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Logo of bmcmidmBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Medical Informatics and Decision Making
 
BMC Med Inform Decis Mak. 2012; 12: 57.
Published online Jun 24, 2012. doi:  10.1186/1472-6947-12-57
PMCID: PMC3473319
Designing and evaluating a web-based self-management site for patients with type 2 diabetes - systematic website development and study protocol
Catherine H Yu,corresponding author1,2,3 Janet Parsons,1,4,5 Muhammad Mamdani,1,4,6 Gerald Lebovic,4 Baiju R Shah,2,7,8 Onil Bhattacharyya,1,6,9 Andreas Laupacis,1,2,6 and Sharon E Straus1,2,6
1Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada
2Department of Medicine, University of Toronto, Toronto, Canada
3Dhalla Lana School of Public Health, University of Toronto, Toronto, Canada
4Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada
5Department of Physical Therapy, University of Toronto, Toronto, Canada
6Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
7Institute for Clinical Evaluative Sciences, G1 06, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada
8Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
9Department of Family and Community Medicine, University of Toronto, Toronto, Canada
corresponding authorCorresponding author.
Catherine H Yu: yuca/at/smh.ca; Janet Parsons: ParsonsJ/at/smh.ca; Muhammad Mamdani: MamdaniM/at/smh.ca; Gerald Lebovic: LebovicG/at/smh.ca; Baiju R Shah: Baiju.Shah/at/ices.on.ca; Onil Bhattacharyya: BhattacharyyaO/at/smh.ca; Andreas Laupacis: LaupacisA/at/smh.ca; Sharon E Straus: Sharon.straus/at/utoronto.ca
Received May 16, 2012; Accepted June 12, 2012.
Abstract
Background
Given that patients provide the majority of their own diabetes care, patient self-management training has increasingly become recognized as an important strategy with which to improve quality of care. However, participation in self management programs is low. In addition, the efficacy of current behavioural interventions wanes over time, reducing the impact of self-management interventions on patient health. Web-based interventions have the potential to bridge the gaps in diabetes care and self-management.
Methods
Our objective is to improve self-efficacy, quality of life, self-care, blood pressure, cholesterol and glycemic control and promote exercise in people with type 2 diabetes through the rigorous development and use of a web-based patient self-management intervention. This study consists of five phases: (1) intervention development; (2) feasibility testing; (3) usability testing; (4) intervention refinement; and (5) intervention evaluation using mixed methods. We will employ evidence-based strategies and tools, using a theoretical framework of self-efficacy, then elicit user feedback through focus groups and individual user testing sessions. Using iterative redesign the intervention will be refined. Once finalized, the impact of the website on patient self-efficacy, quality of life, self-care, HbA1c, LDL-cholesterol, blood pressure and weight will be assessed through a non-randomized observational cohort study using repeated measures modeling and individual interviews.
Discussion
Increasing use of the World Wide Web by consumers for health information and ongoing revolutions in social media are strong indicators that users are primed to welcome a new era of technology in health care. However, their full potential is hindered by limited knowledge regarding their effectiveness, poor usability, and high attrition rates. Our development and research agenda aims to address these limitations by improving usability, identifying characteristics associated with website use and attrition, and developing strategies to sustain patient use in order to maximize clinical outcomes.
Keywords: Diabetes mellitus, Self care, Patient education, Self-efficacy, Medical informatics, Intervention development, Study protocol, User-Computer Interface, Repeated measures modeling, Qualitative methods
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