Design, feasibility, and acceptability of an intervention using personal digital assistant-based self-monitoring in managing type 2 diabetes

Research design/methodology

TYPE: randomized controlled trial

VALIDITY: Some participants were given older generation PDAs that lost dietary entries when the device was not recharged in a timely fashion. Time recording was not facilitated by the software and therefore it did not allow for timeline analysis.

ENVIRONMENT: Combination of scheduled visits and educational sessions at an academic research facility at the University of Pittsburgh and at community settings when participants employed the intervention in their daily lives.

Research question

Can PDA's enhance behavioral adherence to a self-management intervention for type 2 diabetes patients?

The research aimed to determine the acceptability and effectiveness of PDA-based self-management interventions for type 2 diabetes and whether such an approach reduced information processing burdens for patients.

Patient/Problem/Population definition

PROBLEM: Patients with chronic diseases, like type 2 diabetes, face challenges from informational and behavioral standpoints. 

POPULATION: 18 years of age or older with a diagnosis of type 2 diabetes

TYPE: evaluation of patient education for self-management intervention

Intervention

PDAs were given to the intervention group.  PalmOne Tungsten/E2 PDAs preloaded with BalanceLog®  software by MircroLife were handed out to patients at random. The PDA tool helped the intervention group keep track of their dietary intake, manage their activity log, and visualize the progress in their self-management intervention goals.

Over a period of six months, participants from both control and intervention groups were invited to educational self-management intervention sessions specific to type 2 diabetes.

Comparison

The research compared PDA-based self-management intervention of type 2 diabetes with that of the same self-management interventions of type 2 diabetes but without PDAs.

PDAs were preloaded with dietary and activity management software and participants were given Social Cognitive Theory (SCT)-based group counseling. The control group were given SCT-based group counseling with a lay diabetes journal.

The authors compared their results with that of others, Burke et al. (2006)and Yon et al. (2007), and had comparable participation rates with that of one research study by Glanz et. al (2006).

Outcome

The research found that 87.9% of participants thought that PDAs were useful in monitoring activities; 84.8% felt that the application was easy to use; and 69.7% thought the feedback graphs were easily interpreted. Overall, 82% reported that they will keep using the PDA tools after the study concluded.

This 5-year study had 151 randomized participants with 129 individual (85%) completing their 6-month assessment.

Application of results to patient care

PDA-based self-management interventions of type 2 diabetes have proven helpful and yielded a high adoption rate by participants. This approach may be a practical answer for mastering diabetes self-management interventions and changing behaviors related to diet and exercise.

Further areas for research  

• Use the same PDA approach for interventions of other chronic diseases that require close diet and exercise monitoring
• Extend the research to other handheld devices such as mobile phones and portable MP3 players
• Include a younger age group: 12 to 18 years old since this age group may use handheld devices, like mobile phones and MP3 players, extensively