Online diabetes self-management program: A randomized study

Kate Lorig, Philip L. Ritter, Diana D. Laurent, Kathryn Plant, Maurice Green, Valarie Blue Bird Jernigan, Siobhan Case

Research output: Contribution to journalArticle

187 Citations (Scopus)

Abstract

OBJECTIVE - We hypothesized that people with type 2 diabetes in an online diabetes self-management program, compared with usual-care control subjects, would 1) demonstrate reduced A1C at 6 and 18 months, 2) have fewer symptoms, 3) demonstrate increased exercise, and 4) have improved self-efficacy and patient activation. In addition, participants randomized to listserve reinforcement would have better 18-month outcomes than participants receiving no reinforcement. RESEARCH DESIGN AND METHODS- A total of 761 participants were randomized to 1) the program, 2) the program with e-mail reinforcement, or 3) were usual-care control subjects (no treatment). This sample included 110 American Indians/Alaska Natives (AI/ANs). Analyses of covariance models were used at the 6- and 18-month follow-up to compare groups. RESULTS- At 6 months, A1C, patient activation, and self-efficacy were improved for program participants compared with usual care control subjects (P < 0.05). There were no changes in other health or behavioral indicators. The AI/AN program participants demonstrated improvements in health distress and activity limitation compared with usual-care control subjects. The subgroup with initial A1C >7% demonstrated stronger improvement in A1C (P = 0.01). At 18 months, self-efficacy and patient activation were improved for program participants. A1C was not measured. Reinforcement showed no improvement. CONCLUSIONS- An online diabetes self-management program is acceptable for people with type 2 diabetes. Although the results were mixed they suggest 1) that the program may have beneficial effects in reducing A1C, 2) AI/AN populations can be engaged in and benefit from online interventions, and 3) our follow-up reinforcement appeared to have no value.

Original languageEnglish
Pages (from-to)1275-1281
Number of pages7
JournalDiabetes Care
Volume33
Issue number6
DOIs
StatePublished - 1 Jun 2010
Externally publishedYes

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Self Care
Patient Participation
Self Efficacy
North American Indians
Type 2 Diabetes Mellitus
Postal Service
Research Design
Reinforcement (Psychology)
Exercise
Population
Alaska Natives
Therapeutics

Cite this

Lorig, K., Ritter, P. L., Laurent, D. D., Plant, K., Green, M., Jernigan, V. B. B., & Case, S. (2010). Online diabetes self-management program: A randomized study. Diabetes Care, 33(6), 1275-1281. https://doi.org/10.2337/dc09-2153
Lorig, Kate ; Ritter, Philip L. ; Laurent, Diana D. ; Plant, Kathryn ; Green, Maurice ; Jernigan, Valarie Blue Bird ; Case, Siobhan. / Online diabetes self-management program : A randomized study. In: Diabetes Care. 2010 ; Vol. 33, No. 6. pp. 1275-1281.
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Lorig, K, Ritter, PL, Laurent, DD, Plant, K, Green, M, Jernigan, VBB & Case, S 2010, 'Online diabetes self-management program: A randomized study', Diabetes Care, vol. 33, no. 6, pp. 1275-1281. https://doi.org/10.2337/dc09-2153

Online diabetes self-management program : A randomized study. / Lorig, Kate; Ritter, Philip L.; Laurent, Diana D.; Plant, Kathryn; Green, Maurice; Jernigan, Valarie Blue Bird; Case, Siobhan.

In: Diabetes Care, Vol. 33, No. 6, 01.06.2010, p. 1275-1281.

Research output: Contribution to journalArticle

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AU - Lorig, Kate

AU - Ritter, Philip L.

AU - Laurent, Diana D.

AU - Plant, Kathryn

AU - Green, Maurice

AU - Jernigan, Valarie Blue Bird

AU - Case, Siobhan

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N2 - OBJECTIVE - We hypothesized that people with type 2 diabetes in an online diabetes self-management program, compared with usual-care control subjects, would 1) demonstrate reduced A1C at 6 and 18 months, 2) have fewer symptoms, 3) demonstrate increased exercise, and 4) have improved self-efficacy and patient activation. In addition, participants randomized to listserve reinforcement would have better 18-month outcomes than participants receiving no reinforcement. RESEARCH DESIGN AND METHODS- A total of 761 participants were randomized to 1) the program, 2) the program with e-mail reinforcement, or 3) were usual-care control subjects (no treatment). This sample included 110 American Indians/Alaska Natives (AI/ANs). Analyses of covariance models were used at the 6- and 18-month follow-up to compare groups. RESULTS- At 6 months, A1C, patient activation, and self-efficacy were improved for program participants compared with usual care control subjects (P < 0.05). There were no changes in other health or behavioral indicators. The AI/AN program participants demonstrated improvements in health distress and activity limitation compared with usual-care control subjects. The subgroup with initial A1C >7% demonstrated stronger improvement in A1C (P = 0.01). At 18 months, self-efficacy and patient activation were improved for program participants. A1C was not measured. Reinforcement showed no improvement. CONCLUSIONS- An online diabetes self-management program is acceptable for people with type 2 diabetes. Although the results were mixed they suggest 1) that the program may have beneficial effects in reducing A1C, 2) AI/AN populations can be engaged in and benefit from online interventions, and 3) our follow-up reinforcement appeared to have no value.

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Lorig K, Ritter PL, Laurent DD, Plant K, Green M, Jernigan VBB et al. Online diabetes self-management program: A randomized study. Diabetes Care. 2010 Jun 1;33(6):1275-1281. https://doi.org/10.2337/dc09-2153