Background: We determine whether Diabetes Connect (DC), a Web-based diabetes self-management program, can help patients effectively manage their diabetes and improve clinical outcomes. Methods: Diabetes Connect is a 12-month program that allows patients with type 2 diabetes mellitus to upload their blood glucose readings to a database, monitor trends, and share their data with their providers. To examine the impact of the program, we analyzed patient utilization and engagement data, clinical outcomes, as well as qualitative feedback from current and potential users through focus groups. Results: We analyzed 75 out of 166 patients. Mean age was 61 years (range 27-87). Patients engaged in DC had an average hemoglobin A1c (HbA1c) change of 1.5%, while nonengaged patients had a HbA1c change of 0.4% (p = .05). Patients with the best outcomes (HbAlc decline of at least 0.8%) typically took less than 10 days to upload, while patients with the worst outcomes (a rise in HbAlc) took an average of 65 days to upload. Patients with more engaged providers had a better HbA1c change (1.39% versus 0.87%) for practices with an average of 74 versus 30 logins/providers. Conclusions: Patient engagement in the program has a positive impact on the outcomes of this collaborative Web-based diabetes self-management tool. Patients who engage early and remain active have better clinical outcomes than unengaged patients. Provider engagement, too, was found critical in engaging patients in DC.

The prevalence of childhood obesity has more than tripled in the past 30 years. To combat this growing problem it is essential that public health interventions promote healthy eating and regular physical activity (PA). In March 2011 the Center for Connected Health (CCH) launched the Partners Step it UP program to 200 elementary students at two Boston schools. The health promotion program incorporates PA tracking using a pedometer, educational feedback relating to physical activity and a fun team-oriented foot race. This year the program expanded to 6 schools and 400 students. The program has met with huge success and CCH is currently exploring ways to modify the Step it UP program for use among high school students. As a first step in understanding the needs and preferences of this group, we conducted a focus group session with twenty-four 9th graders to understand what features they would want included in a health promotion program. Participants revealed that on average they text 300times/day and would like this to be a way to engage in this program. Participants also provided useful feedback on the frequency of messages to send, how to frame messages and discussed the importance of competition and incentives to drive health behavior changes. These findings have provided CCH with a clear understanding of how to develop a health promotion program for this population. Thirty high school students will be recruited to participate in a11-week pilot study. The participants will be divided into 2 groups based on their PA levels during Week 1 and will compete to earn points based on their PA level during the study. The purpose of this pilot study is to engage high school students in the program, increase and sustain students' level of PA, and understand the role of team competition in promoting healthy behavior change.