StepAdd: A personalized mHealth intervention based on social cognitive theory to increase physical activity among type 2 diabetes patients

Wei Thing Sze; Kayo Waki; Syunpei Enomoto; Yuuki Nagata; Masaomi Nangaku; Toshimasa Yamauchi; Kazuhiko Ohe

doi:10.1016/j.jbi.2023.104481

StepAdd: A personalized mHealth intervention based on social cognitive theory to increase physical activity among type 2 diabetes patients

J Biomed Inform. 2023 Sep:145:104481. doi: 10.1016/j.jbi.2023.104481. Epub 2023 Aug 28.

Authors

Wei Thing Sze¹, Kayo Waki², Syunpei Enomoto³, Yuuki Nagata⁴, Masaomi Nangaku⁵, Toshimasa Yamauchi⁶, Kazuhiko Ohe¹

Affiliations

¹ Department of Biomedical Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Planning, Information and Management, The University of Tokyo Hospital, Tokyo, Japan.
² Department of Biomedical Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Planning, Information and Management, The University of Tokyo Hospital, Tokyo, Japan; Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. Electronic address: kwaki-tky@m.u-tokyo.ac.jp.
³ Department of Planning, Information and Management, The University of Tokyo Hospital, Tokyo, Japan.
⁴ Department of Biomedical Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
⁵ Division of Nephrology and Endocrinology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
⁶ Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

PMID: 37648101
DOI: 10.1016/j.jbi.2023.104481

Abstract

Objective: Investigate the preliminary efficacy and feasibility of a personalized mobile health (mHealth) intervention based on social cognitive theory (SCT) to promote physical activity among type 2 diabetes patients via self-monitoring, goal setting, and automatic feedback.

Methods: We conducted a pilot study involving 33 type 2 diabetes patients attending Mitsui Memorial Hospital in Japan using a pre-post evaluation design over 12 weeks. Participants measured daily step count, body weight, and blood pressure at home, with the measurements synchronized with the StepAdd application (app) automatically. Participants used the app to review daily results, update personalized step goals, identify individualized barriers to achieving the step goals, find coping strategies to overcome each barrier, and implement these strategies, thereby building effective coping skills to meet the goals. Pharmacists examined the usage of the app and provided coaching on lifestyle modifications. Ultimately, patients established skills to enhance diabetes self-care by using the app.

Results: Daily step count increased dramatically with high statistical significance (p < 0.0001), from a mean of 5436 steps/day to 10,150 steps/day, an 86.7 % increase. HbA1c (p = 0.0001) and BMI (p = 0.0038) also improved. Diabetes self-care in diet, exercise, and foot care as well as self-management behavior, self-regulation, and self-efficacy in achieving daily step goals showed significant improvements. The retention rate of the study was very high, at 97.0 % (n = 32).

Conclusions: A personalized smartphone-based mHealth intervention based on SCT is feasible and effective at promoting physical activity among type 2 diabetes patients. The methodology of the intervention could be readily applied to other patient populations.

Keywords: Diabetes; Intervention personalization; Mobile health; Physical activity; Self-management; Social cognitive theory.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Behavior Therapy
Diabetes Mellitus, Type 2* / therapy
Exercise
Humans
Pilot Projects
Psychological Theory