Podiatrist-Delivered Health Coaching to Facilitate the Use of a Smart Insole to Support Foot Health Monitoring in People with Diabetes-Related Peripheral Neuropathy

Abstract

This trial evaluated the feasibility of podiatrist-led health coaching (HC) to facilitate smart-insole adoption and foot monitoring in adults with diabetes-related neuropathy. Adults aged 69.9 ± 5.6 years with diabetes for 13.7 ± 10.3 years participated in this 4-week explanatory sequential mixed-methods intervention. An HC training package was delivered to podiatrists, who used HC to issue a smart insole to support foot monitoring. Insole usage data monitored adoption. Changes in participant understanding of neuropathy, foot care behaviours, and intention to adopt the smart insole were measured. Focus group and in-depth interviews explored quantitative data. Initial HC appointments took a mean of 43.8 ± 8.8 min. HC fidelity was strong for empathy/rapport and knowledge provision but weak for assessing motivational elements. Mean smart-insole wear was 12.53 ± 3.46 h/day with 71.2 ± 13.9% alerts not effectively off-loaded, with no significant effect for time on usage F(3,6) = 1.194 (p = 0.389) or alert responses F(3,6) = 0.272 (p = 0.843). Improvements in post-trial questionnaire mean scores and focus group responses indicate podiatrist-led HC improved participants’ understanding of neuropathy and implementation of footcare practices. Podiatrist-led HC is feasible, supporting smart-insole adoption and foot monitoring as evidenced by wear time, and improvements in self-reported footcare practices. However, podiatrists require additional feedback to better consolidate some unfamiliar health coaching skills. ACTRN12618002053202.

Patient and Provider Perspective of Smart Wearable Technology in Diabetic Foot Ulcer Prevention: A Systematic Review

“…Of these, one article was excluded after thorough examination, as it did not meet the inclusion criteria [28]. Thus, a total of five articles were included in the analysis [29][30][31][32][33]. The publication year of these studies ranged from 2017 to 2021.…”

“…The publication year of these studies ranged from 2017 to 2021. Three articles used a mixed quantitative/qualitative design [31][32][33] and two were quantitative in nature [29,30]. The characteristics of the studies included are summarized in Table 1.…”

“…The characteristics of the studies included are summarized in Table 1. Three of the five studies (60%) were patient-related [29][30][31], one focused on the healthcare provider [33], and one included both patient and provider perspectives [32]. Four articles (80%) considered the use of smart insole devices [29,[31][32][33] and one article focused on smart socks [30].…”

“…Four reports [29,[31][32][33] used theory-based assessment tools to evaluate patient and provider perceptions of usability and ease of use, whereas one study [30] employed an in- The characteristics of the studies included are summarized in Table 1. Three of the five studies (60%) were patient-related [29][30][31], one focused on the healthcare provider [33], and one included both patient and provider perspectives [32]. Four articles (80%) considered the use of smart insole devices [29,[31][32][33] and one article focused on smart socks [30].…”

“…Four reports [29,[31][32][33] used theory-based assessment tools to evaluate patient and provider perceptions of usability and ease of use, whereas one study [30] employed an in-house-designed questionnaire to examine patient levels of satisfaction with the device. The heterogeneous nature of the study designs, aims, and key findings precluded a metaanalysis of the data.…”