PMID- 32216585
OWN - NLM
STAT- MEDLINE
DCOM- 20210114
LR  - 20221207
IS  - 1554-6063 (Electronic)
IS  - 0145-7217 (Linking)
VI  - 46
IP  - 2
DP  - 2020 Apr
TI  - Longitudinal Effects of an Intergenerational mHealth Program for Older Type 2 
      Diabetes Patients in Rural Taiwan.
PG  - 206-216
LID - 10.1177/0145721720907301 [doi]
AB  - PURPOSE: The purpose of the study is to test the longitudinal efficacy of a 
      mHealth intervention (Intergenerational Mobile Technology Opportunities Program, 
      IMTOP) for older type 2 diabetes mellitus (T2DM) patients in rural Taiwan. Few 
      mHealth programs targeted rural older adults and the longitudinal effects are 
      unknown. METHODS: Ninety-seven T2DM patients aged 55+ were recruited from an 
      outpatient in Hualien, Taiwan. The intervention comprised 8-week technology and 
      diabetes self-management training and 4-week technical support. College student 
      tutors facilitated T2DM patients to learn technology. Participants used a 
      diabetes self-management app to track health behaviors. Outcomes measured at 
      baseline and at 4 and 8 months including patient-reported self-care behaviors, 
      T2DM symptoms, clinical outcomes, health resource utilization, and medical 
      expenditure. Linear mixed-effect regressions of repeated measures were conducted 
      for each outcome. RESULTS: At 4 months, improvements in self-care behaviors were 
      reported in diet, exercise, smoking, and blood glucose testing. Patients paid 
      less endocrinology clinic visits, spent less on endocrinology medications, and 
      improvements in fasting blood glucose and total cholesterol were observed. At 8 
      months, the statistical significance of improvements in diet and smoking were 
      maintained, and the averaged endocrinology clinic visits remained less than 
      baseline. However, more frequent occurrence of diabetes symptoms were reported at 
      both follow-ups. CONCLUSIONS: IMTOP had lasting effects on diet and decreased 
      smoking behavior, clinic visits, and medication costs over 8 months. 
      Self-monitoring through an app increased awareness and may explain the increased 
      reporting of diabetes symptoms. IMTOP is a promising model for promoting T2DM 
      self-management in rural areas.
FAU - Yu, Kexin
AU  - Yu K
AUID- ORCID: 0000-0003-4201-5270
AD  - Suzanne Dworak-Peck School of Social Work, University of Southern California, Los 
      Angeles, California.
AD  - Edward R. Roybal Institute on Aging, University of Southern California, Los 
      Angeles, California.
FAU - Wu, Shinyi
AU  - Wu S
AD  - Suzanne Dworak-Peck School of Social Work, University of Southern California, Los 
      Angeles, California.
AD  - Edward R. Roybal Institute on Aging, University of Southern California, Los 
      Angeles, California.
AD  - Daniel J. Epstein Department of Industrial and Systems Engineering, University of 
      Southern California, Los Angeles, California.
AD  - Division of Endocrinology and Metabolism, Hualien Tzu Chi Hospital, Hualien (Dr 
      Wu, Ms. Wang).
FAU - Lee, Pey-Jiuan
AU  - Lee PJ
AD  - Suzanne Dworak-Peck School of Social Work, University of Southern California, Los 
      Angeles, California.
FAU - Wu, Du-An
AU  - Wu DA
AD  - Suzanne Dworak-Peck School of Social Work, University of Southern California, Los 
      Angeles, California.
FAU - Hsiao, Hsin-Yi
AU  - Hsiao HY
AD  - Suzanne Dworak-Peck School of Social Work, University of Southern California, Los 
      Angeles, California.
FAU - Tseng, Yi-Chuan
AU  - Tseng YC
AD  - Suzanne Dworak-Peck School of Social Work, University of Southern California, Los 
      Angeles, California.
FAU - Wang, Ying-Wei
AU  - Wang YW
AD  - Division of Endocrinology and Metabolism, Hualien Tzu Chi Hospital, Hualien.
FAU - Cheng, Ching-Feng
AU  - Cheng CF
AD  - Division of Pediatrics, Taipei Tzu Chi Hospital, Taipei.
FAU - Wang, Yi-Hsuan
AU  - Wang YH
AD  - Ministry of Health and Welfare, Director-General, Health Promotion 
      Administration, Taipei.
AD  - School of Medicine, Tzu Chi University, Hualien.
AD  - Division of Family Medicine, Hualien Tzu Chi Hospital, Hualien.
FAU - Lee, Szu-Pei
AU  - Lee SP
AD  - Sports Medical Center, Hualien Tzu Chi Hospital, Hualien.
FAU - Chi, Iris
AU  - Chi I
AD  - Suzanne Dworak-Peck School of Social Work, University of Southern California, Los 
      Angeles, California.
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Diabetes Educ
JT  - The Diabetes educator
JID - 7701401
RN  - 0 (Glycated Hemoglobin A)
MH  - Aged
MH  - Diabetes Mellitus, Type 2/blood/*therapy
MH  - Female
MH  - Glycated Hemoglobin/analysis
MH  - Health Behavior
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Patient Acceptance of Health Care/*statistics & numerical data
MH  - Program Evaluation
MH  - Rural Population/*statistics & numerical data
MH  - Self-Management/education/*methods
MH  - Taiwan
MH  - Telemedicine/*methods
MH  - Time Factors
EDAT- 2020/03/29 06:00
MHDA- 2021/01/15 06:00
CRDT- 2020/03/29 06:00
PHST- 2020/03/29 06:00 [entrez]
PHST- 2020/03/29 06:00 [pubmed]
PHST- 2021/01/15 06:00 [medline]
AID - 10.1177/0145721720907301 [doi]
PST - ppublish
SO  - Diabetes Educ. 2020 Apr;46(2):206-216. doi: 10.1177/0145721720907301.