Assessing telehealth interventions for physical activity and sedentary behavior self‐management in adults with type 2 diabetes mellitus: An integrative review

Abstract

Type 2 diabetes is a chronic disease, requiring lifestyle management to prevent chronic complications. Increasing physical activity and reducing sedentary behavior are integral to maintaining glycemic control. The purpose of this study was to (1) appraise and synthesize the literature about physical activity and sedentary behavior intervention delivery via telehealth strategies in adults with type 2 diabetes mellitus and (2) to evaluate what is known about the effectiveness of such interventions on physical activity, sedentary behavior, and glycemic control. An integrative literature review was carried out, including the electronic databases PubMed, CINAHL, and PsychInfo, searching for articles published within the past 10 years, meeting specified inclusion and exclusion criteria, following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement guidelines. Seventeen studies were included. Significant improvements in physical activity and sedentary behavior were identified in web and mobile phone‐based interventions. Modest improvements in glycemic control were reported. Theoretical framework use and integration was limited, and intervention length and follow‐up varied greatly in the studies reviewed. Outcomes were measured using both self‐report and objective measures, but objective measures were used less frequently. Further, few studies have been conducted in the United States or in rural populations. Web and mobile phone‐based telehealth interventions to increase physical activity, reduce sedentary behaviors, and improve glycemic control have been supported by the literature. A need exists for future studies that are theory‐driven, include dose‐specific measures, self‐report and objective measures, and long‐term follow‐up. Examining intervention effects in rural populations is needed.

Telephone-based support for physical activity: Results and lessons learned during the COVID-19 pandemic

“…In another study of African American women, weekly phone calls with health coaching significantly increased physical activity and decreased BMI over 24 months [ 34 ]. However, regardless of the technology modality, individualized feedback is necessary for participant engagement and sustainable behavior change [ 35 ].…”

“…First, we only used a telephone-based physical activity strategy. Although internet and mobile phone-based interventions that allow for audio-visual connections can improve physical activity, socioeconomic disparities in internet access limited the accessibility of interventions that required the internet [ 35 ]. Also, approximately 28% of patients who were eligible to participate could not be reached via telephone, despite a clinic protocol to confirm a working telephone number at every clinical encounter.…”

Research-Driven Guidelines for Delivering Group Exercise Programs via Videoconferencing to Older Adults

“…Research has documented much success for telehealth applications to support physical activity. They have been shown to be acceptable and effective for a variety of rehabilitation programs [21][22][23][24][25], including those for people with various degrees of mobility disability [26]. Telehealth physical activity interventions with a social component have been less studied, yet there are some promising findings regarding efficacy for decreasing feelings of loneliness and depression [27].…”

Diabetes self-management education for adults with type 2 diabetes via telehealth in conjunction with remote patient monitoring: a best practice implementation project

“…Best practices regarding telehealth for glycemic control in people with type 2 diabetes include offering telehealth as an option for monitoring their condition and accessing DSME, as a variety of health information and communication technology interventions have shown potential for significant reductions in A1C levels based on a systematic review of the evidence 8 . Several systematic reviews have been conducted to appraise and synthesize the evidence available regarding the effectiveness of telehealth for glycemic control in individuals with type 2 diabetes 11–14 . One review investigated the efficacy of behavioral telehealth interventions aimed at improving glycemic control and found that four of 13 randomized controlled trials reported significant positive treatment effects 11 .…”

“…A meta-analysis of 11 studies showed a small but statistically significant reduction in A1C versus the control groups 13 . In another systematic review, investigators assessed the effectiveness of telehealth strategies in adults with type 2 diabetes, and the most common intervention was patient education 14 . Analysis of findings suggested that internet and phone-based interventions can improve glycemic control in this patient population 14 …”