Investigating the behavioural effects of a mobile-phone based home telehealth intervention in people with insulin-requiring diabetes: Results of a randomized controlled trial with patient interviews

Baron, Justine Sita; Hirani, Shashivadan Parbat; Newman, Stanton Peter

doi:10.1177/1357633x16655911

Cited by 30Telemedicine and Telehealth ImplementationDiabetes Management and EducationMobile Health and mHealth Applications

Investigating the behavioural effects of a mobile-phone based home telehealth intervention in people with insulin-requiring diabetes: Results of a randomized controlled trial with patient interviews

Baron, Justine Sita, Hirani, Shashivadan Parbat, Newman, Stanton Peter·2017·Journal of Telemedicine and Telecare

DOI 10.1177/1357633x16655911

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Abstract

Introduction: Evidence supporting home telehealth effects on clinical outcomes in diabetes is available, yet mechanisms of action for these improvements remain poorly understood. Behavioural change is one plausible explanation. This study investigated the behavioural effects of a mobile-phone based home telehealth (MTH) intervention in people with diabetes. It was hypothesized that MTH would improve self-efficacy, illness beliefs, and diabetes self-care. Methods: A randomized controlled trial compared standard care to standard care supplemented with MTH (self-monitoring, data transmission, graphical and nurse-initiated feedback, educational calls). Self-report measures of self-efficacy, illness beliefs, and self-care were repeated at baseline, three months, and nine months. MTH effects were based on the group by time interactions in hierarchical linear models and effect sizes with 95% confidence intervals (CIs). Interviews with MTH participants explored the perceived effects of MTH on diabetes self-management. Results: Eighty-one participants were randomized to the intervention ( n = 45) and standard care ( n = 36). Significant group by time effects were observed for five out of seven self-efficacy subscales. Effect sizes were large, particularly at nine months. Interaction effects for illness beliefs and self-care were non-significant, but effect sizes and confidence intervals suggested MTH may positively affect diet and exercise. In interviews, MTH was associated with increased awareness, motivation, and a greater sense of security. Improved self-monitoring and diet were reported by some participants. Discussion: MTH empowers people with diabetes to manage their condition and may influence self-care. Future MTH research would benefit from investigating behavioural mechanisms and determining patient profiles predictive of greater behavioural effectiveness.

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The 'improved care' theme was identified in seven of nine included studies.
“The “improved care” theme was identified in seven of nine studies. [19–23, 25, 26]”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [20]
Telemonitoring led to increased understanding of disease, resulting in wider self-care improvements including better insulin adherence, increased blood glucose monitoring, and improved oxygen saturation monitoring.
“Three studies [12, 20, 26] mentioned an increased understanding of their disease through telemonitoring, resulting in wider self-care improvements including better insulin adherence, increased blood glucose monitoring [20] and improved oxygen saturation monitoring. [12, 26].”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [20]
Telemonitoring increased patients' sense of security, with patients feeling more relaxed knowing their health parameters were being monitored.
“Four studies identified an increased sense of security. [20, 22, 25, 26] with patients feeling more relaxed knowing telemonitoring was enabling increased monitoring of their health parameters.”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [20]
Numerous patients with diabetes actively reduced dietary sugar intake when raised blood glucose levels were identified through the telemonitoring device.
“Numerous patients with diabetes sought to actively reduce dietary sugar intake when raised blood glucose levels were identified through the telemonitoring device. [20, 23, 25]”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [20]
Telemonitoring increased patients' awareness of their health, leading them to make improved lifestyle changes.
“Several patients expressed that telemonitoring increased their awareness of their health and consequently they made improved lifestyle changes. [19, 20, 23, 25, 26]”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [20]

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An evaluation of a mobile telehealth intervention for people with insulin-requiring diabetes
Baron, J. (2014) · UCL Discovery (University College London)
Self-citation
A Mobile Telehealth Intervention for Adults With Insulin-Requiring Diabetes: Early Results of a Mixed-Methods Randomized Controlled Trial
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Self-citation
Corresponding Author:
Trial, C., Narang, N., Armstead, S. I., Stream, A., Abdullah, S. M., See, R., Snell, P. G., McGavock, J., Ayers, C. R., Gore, M. O., et al. (2015)
How Do Mobile Phone Diabetes Programs Drive Behavior Change?
Nundy, S., Mishra, A., Hogan, P. C., Lee, S. M., Solomon, M. C., & Peek, M. E. (2014) · The Science of Diabetes Self-Management and Care · doi:10.1177/0145721714551992 · Cited by 84 · see citing works
A randomised, controlled trial of the effects of a mobile telehealth intervention on clinical and patient-reported outcomes in people with poorly controlled diabetes
Baron, J., Hirani, S. P., & Newman, S. P. (2016) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x16631628 · Cited by 55 · see citing works
Self-citation

Authors: Baron, J. S., Hirani, S. P., & Newman, S. P.
Affiliations: Ottawa Hospital Research Institute (CA)
City, University of London (GB)
Corresponding author: Newman, Stanton Peter
ORCID: Baron, Justine Sita
Hirani, Shashivadan Parbat
Newman, Stanton Peter
Venue: Journal of Telemedicine and Telecare
Publisher: SAGE Publications
Published: 2016-07-03
Volume: 23
Issue: 5
Pages: 503-512
ISSN: 1357-633X (ISSN-L)
1758-1109
DOI: 10.1177/1357633x16655911
OpenAlex: W2466449973
Cited by: 29
References: 63
Citations by year: 2026: 2 · 2025: 1 · 2024: 2 · 2023: 6 · 2022: 3 · 2021: 7 · 2020: 2 · 2019: 2 · 2018: 1 · 2017: 3
FWCI: 1.98
Type: journal article
Language: en
Open access: closed
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Journal of Telemedicine and Telecare (publishedVersion)
PubMed (publishedVersion)
City Research Online (City University London) (acceptedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Keywords: home telehealth, mobile phone intervention, insulin-treated diabetes, diabetes self-management, self-efficacy, illness beliefs, diabetes self-care, self-monitoring, patient interviews, behavioral mechanisms, diet and exercise
MeSH terms: Adult, Aged, Diabetes Mellitus, Diet, Female, Humans, Interviews as Topic, Male, Middle Aged, Motivation, Self Care, Health Behavior, Exercise, Telemedicine, Self Efficacy, Cell Phone, Insulins

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Investigating the behavioural effects of a mobile-phone based home telehealth intervention in people with insulin-requiring diabetes: Results of a randomized controlled trial with patient interviews

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