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Feasibility of blended lifestyle coaching for people with diabetes type 2 in secondary care : perspectives of patients and healthcare professionals on CooL+Diameter

Gotink, C.B. (2022) Feasibility of blended lifestyle coaching for people with diabetes type 2 in secondary care : perspectives of patients and healthcare professionals on CooL+Diameter.

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Abstract:Background: Diabetes Mellitus (DM) is causing a major challenge to public health with approximately 537 million diagnosed people worldwide. Ninety percent of people with DM are diagnosed with Type 2 Diabetes Mellitus (T2DM). Changing lifestyle behavior, such as a healthy dietary intake and increasing physical activity is the cornerstone of T2DM treatment. Several self-management interventions such as combined lifestyle interventions and eHealth are available to improve lifestyle behavior. However, long-term adherence to self-management behavior is lacking. Combining face-to-face coaching and the use of an app designed for self-monitoring and digital coaching could be of importance for the treatment of T2DM, however limited research has yet been performed on this combination. Ziekenhuisgroep Twente (ZGT) started with the two-year combined lifestyle intervention CooL led by a certified lifestyle coach. In addition, participants used the Diameter app for self-monitoring physical activity, nutritional intake and glucose values and digital coaching. Aim: The aim of this study was to evaluate the feasibility of using the Diameter app in combination with the combined lifestyle intervention CooL to change lifestyle behaviors in people with T2DM in secondary care from the perspectives of patients and healthcare professionals. Methods: The feasibility of the CooL+Diameter intervention was evaluated in a three-month period with a prospective longitudinal design using mixed-methods. Feasibility was assessed with acceptability, intervention usage, practicality, implementation barriers and facilitators and limited-efficacy testing. Five patients were included in the intervention. Measurements on glycemic regulation, body composition, health-related quality of life, physical activity and nutritional intake were performed at baseline and at the three-month follow-up. In addition, intervention usage was assessed using log-data. Lastly,semi-structured interviews with five patients and eight healthcare professionals were conducted at the end of the three-month intervention period. Results: Patients accepted the use of CooL+Diameter and found the concept of using an app for self-monitoring and digital coaching a valuable addition to the CooL program. Insight in the effect of nutrition and physical activity on glucose values, getting feedback and becoming more aware were identified as the most helpful elements. Despite the overall acceptance of CooL+Diameter, the user friendliness of the Diameter app needs to be improved. Patients were satisfied with the use of the Fitbit and Freestyle Libre, but found it difficult to use the food diary and digital coaching and encountered several technical problems. This resulted in limited use of the Diameter app itself. However, despite the limited use of the Diameter and a small number of participants, glucose levels and BMI were significantly lower at follow-up compared to baseline. Hip and waist circumference also decreased compared to baseline. Conclusion: Overall, CooL+Diameter was predominantly perceived as a feasible intervention for T2DM patients in secondary care by both patients and healthcare professionals. Future research should focus on improving the user friendliness of the Diameter, further personalization of digital coaching and integration of the Diameter app in the CooL program.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Programme:Health Sciences MSc (66851)
Link to this item:https://purl.utwente.nl/essays/92324
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