JMIR Publications

ABSTRACT

Intervention based on family support and risk perception can enhance type 2 diabetes mellitus (T2DM) patients’ self-care activities. In addition, eHealth education is supposed to improve family members’ support for T2DM patients. However, little is known about the effectiveness of the combined intervention through rigorously designed studies. This randomized controlled trial (RCT) aimed to assess the effectiveness of an eHealth family-based health education intervention for T2DM patients to improve T2DM patients’ glucose control, risk perception, and self-care behaviors. This single-center, two-parallel-group RCT was conducted between 2019 and 2020. Overall, 228 patients were recruited from Jiading District, Shanghai, and randomly divided into the intervention and control groups. The intervention group received an eHealth family intervention based on community management via WeChat, whereas the control group received usual care. The primary outcome was T2DM patients’ glycated hemoglobin (HbA1c), and the secondary outcomes were self-management behavior (e.g. general and specific diet, exercise, blood sugar testing, foot care, and smoking), risk perception (e.g. risk knowledge, personal control, worry, optimism bias, and personal risk), and family support (e.g. supportive and non-supportive behaviors). A paired-sample t-test was used to compare the baseline and follow-up within the control and intervention groups. Co-variance analysis was used to measure the intervention effect. In total, 225 T2DM patients were followed up for 1 year. After intervention, they had significantly lower HbA1c values (β=-0.69 [-0.99, -0.39], P<.001), improved general diet (β=0.60 [0.20, 1.00], P=.003), special diet (β=0.71 [0.34, 1.09], P<.001), blood sugar test (β=0.50 [0.02, 0.98], P=.04), foot care (β=1.82 [1.23, 2.42], P<.001), risk knowledge (β=0.89 [0.55, 1.24], P<.001), personal control (β=0.22 [0.12, 0.32], P<.001), worry (β=0.24 [0.10, 0.39], P=.001), optimism bias (β=0.26 [0.09, 0.43], P=.003), and supportive behaviors (β=5.52 [4.03, 7.01], P<.001). The eHealth family-based intervention can improve T2DM patients’ glucose control and self-care activities by implementing interventions based on risk perception about T2DM for family members to improve family support. The intervention is generalizable for T2DM patients based on the health management system in community health centers. ChiCTR1900020736. Registered January 15, 2019.