Implementing a Digital-Enhanced Multiple-Behavior Self-Monitoring Intervention in Diabetes Care and Support: A Mixed-Method Evaluation of Patient Outcomes

Abstract

Purpose:

The purpose of this study is to test the feasibility and exploratory within-participant changes associated with implementing a multiple-behavior self-monitoring intervention in a diabetes care and support program.

Methods:

In this 3-month mixed-method implementation study, 45 adults with type 2 diabetes were planned for enrollment from certified diabetes care and support programs. Participants logged diet, activity, blood glucose, and weight using smartphone apps or paper diaries, based on preference. All received a brief lifestyle intervention adapted from Look AHEAD (Action for Health in Diabetes). Outcomes included weight and A1C at 3 months, and feasibility was assessed through retention and qualitative interviews.

Results:

Thirty-one participants completed the study. Participants showed modest within-participant weight loss and maintained glycemic control, with A1C remaining stable during the study period. Exploratory descriptive comparisons did not suggest meaningful differences between participants using smartphone versus paper methods. Qualitative interviews supported feasibility, with participants reporting the intervention as both acceptable and useful.

Conclusions:

Implementing a digital-optimized multiple-behavior self-monitoring intervention is feasible in a diabetes self-monitoring diabetes care and support program. The findings suggest that implementation of the intervention is feasible and acceptable, with observed weight loss and maintenance of glycemic control over 3 months.