PDF(Pubmed)
Abstract：
BACKGROUND: The escalating global prevalence of type 2 diabetes and prediabetes presents a major public health challenge. Physical activity plays a critical role in managing (pre)diabetes; however, adherence to physical activity recommendations remains low. The ENERGISED trial was designed to address these challenges by integrating mHealth tools into the routine practice of general practitioners, aiming for a significant, scalable impact in (pre)diabetes patient care through increased physical activity and reduced sedentary behaviour.
METHODS: The mHealth intervention for the ENERGISED trial was developed according to the mHealth development and evaluation framework, which includes the active participation of (pre)diabetes patients. This iterative process encompasses four sequential phases: (a) conceptualisation to identify key aspects of the intervention; (b) formative research including two focus groups with (pre)diabetes patients (n = 14) to tailor the intervention to the needs and preferences of the target population; (c) pre-testing using think-aloud patient interviews (n = 7) to optimise the intervention components; and (d) piloting (n = 10) to refine the intervention to its final form.
RESULTS: The final intervention comprises six types of text messages, each embodying different behaviour change techniques. Some of the messages, such as those providing interim reviews of the patients\' weekly step goal or feedback on their weekly performance, are delivered at fixed times of the week. Others are triggered just in time by specific physical behaviour events as detected by the Fitbit activity tracker: for example, prompts to increase walking pace are triggered after 5 min of continuous walking; and prompts to interrupt sitting following 30 min of uninterrupted sitting. For patients without a smartphone or reliable internet connection, the intervention is adapted to ensure inclusivity. Patients receive on average three to six messages per week for 12 months. During the first six months, the text messaging is supplemented with monthly phone counselling to enable personalisation of the intervention, assistance with technical issues, and enhancement of adherence.
CONCLUSIONS: The participatory development of the ENERGISED mHealth intervention, incorporating just-in-time prompts, has the potential to significantly enhance the capacity of general practitioners for personalised behavioural counselling on physical activity in (pre)diabetes patients, with implications for broader applications in primary care.
METHODS: The mHealth intervention for the ENERGISED trial was developed according to the mHealth development and evaluation framework, which includes the active participation of (pre)diabetes patients. This iterative process encompasses four sequential phases: (a) conceptualisation to identify key aspects of the intervention; (b) formative research including two focus groups with (pre)diabetes patients (n = 14) to tailor the intervention to the needs and preferences of the target population; (c) pre-testing using think-aloud patient interviews (n = 7) to optimise the intervention components; and (d) piloting (n = 10) to refine the intervention to its final form.
RESULTS: The final intervention comprises six types of text messages, each embodying different behaviour change techniques. Some of the messages, such as those providing interim reviews of the patients\' weekly step goal or feedback on their weekly performance, are delivered at fixed times of the week. Others are triggered just in time by specific physical behaviour events as detected by the Fitbit activity tracker: for example, prompts to increase walking pace are triggered after 5 min of continuous walking; and prompts to interrupt sitting following 30 min of uninterrupted sitting. For patients without a smartphone or reliable internet connection, the intervention is adapted to ensure inclusivity. Patients receive on average three to six messages per week for 12 months. During the first six months, the text messaging is supplemented with monthly phone counselling to enable personalisation of the intervention, assistance with technical issues, and enhancement of adherence.
CONCLUSIONS: The participatory development of the ENERGISED mHealth intervention, incorporating just-in-time prompts, has the potential to significantly enhance the capacity of general practitioners for personalised behavioural counselling on physical activity in (pre)diabetes patients, with implications for broader applications in primary care.
摘要：
背景：2型糖尿病和前驱糖尿病的全球患病率不断上升是一个重大的公共卫生挑战。体力活动在管理（前期）糖尿病中起着至关重要的作用；然而，坚持体力活动的建议仍然很低。ENERGISED试验旨在通过将mHealth工具整合到全科医生的常规实践中来应对这些挑战。瞄准一个重要的，通过增加身体活动和减少久坐行为，对(前驱)糖尿病患者护理产生可扩展的影响。
方法：ENERGISED试验的mHealth干预是根据mHealth开发和评估框架开发的，其中包括（前驱）糖尿病患者的积极参与。此迭代过程包括四个连续阶段：（a）概念化以确定干预措施的关键方面；（b）形成性研究，包括两个（糖尿病前期）患者（n=14）的焦点小组，以根据目标人群的需求和偏好定制干预措施；（c）使用大声思考的患者访谈进行预测测试（n=7）以优化干预措施的组成部分；（d）试点（n=10）将干预措施细化为最终。
结果：最终干预包括六种类型的短信，每个都体现了不同的行为改变技术。一些信息，例如对患者的每周步数目标或每周表现的反馈进行中期审查，在一周的固定时间交付。其他事件由Fitbit活动跟踪器检测到的特定身体行为事件及时触发：例如，连续步行5分钟后触发提示增加步行速度；并提示在不间断坐30分钟后中断坐着。对于没有智能手机或可靠互联网连接的患者，干预措施是为了确保包容性。患者在12个月内平均每周收到三到六个消息。在最初的六个月里，短信辅以每月的电话咨询，以实现干预的个性化，协助解决技术问题，和加强坚持。
结论：能量健康干预的参与性发展，结合及时提示，有可能显着提高全科医生对（前驱）糖尿病患者的身体活动进行个性化行为咨询的能力，对初级保健中更广泛的应用有影响。
方法：ENERGISED试验的mHealth干预是根据mHealth开发和评估框架开发的，其中包括（前驱）糖尿病患者的积极参与。此迭代过程包括四个连续阶段：（a）概念化以确定干预措施的关键方面；（b）形成性研究，包括两个（糖尿病前期）患者（n=14）的焦点小组，以根据目标人群的需求和偏好定制干预措施；（c）使用大声思考的患者访谈进行预测测试（n=7）以优化干预措施的组成部分；（d）试点（n=10）将干预措施细化为最终。
结果：最终干预包括六种类型的短信，每个都体现了不同的行为改变技术。一些信息，例如对患者的每周步数目标或每周表现的反馈进行中期审查，在一周的固定时间交付。其他事件由Fitbit活动跟踪器检测到的特定身体行为事件及时触发：例如，连续步行5分钟后触发提示增加步行速度；并提示在不间断坐30分钟后中断坐着。对于没有智能手机或可靠互联网连接的患者，干预措施是为了确保包容性。患者在12个月内平均每周收到三到六个消息。在最初的六个月里，短信辅以每月的电话咨询，以实现干预的个性化，协助解决技术问题，和加强坚持。
结论：能量健康干预的参与性发展，结合及时提示，有可能显着提高全科医生对（前驱）糖尿病患者的身体活动进行个性化行为咨询的能力，对初级保健中更广泛的应用有影响。
