Brief, Computer-Assisted Diabetes Dietary Self-Management Counseling: Effects on Behavior, Physiologic Outcomes, and Quality of Life
Abstract
OBJECTIVES: The objective of this work was to evaluate the reach, effectiveness, adoption, and implementation of a brief behavioral dietary intervention and 2 supplemental components of diabetes self-management support: telephone follow-up calls and community resources enhancement. DESIGN AND SUBJECTS: This was a 2 x 2 randomized, controlled trial investigating the incremental effects of telephone follow-up and community resources enhancement with 320 adult type 2 diabetes outpatients. METHODS. Key outcomes included behavioral (dietary patterns, fat intake), physiologic (HbA1c, lipids), and quality-of-life/patient satisfaction measures and were collected at baseline and 3- and 6-month follow-up. RESULTS: Despite high reach (76% patient participation), excellent adoption (all 12 primary care practices approached participated), and good implementation, there were few outcome differences among treatment conditions. There was significant improvement across conditions in most outcomes in each category at both follow-ups. CONCLUSIONS: A brief, computer-assisted, dietary goal-setting intervention basic treatment condition was moderately successful in producing dietary improvements but less so in producing biologic or quality-of-life outcomes. Additions of follow-up phone calls or a community resources enhancement component did not produce incremental improvements over this basic intervention.
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Of 52 included RCTs, 8 (15%) assessed the effects of 7 different DHI strategy combinations on weight loss in patients with T2DM.
“Of 52 included RCTs, 8 (15%) RCTs [50,52,70,72,73,84,85,98] assessed the effects of 7 different DHI strategy combinations on weight loss in patients with T2DM.”
From Assessing the Effectiveness of Digital Health Behavior Strategies on Type 2 Diabetes Management: Systematic Review and Network Meta-Analysis (2025) · cites this paper as [50]
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Wei, X.-L., Barnsley, J., Zakus, D., Cockerill, R., Glazier, R., & Sun, X.-M. (2008) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2007.12.010 · Cited by 19 · see citing works
Graziano, J. A., & Gross, C. R. (2009) · Advances in Nursing Science · doi:10.1097/ans.0b013e3181b0d6d6 · Cited by 16 · see citing works
Shoup, J. A., Gaglio, B., Varda, D., & Glasgow, R. E. (2014) · Translational Behavioral Medicine · doi:10.1007/s13142-014-0300-1 · Cited by 22 · see citing works
Self-citationChung, Y., & Hwang, H.-L. (2008) · Oncology nursing forum · doi:10.1188/08.onf.e83-e89 · Cited by 16 · see citing works
Computer-assisted versus oral-and-written dietary history taking for diabetes mellitus.
Wei, I., Pappas, Y., Car, J., Sheikh, A., & Majeed, A. (2011) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008488.pub2 · Cited by 15 · see citing works
Promoting Physical Activity in Individuals With Diabetes: Telehealth Approaches
Mori, D., Silberbogen, A. K., Collins, A. E., Ulloa, E. W., Brown, K. L., & Niles, B. L. (2011) · Diabetes Spectrum · doi:10.2337/diaspect.24.3.127 · Cited by 15 · see citing works
Assessment of a computer‐supported alcohol education intervention program
Reis, J., & Riley, W. L. (2002) · Health Education · doi:10.1108/09654280210426010 · Cited by 15 · see citing works
Li, M., Liu, S., Yu, B., Li, N., Lyu, A., Yang, H., He, H., Zhang, N., Ma, J., Sun, M., et al. (2025) · Journal of Medical Internet Research · doi:10.2196/63209 · Cited by 12 · see citing works
Probst, Y., & Zammit, G. (2015) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2013.816653 · Cited by 14 · see citing works
“…al., 2008; Barnard et al., 2009, Gold et al., 2009, Hoy et al., 2009), 4.9% paper based (Djuric et al., 1999b; Campbell et al., 2000, Glasgow and Toobert, 2000, Forli et al., 2001a, Forli et al., 2001b, Djuric et al., 2002a, De Mendonca et al., 2003, Djuric et al., 2003, Nydahl et…”
InfluentialKing, D. K., Bull, S. S., Christiansen, S., Nelson, C. C., Strycker, L. A., Toobert, D. J., & Glasgow, R. E. (2004) · Diabetes Spectrum · doi:10.2337/diaspect.17.4.234 · Cited by 11 · see citing works
Self-citationMosha, T. C. E., & Kiangi, R. H. (2009) · Ecology of Food and Nutrition · doi:10.1080/03670240802577457 · Cited by 7 · see citing works
“Results of the general and specific diet practices were comparable to those reported in other studies ( Glasgow and Toobert, 2000 ).”
ResultDietetic practice in type 2 diabetes: An ethnographic study of Australian dietitians
Knights, S., & Tapsell, L. C. (2007) · Nutrition & Dietetics · doi:10.1111/j.1747-0080.2007.00114.x · Cited by 11 · see citing works
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“, 2000 [30] Type 2 Diabetes USA 6 Diet + Telephone support 3 6 Active control”
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Improving Self-Management and Care Coordination with Person-Generated Health Data and Mobile Health
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“…Herman, Brown, Merritt, Fogler, & Halter, 1996; Campbell, 17 1990; Horwath, 1991; Weitzman, 1996) with dietary assessment programs focusing their advice 18 specifically toward this increasing group (Glasgow & Toobert, 2000; Marrero, 2000; Nebel, 19 Bluher, Starcke, Muller, Haak, & Paschke, 2002).”
Assessment and Enhancement of Social and Community Resources Utilization for Disease Self-Management
Strycker, L., & Glasgow, R. (2002) · Health Promotion Practice · doi:10.1177/152483990200300307 · Cited by 7 · see citing works
“Both the touch screen, computer-assisted multimedia component and the interventionist provided skills training and coping models to enhance self-efficacy (Glasgow & Toobert, 2000).”
BackgroundInfluentialSelf-citation
- Authors
- Glasgow, R. E., & Toobert, D. J.
- Affiliations
- Oregon Research Institute (US)
- Corresponding author
- Glasgow, Russell E.
- ORCID
- Glasgow, Russell E.
- Venue
- Medical Care
- Published
- 2000-11
- Volume
- 38
- Issue
- 11
- Pages
- 1062-1073
- ISSN
- 0025-7079 (ISSN-L)
- OpenAlex
- W2049252977
- Cited by
- 129
- References
- 0
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 1 · 2021: 2 · 2019: 2 · 2017: 3 · 2016: 4 · 2015: 4 · 2014: 2 · 2013: 9 · 2012: 6
- FWCI
- 5.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK035524, R01 DK 35524-13)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 2 diabetes, diabetes self-management, nutrition counseling, computer-based intervention, telephone follow-up, community resources, HbA1c, serum lipids, quality of life, patient satisfaction, primary care
- MeSH terms
- Community-Institutional Relations, Computer-Assisted Instruction, Counseling, Diabetes Mellitus, Type 2, Diet, Diabetic, Female, Follow-Up Studies, Glycated Hemoglobin, Humans, Male, Middle Aged, Patient Education as Topic, Quality of Life, Self Care, Program Evaluation, Health Behavior, Treatment Outcome, Patient Satisfaction, Nutritional Sciences
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