PMID- 28559223
OWN - NLM
STAT- MEDLINE
DCOM- 20171214
LR  - 20220331
IS  - 1438-8871 (Electronic)
IS  - 1439-4456 (Print)
IS  - 1438-8871 (Linking)
VI  - 19
IP  - 5
DP  - 2017 May 30
TI  - Dropout From an eHealth Intervention for Adults With Type 2 Diabetes: A 
      Qualitative Study.
PG  - e187
LID - 10.2196/jmir.7479 [doi]
LID - e187
AB  - BACKGROUND: Adequate self-management is the cornerstone of type 2 diabetes 
      treatment, as people make the majority of daily treatment measures and health 
      decisions. The increasing prevalence of type 2 diabetes mellitus (T2DM) and the 
      complexity of diabetes self-management demonstrate the need for innovative and 
      effective ways to deliver self-management support. eHealth interventions are 
      promoted worldwide and hold a great potential in future health care for people 
      with chronic diseases such as T2DM. However, many eHealth interventions face high 
      dropout rates. This led to our interest in the experiences of participants who 
      dropped out of an eHealth intervention for adults with T2DM, based on the Guided 
      Self-Determination (GSD) counseling method. OBJECTIVE: In this study, we aimed to 
      explore experiences with an eHealth intervention based on GSD in general practice 
      from the perspective of those who dropped out and to understand their reasons for 
      dropping out. To the best of our knowledge, no previous qualitative study has 
      focused on participants who withdrew from an eHealth self-management support 
      intervention for adults with T2DM. METHODS: A qualitative design based on 
      telephone interviews was used to collect data. The sample comprised 12 adults 
      with type 2 diabetes who dropped out of an eHealth intervention. Data were 
      collected in 2016 and subjected to qualitative content analysis. RESULTS: We 
      identified one overall theme: "Losing motivation for intervention participation." 
      This theme was illustrated by four categories related to the participants' 
      experiences of the eHealth intervention: (1) frustrating technology, (2) 
      perceiving the content as irrelevant and incomprehensible, (3) choosing other 
      activities and perspectives, and (4) lacking face-to-face encounters. 
      CONCLUSIONS: Our findings indicate that the eHealth intervention based on GSD 
      without face-to-face encounters with nurses reduced participants' motivation for 
      engagement in the intervention. To maintain motivation, our study points to the 
      importance of combining eHealth with regular face-to-face consultations. Our 
      study also shows that the perceived benefit of the GSD eHealth intervention 
      intertwined with choosing to focus on other matters in complex daily lives are 
      critical aspects in motivation for such interventions. This indicates the 
      importance of giving potential participants tailored information about the aim, 
      the content, and the effort needed to remain engaged in complex interventions so 
      that eligible participants are recruited. Finally, motivation for engagement in 
      the eHealth intervention was influenced by the technology used in this study. It 
      seems important to facilitate more user-friendly but high-security eHealth 
      technology. Our findings have implications for improving the eHealth intervention 
      and to inform researchers and health care providers who are organizing eHealth 
      interventions focusing on self-management support in order to reduce dropout 
      rates.
CI  - (c)Silje Stangeland Lie, Bjorg Karlsen, Ellen Renate Oord, Marit Graue, Bjorg 
      Oftedal. Originally published in the Journal of Medical Internet Research 
      (http://www.jmir.org), 30.05.2017.
FAU - Lie, Silje Stangeland
AU  - Lie SS
AUID- ORCID: 0000-0002-6530-3710
AD  - Department of Health Studies, University of Stavanger, Stavanger, Norway.
FAU - Karlsen, Bjorg
AU  - Karlsen B
AUID- ORCID: 0000-0001-7606-2927
AD  - Department of Health Studies, University of Stavanger, Stavanger, Norway.
FAU - Oord, Ellen Renate
AU  - Oord ER
AUID- ORCID: 0000-0002-1194-5195
AD  - Stavanger University Hospital, Stavanger, Norway.
FAU - Graue, Marit
AU  - Graue M
AUID- ORCID: 0000-0002-3149-6227
AD  - Centre for Evidence-based Practice, Western Norway University of Applied 
      Sciences, Bergen, Norway.
FAU - Oftedal, Bjorg
AU  - Oftedal B
AUID- ORCID: 0000-0002-6320-8509
AD  - Department of Health Studies, University of Stavanger, Stavanger, Norway.
LA  - eng
PT  - Journal Article
DEP - 20170530
PL  - Canada
TA  - J Med Internet Res
JT  - Journal of medical Internet research
JID - 100959882
SB  - IM
MH  - Adult
MH  - Aged
MH  - Diabetes Mellitus, Type 2/*therapy
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Patient Dropouts/*statistics & numerical data
MH  - Qualitative Research
MH  - Telemedicine/*statistics & numerical data
PMC - PMC5470008
OTO - NOTNLM
OT  - Internet
OT  - Telehealth
OT  - counseling
OT  - eHealth
OT  - general practice, self-management
OT  - patient dropouts
OT  - qualitative research
OT  - self-management support
OT  - type 2 diabetes
COIS- Conflicts of Interest: None declared.
EDAT- 2017/06/01 06:00
MHDA- 2017/12/15 06:00
PMCR- 2017/05/30
CRDT- 2017/06/01 06:00
PHST- 2017/02/10 00:00 [received]
PHST- 2017/04/14 00:00 [accepted]
PHST- 2017/04/10 00:00 [revised]
PHST- 2017/06/01 06:00 [entrez]
PHST- 2017/06/01 06:00 [pubmed]
PHST- 2017/12/15 06:00 [medline]
PHST- 2017/05/30 00:00 [pmc-release]
AID - v19i5e187 [pii]
AID - 10.2196/jmir.7479 [doi]
PST - epublish
SO  - J Med Internet Res. 2017 May 30;19(5):e187. doi: 10.2196/jmir.7479.