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Computer-assisted intervention improves patient-centered diabetes care by increasing autonomy support.
Abstract
OBJECTIVE: To determine if a patient-centered, computer-assisted diabetes care intervention increased perceived autonomy support, perceived competence (from self-determination theory), and if these constructs mediated the effect of the intervention on ADA/NCQA recommended diabetes care outcomes. DESIGN: A randomized controlled trial of 866 adult type 2 diabetes patients in heterogeneous primary care settings in Colorado. MAIN OUTCOME MEASURES: Perceived autonomy support, perceived competence, patient satisfaction, glycemic control (HbA1c), ratio of total to HDL cholesterol, diabetes distress, and depressive symptoms. RESULTS: The computer-assisted intervention increased patient perception of autonomy support relative to a computer-based control condition ( p = .05). Change in perceived competence partially mediated the effects of increased autonomy support on the change in lipids, diabetes distress, and depressive symptoms. The construct of autonomy support was found to be separate from that of patient satisfaction. CONCLUSIONS: A patient-centered, computer-assisted intervention was effective in improving diabetes self-management outcomes, in part, because it increased patients' perception that their autonomy was supported which changed perceived competence. These findings support the self-determination model for health behavior change and the chronic care model and support the further study of the use of these technologies to motivate patients to improve their health outcomes.
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“In addition, in the case of an app-based mode of delivery, the presence of a mobile device throughout most daily activities and experiences may facilitate the integration of newly learned skills into daily life [138,139].”
From New evidence in the booming field of online mindfulness: An updated meta-analysis of randomized controlled trials (2021) · cites this paper as [139]
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Metadata
- Authors
- Williams, G. C., Lynch, M., & Glasgow, R. E.
- Affiliations
- University of Rochester Medicine (US)
- University of South Florida Sarasota–Manatee (US)
- Kaiser Permanente (US)
- Venue
- Health Psychology
- Published
- 2007-11
- Volume
- 26
- Issue
- 6
- Pages
- 728-734
- ISSN
- 0278-6133 (ISSN-L)
- 1930-7810
- OpenAlex
- W2047333489
- Cited by
- 236
- References
- 29
- Citations by year
- 2025: 4 · 2024: 3 · 2023: 7 · 2022: 6 · 2021: 7 · 2020: 63 · 2019: 10 · 2018: 9 · 2017: 12 · 2016: 12 · 2015: 8 · 2014: 19 · 2013: 16 · 2012: 16
- FWCI
- 6.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Health Psychology (publishedVersion)
- PubMed (publishedVersion)
- UR Research (University of Rochester) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Social Sciences › Psychology › Social Psychology › Motivation and Self-Concept in Sports
- Keywords
- computer-based intervention, type 2 diabetes, autonomy support, perceived competence, self-determination theory, patient-centered care, diabetes self-management, glycemic control, HbA1c, diabetes distress, depressive symptoms, lipid ratios, patient satisfaction, Chronic Care Model, health behavior change
- MeSH terms
- Adult, Colorado, Diabetes Mellitus, Type 2, Humans, Middle Aged, Models, Psychological, Motivation, Regression Analysis, Self Care, Social Support, Therapy, Computer-Assisted, Treatment Outcome, Patient Satisfaction, Patient-Centered Care, Personal Autonomy
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