Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jun 26, 2021
Date Accepted: Feb 4, 2022
Social-Media-Delivered Patient Education to enhance Self-Management and Attitudes of Type 2 Diabetics during the COVID-19 Pandemic: A Randomized Controlled Trial
ABSTRACT
Background:
The globally increasing incidence of diabetes, as well as the impact of the coronavirus disease 2019 (COVID-19), raised the specter of unmet needs in providing face-to-face patient education. It is crucial to develop innovative and effective educational programs for diabetes patients.
Objective:
This randomized clinical trial evaluated the clinical and humanistic outcomes of a Line-based diabetic educational platform, Taipei Medical University-Line Oriented Video Education (TMU-LOVE), for type 2 diabetes patients.
Methods:
There were 164 type 2 diabetes patients recruited and randomly assigned to either an intervention (n=82) or a control (n=82) group in 2020. The educational platform had 51 videos, including 10 on understanding diabetes and daily care, 6 on nutrition care, 21 on diabetes drugs and 4 for quizzes. The intervention group received two or three videos every week and care messages every 2 weeks through TMU-LOVE for 3 months, in addition to usual care. The control group only received care as usual. Outcomes were measured at baseline and 3 months after the intervention, including glycated hemoglobin (HbA1C), attitudes as assessed by the Diabetes Care Profile- Attitudes Towards Diabetes Scale, knowledge as assessed by the Simplified True/False version of the revised Diabetes Knowledge Scale, and self-care activities as assessed by the Summary of Diabetes Self-Care Activities. Health literacy was also measured by the Newest Vital Sign at the baseline.
Results:
Over 12 weeks of the intervention, attitudes in the intervention group increased from 3.59 ± 0.39 to 3.85 ± 0.44 (P<.001) which differed from the change in the control group. (mean difference to the control group 0.20, 95% CI -0.31 to -0.01; (P<.001). Changes in A1C did not significantly differ between the two groups (from 6.95 ± 0.87 to 7.03 ± 0.91 in the intervention group, P=.34 and from 6.75 ± 0.63 to 6.76 ± 0.69 in the control group, P=.91). A positive effect was seen in self-care activities within the intervention group, from 3.69 ± 1.26 to 3.98 ± 1.23 (P=.02). In addition, both groups experienced an increase in knowledge scores at 12 weeks, with the percentage correct changing from 67.74% ± 16.99% to 77.32% ± 11.87% (P<.001) and 65.27% ± 18.07% to 72.83% ± 12.93% (P<.001) in the intervention and control group, respectively. Among the 51 videos, medication-related videos had the highest utility rates.
Conclusions:
The social media-based program, TMU-LOVE, was effective in enhancing diabetes patients’ knowledge, attitudes and self-care activities. It was also helpful for patients with inadequate health literacy. The program could be a potential tool for boosting patient education in clinical settings during the COVID-19 pandemic. Clinical Trial: ClinicalTrials.gov NCT04876274.
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