Evaluation of the Clinical and Economic Effects of a Primary Care Anchored, Collaborative, Electronic Health Lifestyle Coaching Program in Denmark: Protocol for a Two-Year Randomized Controlled Trial

Brandt, Carl J.; Christensen, Jeanette Reffstrup; Lauridsen, Jørgen; Nielsen, Jesper Bo; Søndergaard, Jens; Sortsø, Camilla

doi:10.2196/19172

Cited by 21 publications

(46 citation statements)

References 38 publications

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“…Given the challenges and the potential of eHealth lifestyle interventions within T2D, we aim to test the feasibility of a newly developed digital individualised coaching and lifestyle treatment intervention of T2D in general practice (DICTA). The digital lifestyle treatment intervention we test in this study uses the same lifestyle app as the intervention tested in municipal settings mentioned above [ 28 , 29 ]. However, in the general practice setting, the first coaching session takes place via video consultations by a trained external health coach and not in person by a municipality employed health coach such as in the municipalities.…”

Section: Introductionmentioning

confidence: 99%

Identification of Important Factors Affecting Use of Digital Individualised Coaching and Treatment of Type 2 Diabetes in General Practice: A Qualitative Feasibility Study

Jakobsen

Christensen

Nielsen

et al. 2021

IJERPH

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Most type 2 diabetes patients are treated in general practice and there is a need of developing and implementing efficient lifestyle interventions. eHealth interventions have shown to be effective in promoting a healthy lifestyle. The purpose of this study was to test the feasibility, including the identification of factors of importance, when offering digital lifestyle coaching to type 2 diabetes patients in general practice. We conducted a qualitative feasibility study with focus group interviews in four general practices. We identified two overall themes and four subthemes: (1) the distribution of roles and lifestyle interventions in general practice (subthemes: external and internal distribution of roles) and (2) the pros and cons for digital lifestyle interventions in general practice (subthemes: access to real life data and change in daily routines). We conclude that for digital lifestyle coaching to be feasible in a general practice setting, it was of great importance that the general practitioners and practice nurses knew the role and content of the intervention. In general, there was a positive attitude in the general practice setting towards referring type 2 diabetes patients to digital lifestyle intervention if it was easy to refer the patients and if easily understandable and accessible feedback was implemented into the electronic health record. It was important that the digital lifestyle intervention was flexible and offered healthcare providers in general practice an opportunity to follow the type 2 diabetes patient closely.

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Section: Introductionmentioning

confidence: 99%

Identification of Important Factors Affecting Use of Digital Individualised Coaching and Treatment of Type 2 Diabetes in General Practice: A Qualitative Feasibility Study

Jakobsen

Christensen

Nielsen

et al. 2021

IJERPH

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“…We identified the Liva app as the best e-solution for adaptation and tailoring to the families in the Face-it intervention [ 41 , 42 ]. The Liva app is an interactive eHealth lifestyle coaching program (long-term Lifestyle change InterVention and eHealth Application [LIVA 2.0]) [ 43 ]. The app builds on a strong personal relationship between user and a health coach, who supports the user through individualised goal-setting and feedback [ 43 ].…”

Section: Resultsmentioning

confidence: 99%

Systematically developing a family-based health promotion intervention for women with prior gestational diabetes based on evidence, theory and co-production: the Face-it study

et al. 2021

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Background Women with prior gestational diabetes mellitus (GDM) are at high risk of developing type 2 diabetes; however, this risk can be reduced by engaging in positive health behaviours e.g. healthy diet and regular physical activity. As such behaviours are difficult to obtain and maintain there is a need to develop sustainable behavioural interventions following GDM. We aimed to report the process of systematically developing a health promotion intervention to increase quality of life and reduce diabetes risk among women with prior GDM and their families. We distil general lessons about developing complex interventions through co-production and discuss our extensions to intervention development frameworks. Methods The development process draws on the Medical Research Council UK Development of complex interventions in primary care framework and an adaptation of a three-stage framework proposed by Hawkins et al. From May 2017 to May 2019, we iteratively developed the Face-it intervention in four stages: 1) Evidence review, qualitative research and stakeholder consultations; 2) Co-production of the intervention content; 3) Prototyping, feasibility- and pilot-testing and 4) Core outcome development. In all stages, we involved stakeholders from three study sites. Results During stage 1, we identified the target areas for health promotion in families where the mother had prior GDM, including applying a broad understanding of health and a multilevel and multi-determinant approach. We pinpointed municipal health visitors as deliverers and the potential of using digital technology. In stage 2, we tested intervention content and delivery methods. A health pedagogic dialogue tool and a digital health app were co-adapted as the main intervention components. In stage 3, the intervention content and delivery were further adapted in the local context of the three study sites. Suggestions for intervention manuals were refined to optimise flexibility, delivery, sequencing of activities and from this, specific training manuals were developed. Finally, at stage 4, all stakeholders were involved in developing realistic and relevant evaluation outcomes. Conclusions This comprehensive description of the development of the Face-it intervention provides an example of how to co-produce and prototype a complex intervention balancing evidence and local conditions. The thorough, four-stage development is expected to create ownership and feasibility among intervention participants, deliverers and local stakeholders. Trial registration ClinicalTrials.gov NCT03997773, registered retrospectively on 25 June 2019.

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“…We identi ed the Liva app as the best e-solution for adaptation and tailoring to the families in the Face-it intervention (41,42). The Liva app is an interactive eHealth lifestyle coaching program (long-term Lifestyle change InterVention and eHealth Application [LIVA 2.0]) (43). The app builds on a strong personal relationship between user and a health coach supporting the app through individualised goal-setting and feedback (43).…”

Section: Resultsmentioning

confidence: 99%

“…The Liva app is an interactive eHealth lifestyle coaching program (long-term Lifestyle change InterVention and eHealth Application [LIVA 2.0]) (43). The app builds on a strong personal relationship between user and a health coach supporting the app through individualised goal-setting and feedback (43). As digital support was suggested by the women themselves in initial interviews, we found that the combination of providing digital support as an addition to home visits aligned with the tailoring of intervention to meet the needs of the target group.…”

Section: Resultsmentioning

confidence: 99%

“…The Liva app includes health behaviour features; however, it was clear that the content was shaped by other target groups e.g. those with diabetes or overweight who reported on medication use and blood sugar values (43). When introducing the app to the health visitors, they were less enthusiastic about the digital solution.…”

Section: Digital Health Promotion Counselling Through 'The Liva App'mentioning

confidence: 99%

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Systematically developing a family-based health promotion intervention for women with prior gestational diabetes based on evidence, theory and co-production: the Face-it study

Maindal

Timm

Dahl-Petersen

et al. 2021

Preprint

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Background: Women with prior gestational diabetes mellitus (GDM) are at high risk of developing type 2 diabetes; however, this risk can be reduced by engaging in e.g. healthy diet and regular physical activity. As such behaviours are difficult to obtain there is a need to develop sustainable behavioural interventions following GDM. We aimed to report the process of systematically developing a health promotion intervention to increase quality of life and reduce diabetes risk among women with prior GDM and their families. We distil general lessons about developing complex interventions through co-production and discuss our extensions to intervention development frameworks.Methods: The development process draws on the Medical Research Council UK Development of complex interventions in primary care framework and an adaptation of a three-stage framework proposed by Hawkins et al. We iteratively developed the Face-it intervention in four stages: 1) Evidence review, qualitative research and stakeholder consultations; 2) Co-production of the intervention content; 3) Prototyping, feasibility- and pilot-testing and 4) Core outcome development. In all stages, we involved stakeholders from three study sites. Results: During stage 1, we identified the target areas for health promotion in families where the mother had prior GDM, including applying a broad understanding of health and a multilevel and multi-determinant approach. We pinpointed municipal health visitors as deliverers and the potential of using digital technology. In stage 2, we tested intervention content and delivery methods. A health pedagogic dialogue tool and a digital health app were co-adapted as the main intervention components. In stage 3, the intervention content and delivery were further adapted in the local context of the three study sites. Suggestions for intervention manuals were refined to optimise flexibility, delivery, sequencing of activities and from this, specific training manuals were developed. Finally, at stage 4, all stakeholders were involved in developing realistic and relevant evaluation outcomes. Conclusions: This comprehensive description of the development of the Face-it intervention provides an example of how to co-produce and prototype a complex intervention balancing evidence and local conditions. The thorough, four-stage development is expected to create ownership and feasibility among intervention participants, deliverers and local stakeholders. Trial registration: ClinicalTrials.gov NCT03997773, registered retrospectively on 25 June 2019. https://clinicaltrials.gov/ct2/show/NCT03997773

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Evaluation of the Clinical and Economic Effects of a Primary Care Anchored, Collaborative, Electronic Health Lifestyle Coaching Program in Denmark: Protocol for a Two-Year Randomized Controlled Trial

Cited by 21 publications

References 38 publications

Identification of Important Factors Affecting Use of Digital Individualised Coaching and Treatment of Type 2 Diabetes in General Practice: A Qualitative Feasibility Study

Identification of Important Factors Affecting Use of Digital Individualised Coaching and Treatment of Type 2 Diabetes in General Practice: A Qualitative Feasibility Study

Systematically developing a family-based health promotion intervention for women with prior gestational diabetes based on evidence, theory and co-production: the Face-it study

Systematically developing a family-based health promotion intervention for women with prior gestational diabetes based on evidence, theory and co-production: the Face-it study

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