University of Twente Student Theses


The development and evaluation of an eCoaching module to improve healthy nutrition in type 2 diabetes patients

Fokkema, E.M.S. (2019) The development and evaluation of an eCoaching module to improve healthy nutrition in type 2 diabetes patients.

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Abstract:Type 2 Diabetes Mellitus (T2DM) is one of the most common chronic diseases worldwide with a still rising prevalence. An unhealthy lifestyle increases the risk of microvascular and macrovascular complications. However, patients are often obese and adherence to nutritional guidelines is low. eHealth interventions by using smartphones showed positive results on diet when using text messages. By tailoring the messages, patient engagement and adherence could be maximised. An eCoaching module has already been developed for improving physical activity (PA). This was positively evaluated by Healthcare Professionals (HCPs) and T2DM patients. However, SMS-messages were not tailored and were valued as too general and not personal by patients. The aim of this study is to develop a tailored nine-week evidence-based eCoaching module for increasing healthy nutrition in people with T2DM, and evaluate it on content, design, user acceptance, and effectiveness. An eCoaching module was developed using behavioural change theories. Subsequently, in phase 1, a database of SMS-messages was developed. This set of messages was evaluated by health care professionals and adapted to their feedback. With the adapted messages, a nine-week eCoaching module was tested on five T2DM patients, where 2 SMS-messages per day and one email per week were sent. Halfway and at the end of the module, semi-structured telephone interviews took place with the patients to receive their feedback and suggestions. Furthermore, it was investigated whether patients improved their diet. The SMS-messages were positively evaluated by health care professionals, and only small adaptations were made. Eventually, 228 messages were developed and approved. Patients valued the eCoaching module as highly positive. Patients were satisfied with the length, frequency, and content of the SMS-messages and emails. Both the SMS-messages and emails felt personal, but the emails did to a greater extent. Self-efficacy increased within patients, and they improved at least one aspect of their diet. All patients reached their goal(s) in at least seven out of nine weeks. A first version of an eCoaching module for healthy nutrition was developed and positively evaluated. However, a bigger set of messages needs to be made, tailoring on personal preferences needs to be further improved, and the module should be tested with a more representative population. Tailoring on stages of change is an innovative feature of this study and should be further improved.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:01 general works, 44 medicine
Programme:Health Sciences MSc (66851)
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