behind individuals' behavioral changes have not been determined. The objective of this study was to gain insight into patients' self-efficacy with newly diagnosed diabetes (type 2 diabetes mellitus) and analyze the association of patient-centered health promotion behavior and to examine the implications of the results for IoT and mobile health mobile app features. The study used data from the electronic health database (n=3128). An experimental design (n=121) and randomized controlled trials were employed to determine patient preferences in the health promotion program (n=62) and mobile self-management education (n=28). The transtheoretical model was used as a framework for observing self-management behavior for the improvement of individual health, and the theory of planned behavior was used to evaluate personal goals, execution, outcome, and personal preferences. A mobile app was used to determine individualized health promotion interventions and to apply these interventions to improve patients' self-management and self-efficacy. Mobile questionnaires were administered for pre- and postintervention assessment through mobile app. A dynamic questionnaire allocation method was used to follow up and monitor patient behavioral changes in the subsequent 6 to 18 months. Participants at a high risk of problems related to blood pressure (systolic blood pressure ≥120 mm Hg) and body mass index (≥23 kg/m ) indicated high motivation to change and to achieve high scores in the self-care knowledge assessment (n=49, 95% CI -0.26% to -0.24%, P=.052). The associated clinical outcomes in the case group with the mobile-based intervention were slightly better than in the control group (glycated hemoglobin mean -1.25%, 95% CI 6.36 to 7.47, P=.002). In addition, 86% (42/49) of the participants improved their health knowledge through the mobile-based app and information and communications technology. The behavior-change compliance rate was higher among the women than among the men. In addition, the personal characteristics of steadiness and dominance corr