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Ortíz GO, Vega García S, Islas Salinas C, Muñoz Torres AV, Velázquez López L. Usability evaluation of the educational website "understanding my diabetes" for Mexican patients with type 2 diabetes. Front Public Health 2024; 12:1394066. [PMID: 38799692 PMCID: PMC11116676 DOI: 10.3389/fpubh.2024.1394066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 04/23/2024] [Indexed: 05/29/2024] Open
Abstract
Background Diabetes education is an integral part of the treatment for the metabolic control of patients with diabetes. The use of the Internet as a tool for diabetes education, as well as its acceptance, is still under study. Aim To assess the usability of the educational website "I understand my diabetes" designed for patients with type 2 diabetes attending primary care clinics. Material and method A cross-sectional study was done in 110 patients with type 2 diabetes from two family medicine clinics, each of whom was assigned a user account on the educational website "Entiendo mi diabetes." The web site assigned a user name and password to each patient. They were able to access the educational website at home. After a 15-day review period, participants were asked to evaluate usability using the Computer System Usability Questionnaire. Additionally, we developed an eight-item questionnaire usability focusing on diabetes care. Sociodemographic data, blood pressure, and anthropometric measurements were recorded. Glucose levels and lipid profiles were also measured. Results The patients with diabetes had a mean age of 52.7 years and a median of 5 years since they were diagnosed with diabetes. The website received a good usability rating from 89.1% of participants, with favorable assessments in all three dimensions: 87.3% for information, 85.5% for quality, and 88.2% for interface. Regarding usability specifically for diabetes care, 98.2% rated it as having good usability. Conclusion The website for education about the disease in patients "I understand my diabetes" had an adequate usability evaluation by patients, so they also considered it very useful for diabetes care. The diabetes care instrument had adequate usability and reliability.
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Affiliation(s)
- Gabriela Ortíz Ortíz
- Unidad de Investigación en Epidemiología Clínica, Hospital General Regional No. 1 “Dr. Carlos Mac Gregor Sánchez Navarro” Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
| | - Sandra Vega García
- Unidad de Medicina Familiar Número 7, Coordinación de Educación e Investigación en Salud, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
| | - Cristina Islas Salinas
- Unidad de Medicina Familiar Número 7, Coordinación de Educación e Investigación en Salud, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
| | - Abril Violeta Muñoz Torres
- Departamento de Salud Publica, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Lubia Velázquez López
- Unidad de Investigación en Epidemiología Clínica, Hospital General Regional No. 1 “Dr. Carlos Mac Gregor Sánchez Navarro” Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
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Velázquez López L, Achar de la Macorra R, Colin Ramirez E, Muñoz Torres AV, Pineda Del Aguila I, Medina Bravo PG, Klünder Klünder M, Medina Gómez OS, Escobedo de la Peña J. The diabetes education material on diabetes for website: Results of a validation process. J Healthc Qual Res 2023; 38:346-353. [PMID: 37567853 DOI: 10.1016/j.jhqr.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/27/2023] [Accepted: 07/14/2023] [Indexed: 08/13/2023]
Abstract
OBJECTIVE To validate an educational material on diabetes through an expert consensus for its implementation into a web site. MATERIAL AND METHODS An observational study was carried out in a group of health professionals, for which an educational material was developed for patients with diabetes. Topics included nutrition, physical exercise, control indicators, complications, pharmacological treatment, among others. The language, text and figures were focused on easy comprehension, additionally, a section of didactic activities to be answered by the patient with diabetes at the end of each module was included. To evaluate the educational material by health professionals, an instrument was designed and validated. Once all the educational material was available, each of the modules was sent by e-mail to at least three clinical experts in the assigned topic, as well as the instrument for the evaluation of the module. RESULTS Thirty-seven experts were included in the study, 76% rated the educational modules evaluated as highly adequate, while only 24% rated them as adequate. The instrument used obtained a good level of internal consistency, with a Cronbach's alpha coefficient of 0.92. In the dimensions of the instrument, the lowest Cronbach's alpha score was that of "call-to-action", with a value of 0.71. CONCLUSION The diabetes educational material was rated as highly appropriate by the clinical experts. The developed instrument has an adequate content validity, as well as a good level of internal consistency.
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Affiliation(s)
- L Velázquez López
- Unidad de Investigación en Epidemiología Clínica, Hospital Regional No 1, "Dr. Carlos Mac Gregor Sánchez Navarro" Instituto Mexicano del Seguro Social, Ciudad de México, Mexico.
| | - R Achar de la Macorra
- Departamento de Salud, Universidad Iberoamericana, sede Santa Fe, Ciudad de México, Mexico
| | - E Colin Ramirez
- Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac, México Campus Norte, Huixquilucan Edo. de México 52786, Mexico
| | - A V Muñoz Torres
- Departmento de Salud Publica, Escuela de Medicina, Universidad Nacional Autónoma de México, 04510 Mexico City, Mexico
| | - I Pineda Del Aguila
- Unidad de Investigación en Epidemiología Clínica, Hospital Regional No 1, "Dr. Carlos Mac Gregor Sánchez Navarro" Instituto Mexicano del Seguro Social, 03100 Mexico City, Mexico
| | - P G Medina Bravo
- Departamento de Endocrinología, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - M Klünder Klünder
- Departamento de Investigación, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - O S Medina Gómez
- Unidad de Investigación en Epidemiología Clínica, Hospital Regional No 1, "Dr. Carlos Mac Gregor Sánchez Navarro" Instituto Mexicano del Seguro Social, 03100 Mexico City, Mexico
| | - J Escobedo de la Peña
- Unidad de Investigación en Epidemiología Clínica, Hospital Regional No 1, "Dr. Carlos Mac Gregor Sánchez Navarro" Instituto Mexicano del Seguro Social, 03100 Mexico City, Mexico
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Geurts KAM, Woodcock-Nekeman S, Hummel M, Dietvorst CAW, van Rossum EFC, Berk KA. The Effect of Including eHealth in Dietary Interventions for Patients with Type 2 Diabetes with Overweight or Obesity: A Systematic Review. Nutrients 2023; 15:3776. [PMID: 37686808 PMCID: PMC10490324 DOI: 10.3390/nu15173776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/11/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
eHealth has a growing impact on the delivery of healthcare, making health systems more efficient. This study examined the effect of dietary interventions using eHealth compared to face-to-face contact in patients with (pre-) type 2 diabetes (T2D) and who are overweight/obese. Literature databases were searched upon November 2022. Inclusion criteria: randomized controlled trial; duration ≥ 6 months; involving dietary interventions; performed in adults with (pre-) T2D and who are overweight/obese; using eHealth compared to face-to-face contact; and report outcomes on weight loss, glycemic regulation, and/or cost-effectiveness. Selection of articles was performed manually and using ASReviewLab. Fifteen studies were included for data extraction, investigating a wide variety of eHealth interventions. Seven studies reporting on weight loss showed a significant between-group difference (-1.18 to -5.5 kg); five studies showed a trend in favor of the eHealth programs. Eleven studies reported on HbA1c; three found a significant between-group difference (-0.23 to -0.70%) in favor of the eHealth programs and six studies showed non-significant improvements. Interaction with healthcare professionals led to better results of the dietary interventions. Two studies reported incomplete data on cost-effectiveness. In conclusion, eHealth shows better results of dietary interventions in (pre-) T2D patients compared to face-to-face, especially when combined with interaction with healthcare professionals.
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Affiliation(s)
- Karlijn A. M. Geurts
- Department of Internal Medicine, Division of Dietetics, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (K.A.M.G.); (S.W.-N.); (C.A.W.D.)
| | - Sandra Woodcock-Nekeman
- Department of Internal Medicine, Division of Dietetics, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (K.A.M.G.); (S.W.-N.); (C.A.W.D.)
| | - Mitchell Hummel
- Department of Internal Medicine, Division of Dietetics, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (K.A.M.G.); (S.W.-N.); (C.A.W.D.)
| | - Carmen A. W. Dietvorst
- Department of Internal Medicine, Division of Dietetics, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (K.A.M.G.); (S.W.-N.); (C.A.W.D.)
| | - Elisabeth F. C. van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands;
- Obesity Center CGG, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Kirsten A. Berk
- Department of Internal Medicine, Division of Dietetics, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (K.A.M.G.); (S.W.-N.); (C.A.W.D.)
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Múzquiz-Barberá P, Ruiz-Cortés M, Herrero R, Vara MD, Escrivá-Martínez T, Baños RM, Rodilla E, Lisón JF. "Own doctor" presence in a web-based lifestyle intervention for adults with obesity and hypertension: A randomized controlled trial. Front Public Health 2023; 11:1115711. [PMID: 36998287 PMCID: PMC10043391 DOI: 10.3389/fpubh.2023.1115711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 02/23/2023] [Indexed: 03/18/2023] Open
Abstract
Introduction Online interventions have long been shown to be an effective means to promote a healthy lifestyle, thereby helping to control body weight and blood pressure figures. Likewise, using video modeling is also considered an effective way to guide patients through behavioral interventions. Nonetheless, to the best of our knowledge, this study is the first to analyze how the presence of patients' "own doctor" in the audiovisual content of a web-based lifestyle program ("Living Better") aimed at promoting regular physical exercise and healthy eating behavior, compared with an "unknown doctor," influences the outcomes of adults with obesity and hypertension. Materials and methods A total of 132 patients were randomly assigned either to the experimental (n = 70) or control (n = 62) group ("own doctor" or "unknown doctor", respectively). The body mass index, systolic and diastolic blood pressure, number of antihypertensive drugs used, physical activity level, and quality of life was assessed and compared at baseline and post-intervention (12 weeks). Results The intention-to-treat analysis showed intragroup significant improvements in both groups in terms of the body mass index (control group: mean difference -0.3, 95% CI [-0.5, -0.1], p = 0.002; experimental group: -0.4 [-0.6, -0.2], p < 0.001) and systolic blood pressure (control group: -2.3 [-4.4, -0.2], p = 0.029; experimental group: -3.6 [-5.5, -1.6], p< 0.001). In addition, there were also significant improvements in the experimental group for the diastolic blood pressure (-2.5 [-3.7, -1.2], p < 0.001), physical activity (479 [9, 949], p = 0.046), and quality of life (5.2 [2.3, 8.2], p = 0.001). However, when comparing the experimental with the control group, no between-group significant differences were found in these variables. Conclusions This study suggests that the presence of patients' "own doctor" in the audiovisual content of a web-based intervention, aimed at promoting a healthy lifestyle among adults with obesity and hypertension, do not show significant additional benefits over the efficacy of e-counseling. Trial registration ClinicalTrials.gov NCT04426877. First Posted: 11/06/2020. https://clinicaltrials.gov/ct2/show/NCT04426877.
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Affiliation(s)
- Pedro Múzquiz-Barberá
- Department of Nursing and Physiotherapy, Faculty of Health Sciences, University CEU-Cardenal Herrera, CEU Universities, Valencia, Spain
| | - Marta Ruiz-Cortés
- Department of Biomedical Sciences, Faculty of Health Sciences, University CEU-Cardenal Herrera, CEU Universities, Valencia, Spain
| | - Rocío Herrero
- Department of Psychology and Sociology, Universidad de Zaragoza, Teruel, Spain
- CIBER-Obn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Tamara Escrivá-Martínez
- CIBER-Obn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain
- Polibienestar Research Institute, Universitat de València, Valencia, Spain
| | - Rosa María Baños
- CIBER-Obn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain
- Polibienestar Research Institute, Universitat de València, Valencia, Spain
| | - Enrique Rodilla
- Department of Medicine and Surgery, Faculty of Health Sciences, University CEU-Cardenal Herrera, CEU Universities, Valencia, Spain
- Hypertension and Vascular Risk Unit, Hospital Universitario de Sagunto, Valencia, Spain
| | - Juan Francisco Lisón
- Department of Biomedical Sciences, Faculty of Health Sciences, University CEU-Cardenal Herrera, CEU Universities, Valencia, Spain
- CIBER-Obn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain
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Oliveira TW, Pereira PPDS, Fonseca LA, de Oliveira LML, Pereira DS, Neira CPD, Figueiredo ACMG. Use of Information and Communication Technologies among Adults in Weight Control: Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14224809. [PMID: 36432496 PMCID: PMC9696910 DOI: 10.3390/nu14224809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/16/2022] [Accepted: 10/20/2022] [Indexed: 11/16/2022] Open
Abstract
Information and communication technologies are part of our day-to-day life in the execution of all activities, including health care. However, it is not known how much the use of technologies can contribute to the adoption of healthy lifestyle habits. Thus, the objective of this study was to analyze whether the use of information and communication technologies contributes to weight control among adults when compared to the traditional approach method. The search was performed in November 2021 in eight electronic databases in addition to gray literature bases. The quality of the studies was assessed using the Cochrane risk of bias tool. The standardized mean difference was used for the meta-analytic measurement using the random effects model using the Dersimonian-Laid method in the Stata statistical package version 17. The body mass index of the intervention group decreased by an average of 0.56 (95% CI: -0.83; -0.30) when compared to the control group. When comparing the before and after groups, the intervention group also had a greater reduction in BMI (summarized mean: -0.83; 95% CI: -1.40; -0.26). Information and communication technologies contribute to the reduction of the body mass index in the adult population when compared to the traditional model of monitoring. Prospero registration: number 42020186340.
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Affiliation(s)
- Thatiana Wanessa Oliveira
- Health Care Research Laboratory, Federal University of Rondônia, Br 364, Porto Velho 76801-059, Brazil
| | - Priscilla Perez da Silva Pereira
- Health Care Research Laboratory, Federal University of Rondônia, Br 364, Porto Velho 76801-059, Brazil
- Correspondence: ; Tel.: +55-69-992586851
| | - Leonice Antunes Fonseca
- Health Care Research Laboratory, Federal University of Rondônia, Br 364, Porto Velho 76801-059, Brazil
| | | | - Dauster Souza Pereira
- Centro Interdisciplinar de Novas Tecnologias na Educação (CINTED), Federal Institute of Rondônia, Avenida Lauro Sodré, 6500, Porto Velho 76804-124, Brazil
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Okuda S, Tunematsu M, Tabuchi K, Kobayashi T, Kakehashi M, Nakatani H. A New Health Promotion Program That Includes Wadaiko Rhythm Exercise to Maintain the Health of Persons Excluded from Receiving Specific Health Guidance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148520. [PMID: 35886382 PMCID: PMC9321626 DOI: 10.3390/ijerph19148520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/07/2022] [Accepted: 07/08/2022] [Indexed: 02/05/2023]
Abstract
This study examined the effectiveness of a new health promotion program, which is a collective intervention program aimed at improving lifestyle habits. It was designed as a one-year prospective cohort study. This program targeted non-obese persons at risk of developing lifestyle-related diseases and participants with hypertension, dyslipidemia, or hyperglycemia who were not included in the specific health guidance system in Japan. The Wadaiko rhythm exercise, which is a traditional performing art, is incorporated into this intervention as an enjoyable routine that can help participants continue the program, preventing them from dropping out. After a one-year follow-up, the effectiveness of the health promotion program was evaluated in 18 participants (2 males, 16 females; mean age 65.2 ± 3.4 years) and 92 controls. The results showed that triglyceride in the intervention group significantly decreased (−24.5 mg/dL; p = 0.02; 95% confidence interval [CI], −44.73 to −4.27) and high-density lipoprotein cholesterol significantly increased (+6.1 mg/dL; p < 0.01; 95% CI, 2.46 to 9.65), although levels in the control group did not change. These results suggest that the health promotion program could contribute to lifestyle habit improvements in those who are excluded from receiving specific health guidance.
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Affiliation(s)
- Suzumi Okuda
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.T.); (M.K.); (H.N.)
- Correspondence: ; Tel.: +81-82-257-5353
| | - Miwako Tunematsu
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.T.); (M.K.); (H.N.)
| | - Keiji Tabuchi
- Nursing Science Unit, Research and Education Faculty, Medical Sciences Cluster, Kochi University, 185-1, Kohasu Oko-cyo, Nankoku-City 783-8505, Japan;
| | - Toshio Kobayashi
- School of Nursing and Health, Aichi Prefectural University, Tohgoku, Kamishidami, Moriyama-ku, Nagoya-City 463-8502, Japan;
| | - Masayuki Kakehashi
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.T.); (M.K.); (H.N.)
| | - Hisae Nakatani
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.T.); (M.K.); (H.N.)
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Sanaeinasab H, Saffari M, Yazdanparast D, Karimi Zarchi A, Al-Zaben F, Koenig HG, Pakpour AH. Effects of a health education program to promote healthy lifestyle and glycemic control in patients with type 2 diabetes: A randomized controlled trial. Prim Care Diabetes 2021; 15:275-282. [PMID: 33055009 DOI: 10.1016/j.pcd.2020.09.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/23/2020] [Accepted: 09/25/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a common chronic disease with an increase in prevalence within developing countries. The aim of this study was to determine the efficacy of a structured educational program for improving lifestyle and health-related measures in Iranians with T2DM. METHODS A randomized controlled trial was conducted in 80 participants with T2DM who were randomly assigned to either the intervention or a control group. A demographic questionnaire along with the Health Promoting Lifestyle Profile-II and related laboratory tests were used to assess the efficacy of the program. The intervention consisted of six educational sessions held over 45 days. The control group received routine diabetic care at the clinic. Three months after the intervention, participants completed the measures again. Within-group and between-group comparisons were then made. RESULTS All subscales of lifestyle measure improved in the intervention group, whereas only the nutrition domain improved in the control group. After adjusting for baseline differences, physical activity and nutrition domains showed the greatest improvement in the intervention group compared to controls. All clinical measures were also significantly improved within intervention group from baseline to follow-up (p < 0.001), whereas HbA1c, fasting blood glucose, HDL, triglyceride, cholesterol, and weight also changed significantly in the control group. The frequency of HbA1c < 7% was increased from 27.5% at baseline to 37.5% at follow-up (10%) in the intervention group compared to only a 5% increase in the control group. CONCLUSION This educational health program significantly improved lifestyle changes and health-related clinical characteristics in persons with T2DM, compared to routine diabetic care in Iran. Further research is needed to better understand the usefulness of such programs in diabetics and other medical conditions among those in different cultural settings.
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Affiliation(s)
- Hormoz Sanaeinasab
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran; Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Mohsen Saffari
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran; Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Davoud Yazdanparast
- Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Aliakbar Karimi Zarchi
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran; Department of Epidemiology and Biostatistics, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Faten Al-Zaben
- Division of Psychiatry, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Harold G Koenig
- Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA; Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; School of Public Health, Ningxia Medical University, Yinchuan, China.
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran; Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
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Liao LZ, Chen ZC, Li WD, Zhuang XD, Liao XX. Causal effect of education on type 2 diabetes: A network Mendelian randomization study. World J Diabetes 2021; 12:261-277. [PMID: 33758646 PMCID: PMC7958473 DOI: 10.4239/wjd.v12.i3.261] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/10/2020] [Accepted: 12/23/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The causality between education and type 2 diabetes (T2DM) remains unclear.
AIM To identify the causality between education and T2DM and the potential metabolic risk factors [coronary heart disease (CHD), total cholesterol, low-density lipoprotein, triglycerides (TG), body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), fasting insulin, fasting glucose, and glycated hemoglobin] from summarized genome-wide association study (GWAS) data used a network Mendelian randomization (MR).
METHODS Two-sample MR and network MR were performed to obtain the causality between education-T2DM, education-mediator, and mediator-T2DM. Summary statistics from the Social Science Genetic Association Consortium (discovery data) and Neale Lab consortium (replication data) were used for education and DIAGRAMplusMetabochip for T2DM.
RESULTS The odds ratio for T2DM was 0.392 (95%CI: 0.263-0.583) per standard deviation increase (3.6 years) in education by the inverse variance weighted method, without heterogeneity or horizontal pleiotropy. Education was genetically associated with CHD, TG, BMI, WC, and WHR in the discovery phase, yet only the results for CHD, BMI, and WC were replicated in the replication data. Moreover, BMI was genetically associated with T2DM.
CONCLUSION Short education was found to be associated with an increased T2DM risk. BMI might serve as a potential mediator between them.
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Affiliation(s)
- Li-Zhen Liao
- Department ofHealth, Guangdong Pharmaceutical University, Guangzhou 510275, Guangdong Province, China
- Guangdong Provincial Key Laboratory of Pharmaceutical Bioactive Substances, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong Province, China
| | - Zhi-Chong Chen
- Department of Cardiology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China
| | - Wei-Dong Li
- Department ofHealth, Guangdong Pharmaceutical University, Guangzhou 510275, Guangdong Province, China
- Guangdong Provincial Key Laboratory of Pharmaceutical Bioactive Substances, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong Province, China
| | - Xiao-Dong Zhuang
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China
| | - Xin-Xue Liao
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China
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9
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Reséndiz Lara T, Muñoz Torres AV, Mendoza Salmerón G, Zendejas Vela DD, Medina Bravo P, Roy García I, Velázquez López L. La educación con una plataforma multimedia en web mejora los conocimientos y la HbA1c de pacientes mexicanos con diabetes tipo 2. Ensayo clínico abierto. ENDOCRINOL DIAB NUTR 2020; 67:530-539. [DOI: 10.1016/j.endinu.2019.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 06/24/2019] [Accepted: 07/04/2019] [Indexed: 10/25/2022]
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10
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Aligholipour M, Feizollahzadeh H, Ghaffari M, Jabbarzadeh F. Comparison of In-Person and MMS -Based Education in Telegram on Self-care and Fasting Blood Sugar of Patients with Diabetes Mellitus: A Randomized Clinical Trials. J Caring Sci 2019; 8:157-164. [PMID: 31598508 PMCID: PMC6778313 DOI: 10.15171/jcs.2019.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 10/31/2018] [Indexed: 12/05/2022] Open
Abstract
Introduction: Diabetes is a disease whose control requires effective self-care and patient education. Multimedia Messaging Service-based (MMS) education is one of the new methods for education. The purpose of this study was to investigate the effect of two types of in-person and MMS-based education in the Telegram application on self-care and weekly fasting blood sugar levels in patients with insulin-dependent diabetes. Methods: In this clinical trial, a sample of 66 patients with diabetes who referred to the Sina hospital in Tabriz, were randomly assigned into two groups: in person and MMSM-based education. Data gathering tools included a demographic form, Toobert’s self-care activities questionnaire (as primary outcome), and a checklist to record fasting blood sugar weekly measured by a glucometer. Data were analyzed using independent and paired sample t-tests, chi-square, and repeated measures ANOVA. Results: After the education the mean scores of self-care in terms of diet, exercise, foot care, and blood sugar testing activity significantly increased in both groups and results of ANCOVA of the scores for all dimensions revealed no significant difference between two groups. Reduction in the fasting weekly blood sugar levels over a 12-week period were statistically significant in both groups. But there was no significant difference between the two groups. Conclusion: MMS-based education same as in-person, improves self-care in patients with diabetes. Given the disadvantages of in-person education, this new educational strategy can be used to facilitate the patient education process and improve its quality.
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Affiliation(s)
- Mahtab Aligholipour
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Feizollahzadeh
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mozaffar Ghaffari
- Departmen of Psychology, Faculty of Education and amp; Psychology, Payame Noor University (PNU), Iran
| | - Faranak Jabbarzadeh
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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Dłużniak-Gołaska K, Panczyk M, Szypowska A, Sińska B, Szostak-Węgierek D. Interactive Nutrition Education Is More Effective in Terms of Improved Levels of Glycated Hemoglobin in Adolescent Patients with Poorly Controlled Type 1 Diabetes - A Randomized Study. Diabetes Metab Syndr Obes 2019; 12:2619-2631. [PMID: 31849506 PMCID: PMC6911330 DOI: 10.2147/dmso.s229246] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 11/05/2019] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Effectively conducted nutrition education is one of the key elements of the therapy of type 1 diabetes. The aim of the study was to compare the effectiveness of two methods of nutrition education. MATERIAL AND METHODS A noninvasive interventional randomized single-blind study included 151 patients (13.7±2.2 years old) with poorly controlled type 1 diabetes, treated with the use of insulin pumps. The participants were randomly divided into two groups: a control group (C) in which informative education methods were used (a lecture) and an experimental group (E) in which interactive methods (quiz and multimedia application) were additionally applied. The concentration of glycated hemoglobin (HbA1c) was the primary outcome. The secondary outcomes were: standard deviation score-body mass index (SDS-BMI), standard deviation score-systolic blood pressure (SDS-SBP), standard deviation score-diastolic blood pressure (SDS-DBP), scores of Nutrition Knowledge Survey (NKS) and indices of healthy and unhealthy diet. RESULTS A marked reduction in HbA1c concentrations was observed after 3 months in group E [-0.47% (-0.77; -0.17), P<0.01; P=0.038 for the intergroup difference]. The positive effect was no longer present after 6 months. No significant changes regarding HbA1c were noted in group C at any stage of the study. After 6 months, both groups obtained better results in one part of NKS ("Blood glucose response to food"): group C [0.41 (0.15; 0.66), P<0.01], group E [0.80 (0.52; 1.08), P<0.001; P=0.042 for the intergroup difference]. No statistically significant differences between groups were noted as regards the remaining parameters. CONCLUSION Interactive nutrition education is more effective in terms of improved levels of HbA1c in children and adolescents with poorly controlled diabetes. However, an intensification of training frequency is recommended due to the transient effect of education.
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Affiliation(s)
- Karolina Dłużniak-Gołaska
- Department of Clinical Dietetics, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Mariusz Panczyk
- Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
- Correspondence: Mariusz Panczyk Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, Zwirki i Wigury 61, Warsaw02-091, PolandTel +48 22 572 0490Fax +48 22 572 0491 Email
| | - Agnieszka Szypowska
- Department of Pediatrics, The First Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Beata Sińska
- Department of Human Nutrition, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Dorota Szostak-Węgierek
- Department of Clinical Dietetics, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
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