Combining the High Tech with the Soft Touch: Population Health Management Using eHealth and Peer Support

Kowitt, Sarah D.; Tang, Patrick Y.; Peeples, Malinda; Duni, Janet; Peskin, Steven; Fisher, Edwin B.

doi:10.1089/pop.2016.0027

Cited by 9 publications

(5 citation statements)

References 7 publications

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“…YWD seems to have the potential to complement this process, but methods for encouraging collaborative use of mHealth apps by young people and their parents are needed; only 13 of 20 young people used YWD with their parents ( Table 1 ). However, our findings suggest that combining an online space for exchanging peer support with support from health care providers and parents seems to facilitate more successful self-management, as also identified by Kowitt et al [ 52 ].…”

Section: Discussionsupporting

confidence: 64%

Exploring the Influence of a Smartphone App (Young with Diabetes) on Young People’s Self-Management: Qualitative Study

Husted¹,

Weis²,

Teilmann³

et al. 2018

JMIR Mhealth Uhealth

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BackgroundAdequate self-management is the cornerstone of preventing type 1 diabetes mellitus (T1DM) complications. However, T1DM self-management is challenging for young people, who often struggle during the transition from childhood to adulthood. The mobile health (mHealth) app Young with Diabetes (YWD) was developed in collaboration with young people to enhance their T1DM self-management during this transition.ObjectiveThe purpose of this study was to explore the influence of YWD on young people’s self-management during a 12-month period.MethodsA qualitative explorative approach was used, comprising a purposive sample of 20 young people (11 females and 9 males, ages 15 to 23 years, with app use of 3 to 64 days) from 3 pediatric and 3 adult departments. Participants were interviewed individually using a semistructured interview guide. Data were collected from January to March 2017 and analyzed using thematic analysis.ResultsA total of 5 themes were identified: (1) not feeling alone anymore (“we are in this together”); (2) gaining competence by sharing experiences and practical knowledge (“they know what they are talking about”); (3) feeling safer (“it’s just a click away”); (4) breaking the ice by starting to share thoughts and feelings and asking for help (“it is an outstretched hand”); and (5) lack of motivating factors (“done with the app”). Young people reported that YWD promoted self-management by peer-to-peer social support, exchanging messages with health care providers, and sharing YWD with parents. Participants recommended YWD as a supplement to self-management for newly diagnosed young people with T1DM and suggested improvements in app content and functionality.ConclusionsThe mHealth app YWD has the potential to support self-management. In particular, peer-to-peer support reduced feelings of loneliness and helped young people to gain knowledge and skills for managing T1DM. A need exists for alternative ways to train health care providers in using YWD and to support collaboration between young people and their parents to further improve young people’s self-management of T1DM.

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Section: Discussionsupporting

confidence: 64%

Exploring the Influence of a Smartphone App (Young with Diabetes) on Young People’s Self-Management: Qualitative Study

Husted¹,

Weis²,

Teilmann³

et al. 2018

JMIR Mhealth Uhealth

View full text Add to dashboard Cite

show abstract

“…Furthermore, health and wellness coaching efforts could be complemented by the utilization of smartphone-based virtual health coaching which has demonstrated positive effects in recent studies (29)(30)(31)(32)(33). At the completion of the live health coaching intervention, digital health coaching could take over, providing the lower-cost self-management tools and accountability which would help individuals to remain on track.…”

Section: Acceptability Of Whole Person Health Coachingmentioning

confidence: 99%

“…At the completion of the live health coaching intervention, digital health coaching could take over, providing the lower-cost self-management tools and accountability which would help individuals to remain on track. Similar models exist, and the combination of live, electronic and peer coaching should be researched further (30).…”

Section: Acceptability Of Whole Person Health Coachingmentioning

confidence: 99%

Pilot Feasibility Study of Incorporating Whole Person Care Health Coaching Into an Employee Wellness Program

Nelson

Moses

Rea

et al. 2021

Front. Public Health

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Prior research supports positive health coaching outcomes, but there is limited literature on the integration of employer-sponsored health coaching into employee wellness strategy. The aim of our mixed methods study was to assess feasibility, acceptability, and preliminary efficacy of incorporating a whole-person care model of health coaching into an employee wellness program (i.e., weight loss, smoking cessation) that is made available by an employer-sponsored health plan. For the quantitative study, eligible employees and covered spouses (n = 39) from Loma Linda University Health were recruited into a novel, 12-week, whole person care intervention that combined health coaching and health education and examined outcomes from surveys detailing the participants' experience and biometric data from the intervention and maintenance periods. For the qualitative study, data were collected through key informant interviews from three health coaches and six intervention participants who were recruited via random sampling. Health coaching was well-received by the participants, and led to a slight albeit positive behavioral change for obesity. A significant decrease in body mass index occurred over 12 weeks of intervention (−0.36 kg/m2, p = 0.016), that did not continue during the maintenance phase (−0.17 kg/m2, p = 0.218). Qualitative findings indicated improved personal health awareness, accountability, motivation, and self-efficacy along with goal setting and barrier overcoming skills among the key themes. Our pilot study findings identify positive behavior change effects of an employee health intervention based on a whole person care model of health coaching with integrated health education, and also identify the need for methods to maintain behavior change (i.e., mHealth, peer-support) post-intervention. Further investigation in randomized controlled trials is the next step in this research.

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“…As previously described (33), participants noted potential value in a diabetes self-management intervention that employed some combination of DMA and live peer support. Contrary to possible expectations that individuals might object to having their choices and activities guided by an automated or artificial system, no one expressed such objections to using the DMA.…”

Section: Formative Evaluation and Intervention Developmentmentioning

confidence: 72%

“…UNC-CH researchers conducted a formative evaluation in June–July 2015, following standard health education methods ( 32 ), to determine the feasibility of combining peer support and digital health. Telephone interviews were conducted with 4 care coordinators, 1 physician’s assistant, and 4 patients with T2DM at Vanguard ( 33 ). Vanguard patients each received a $30 gift card for their participation in the interviews.…”

Section: Methodsmentioning

confidence: 99%

Complementarity of Digital Health and Peer Support: “This Is What’s Coming”

Tang

Duni

Peeples

et al. 2021

Front. Clin. Diabetes Healthc.

Self Cite

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PurposeThis study examined integration of peer support and a Food and Drug Administration-cleared, diabetes management app (DMA) in diabetes self-management support as a scalable model for those with type 2 diabetes mellitus (T2DM).MethodsTwo lay health Coaches delivered telephone-based self-management support to adults (N = 43) with T2DM recruited through a primary group practice. Those eligible were offered no-cost access to DMA for the entire 6-month study. Coaches introduced DMA and contacted individuals by phone and text with frequency dependent on participant needs/preferences. DMA supported monitoring of blood glucose, carbohydrate intake, and medication use, as well as messaging personalized to participants’ medication regimens. Clinical data were extracted from DMA, electronic medical records, and Coaches’ records. Structured interviews of 12 participants, 2 Coaches, and 5 project staff were analyzed using deductive pre-identified codes (regarding adoptability, patterns of use, value added, complementarity, and sustainability) utilizing standard procedures for qualitative analysis.ResultsOf the 43 participants, 38 (88.4%) enrolled in DMA. In general, participants used both DMA and lay health coaches, averaging 144.14 DMA entries (structured, e.g., medications, and free form, e.g., “ate at a restaurant” and “stressed”) and 5.86 coach contacts over the 6-month intervention. Correlation between DMA entries and coach contacts (r = .613, p < 0.001) was consistent with complementarity as were participants’ and coaches’ observations that (a) DMA facilitated recognition of patterns and provided reminders and suggestions to achieve self-management plans, whereas (b) coaching provided motivation and addressed challenges that emerged. Mean hemoglobin A1c (A1c) declined from 9.93% to 8.86% (p < 0.001), with no pattern of coaching or DMA use significantly related to reductions. Staff identified resources to coordinate coach/DMA interventions as a major sustainability challenge.ConclusionsDMA and peer support for diabetes management are compatible and complementary. Additional practice integration research is needed for adoption and scale-up.

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Combining the High Tech with the Soft Touch: Population Health Management Using eHealth and Peer Support

Cited by 9 publications

References 7 publications

Exploring the Influence of a Smartphone App (Young with Diabetes) on Young People’s Self-Management: Qualitative Study

Exploring the Influence of a Smartphone App (Young with Diabetes) on Young People’s Self-Management: Qualitative Study

Pilot Feasibility Study of Incorporating Whole Person Care Health Coaching Into an Employee Wellness Program

Complementarity of Digital Health and Peer Support: “This Is What’s Coming”

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