Abstract
Purpose
The primary objective of the present pilot study was to investigate the feasibility and acceptability of the newly developed self-care system using personal digital assistance in patients with type 2 diabetes. The secondary objective was to investigate changes in daily calorie intake, body weight, and hemoglobin A1c after using the system for 6 months.
Method
The participants were nine outpatients with type 2 diabetes, aged 34–72 and living in Tokyo or surrounding prefectures. They were instructed to use the electronic food diary and to review the graphs of the total energy intake to control food intake under their own target value for 6 months. After they completed the study, the feasibility indicated by adherence rate for food recording and acceptability of the system rated with 6-point Likert scale from 1 (worst) to 6 (best) by the participants were investigated.
Results
Seven participants out of nine completed the study protocol. The median adherence rate for food recording was 80.6 %. Regarding the acceptability, six patients rated 6 for desire to use the system while one rated 5. In addition, regarding improvement in self-care for diabetes, the median score was 5. Daily calorie intake, body weight, and HbA1c, however, did not change significantly over the 6-month period.
Conclusion
The newly developed self-care system might be feasible and acceptable in diabetes patients, which could be applied as an ecological momentary intervention tool, although there was some room to refine it to raise adherence.
References
American Diabetes Association. Standards of medical care in diabetes—2008. Diabetes Care. 2008;31:S12–54.
The Diabetes Prevention Program Research Group. Diabetes Prevention Program Research Group: reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393–403.
The Look AHEAD Research Group. Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial. Diabetes Care. 2007;30:1374–83.
Baker RC, Kirshenbaum DS. Self-monitoring may be necessary for successful weight control. Behav Ther. 1993;24:377–94.
Foreyt JP, Goodrick GK. Evidence for success of behavior modification in weight loss and control. Ann Intern Med. 1993;119:698–701.
Helsel DL, Jakicic JM, Otto AD. Comparison of techniques for self-monitoring eating and exercise behaviors on weight loss in a correspondence-based intervention. J Am Diet Assoc. 2007;107:1807–10.
Burke LE, Warziski M, Starrett T, Choo J, Music E, Sereika S, et al. Self-monitoring dietary intake: current and future practices. J Ren Nutr. 2005;15:281–90.
Stone AA, Shiffman SS. Ecological momentary assessment(EMA) in behavioral medicine. Ann Behav Med. 1994;35:397–403.
Fukuo W, Yoshiuchi K, Ohashi K, Togashi H, Sekine R, Kikuchi H, et al. Development of a hand-held personal digital assistant-based food diary with food photographs for Japanese subjects. J Am Diet Assoc. 2009;109:1232–6.
Forjuoh SN, Reis MD, Couchman GR, Ory MG, Mason S, Molonket-Lanning S. Incorporating PDA use in diabetes self-care: a central Texas Primary Care Research Network (CenTexNet) study. J Am Board Fam Med. 2007;20:375–84.
Sevick MA, Stone RA, Zickmund S, Wang Y, Korytkowski M, Burke LE. Factors associated with probability of personal digital assistant-based dietary self-monitoring in those with type 2 diabetes. J Behav Med. 2010;33:315–25.
Seino Y, Nanjo K, Tajima N, Kadowaki T, Kashiwagi A, Araki E, et al. Report of the Committee on the classification and diagnostic criteria of diabetes mellitus: the Committee of the Japan Diabetes Society on the diagnostic criteria of diabetes mellitus. Diabetol Int. 2010;1:2–20.
Heron KE, Smyth JM. Ecological momentary interventions: incorporating mobile technology into psychosocial and health behaviour treatments. Br J Health Psychol. 2010;15:1–39.
Takahashi K, Yoshimura Y, Kaimoto T, Kunii D, Komatsu T, Yamamoto S. Validation of a food frequency questionnaire based on food groups for estimating individual nutrient intake. Jpn J Nutr. 2001;59:221–32 (in Japanese).
Armitage P, Berry G, Matthews JNS. Analysing non-normal data. In: Armitage P, Berry G, Matthews JNS, editors. Statistical Methods in Medical Research. 4th ed. Oxford: Blackwell Science; 2001. p. 272–311.
Sevick MA, Zickmund S, Korytkowski M, Piraino B, Sereika S, Mihalko S, et al. Design, feasibility, and acceptability of an intervention using personal digital assistant-based self-monitoring in managing type 2 diabetes. Contemp Clin Trials. 2008;29:396–409.
Burke LE, Styn MA, Sereika SM, et al. Using mHealth technology to enhance self-monitoring for weight loss a randomized trial. Am J Prev Med. 2012;43:20–6.
Acknowledgments
The authors thank all of the study participants. The University of Tokyo (person in charge: Dr. Yoshiuchi) conducted cooperative research with Sharp Cooperation. Gratitude is also expressed to Dr. Kojima from Sharp Corporation for his technical help in developing the software in Windows Mobile.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Funding
This study was financially supported by Sharp Cooperation.
Conflict of Interest
Author Yoshiuchi K. received research grants from Sharp Cooperation for the submitted work. Any authors did not have relationships with companies or other competing interests in the past 3 years that could be perceived to constitute a conflict of interest. Spouses, partners, or children of authors did not have financial relationships that may be relevant to the submitted work. And any authors did not have non-financial interests that may be relevant to the submitted work.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Rights and permissions
About this article
Cite this article
Inada, S., Yoshiuchi, K., Iizuka, Y. et al. Pilot Study for the Development of a Self-Care System for Type 2 Diabetes Patients Using a Personal Digital Assistant (PDA). Int.J. Behav. Med. 23, 295–299 (2016). https://doi.org/10.1007/s12529-016-9535-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12529-016-9535-1