背景:增加体力活动可改善2型糖尿病(T2D)患者的血糖控制。移动健康(mHealth)干预措施已被证明可以增加运动,但是订婚往往随着时间的推移而消失。由于在mHealth设计中使用健康行为理论可以提高有效性,我们开发了StepAdd,基于社会认知理论(SCT)构建的移动健康干预。StepAdd通过使用目标设定来提高运动行为的自我效能感和自我调节能力,屏障识别,和障碍应对策略,以及自动反馈功能。在33名T2D患者中进行的StepAdd的单臂试点研究显示,步数大幅增加(平均变化为4714,SD3638日步数或86.7%),随着BMI(平均变化-0.3kg/m2)和血红蛋白A1c水平(平均变化-0.79个百分点)的显著改善。
目的:在本研究中,我们的目的是研究StepAdd的疗效和安全性,针对T2D患者的m健康运动支持系统,通过一个大的,长,以及对试点研究的受控随访。
方法:这是一个随机的,开放标签,针对来自日本5个机构的160名T2D患者进行24周干预的多中心研究。干预组将记录每日步数,体重,和使用基于SCT的移动应用程序的血压,StepAdd,并接收有关这些测量的反馈。此外,他们将设定每周步数目标,识别行走的个人障碍,并确定克服这些障碍的策略。对照组将记录每日步数,体重,使用非基于SCT的安慰剂应用程序和血压。两组都将每月与医生进行咨询,医生将就生活方式的改变和应用程序的使用向患者提供建议。在24周的干预期之后,将进行12周的观察期,以调查干预效果的可持续性。主要结果是24周时血红蛋白A1c值变化的组间差异。次要结果包括其他健康措施,步骤的测量,其他行为变化的测量,和应用程序使用评估。该试验于2023年1月开始,计划于2025年12月完成。
结果:截至2023年9月5日,我们招募了44名患者。我们预计该试验将于2025年10月8日完成,随访观察期将于2025年12月31日完成。
结论:该试验将为基于SCT的mHealth干预在改善T2D患者身体活动和血糖控制方面的有效性提供重要证据。如果这项研究证明干预措施是有效和安全的,这可能是mHealth整合为日本T2D患者接受的标准治疗的关键一步。
背景:日本临床试验注册中心(JRCT)jRCT2032220603;https://rctportal。尼夫.走吧。jp/en/detail?trial_id=jRCT2032220603。
■DERR1-10.2196/53514。
BACKGROUND: Increasing physical activity improves glycemic control in patients with type 2 diabetes (T2D). Mobile health (mHealth) interventions have been proven to increase exercise, but engagement often fades with time. As the use of health behavior theory in mHealth design can increase effectiveness, we developed StepAdd, an mHealth intervention based on the constructs of social cognitive theory (SCT). StepAdd improves exercise behavior self-efficacy and self-regulation through the use of goal-setting, barrier-identifying, and barrier-coping strategies, as well as automatic feedback functions. A single-arm pilot
study of StepAdd among 33 patients with T2D showed a large increase in step count (mean change of 4714, SD 3638 daily steps or +86.7%), along with strong improvements in BMI (mean change of -0.3 kg/m2) and hemoglobin A1c level (mean change of -0.79 percentage points).
OBJECTIVE: In this study, we aim to investigate the efficacy and safety of StepAdd, an mHealth exercise support system for patients with T2D, via a large, long, and controlled follow-up to the pilot study.
METHODS: This is a randomized, open-label, multicenter
study targeting 160 patients with T2D from 5 institutions in Japan with a 24-week intervention. The intervention group will record daily step counts, body weight, and blood pressure using the SCT-based mobile app, StepAdd, and receive feedback about these measurements. In addition, they will set weekly step count goals, identify personal barriers to walking, and define strategies to overcome these barriers. The control group will record daily step counts, body weight, and blood pressure using a non-SCT-based placebo app. Both groups will receive monthly consultations with a physician who will advise patients regarding lifestyle modifications and use of the app. The 24-week intervention period will be followed by a 12-week observational period to investigate the sustainability of the intervention\'s effects. The primary outcome is between-group difference in the change in hemoglobin A1c values at 24 weeks. The secondary outcomes include other health measures, measurements of steps, measurements of other behavior changes, and assessments of app use. The
trial began in January 2023 and is intended to be completed in December 2025.
RESULTS: As of September 5, 2023, we had recruited 44 patients. We expect the
trial to be completed by October 8, 2025, with the follow-up observation period being completed by December 31, 2025.
CONCLUSIONS: This
trial will provide important evidence about the efficacy of an SCT-based mHealth intervention in improving physical activities and glycemic control in patients with T2D. If this study proves the intervention to be effective and safe, it could be a key step toward the integration of mHealth as part of the standard treatment received by patients with T2D in Japan.
BACKGROUND: Japan Registry of Clinical Trials (JRCT) jRCT2032220603; https://rctportal.niph.go.jp/en/detail?trial_id=jRCT2032220603.
UNASSIGNED: DERR1-10.2196/53514.