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Noah Wayne

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  • OS06 - Advancing Frameworks for Patient Engagement (ID 6)

    • Event: e-Health 2017 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical
    • Presentations: 1
    • Coordinates: 6/05/2017, 04:00 PM - 05:30 PM, Room 203CD
    • OS06.04 - Health Coaching in the Cloud: Results from Multiple Studies (ID 294)

      Noah Wayne, NexJ Health; Toronto/CA

      • Abstract
      • Slides

      Purpose/Objectives: Adoptions of healthy behaviors are crucial for maintaining good health after type 2 diabetes mellitus diagnoses. However, adherence to behaviors that promote optimal diabetes management like regular exercise and balanced diet can be challenging. Developing innovative interventions and tools that facilitate chronic disease self-management is important for improving quality of life and the sustainability of health care systems, but must be thoroughly evaluated prior wide scale adoption. The purpose of the presentation is to describe the methodology and results from an innovative health coaching intervention using a cloud-based client management platform to support adoption of healthy behaviours in an underserved population with poorly controlled type 2 diabetes.

      Methodology/Approach: Pilot and pragmatic randomized controlled trials were conducted at the Black Creek Community Health Centre in Toronto, Canada between 2010 and 2014. During this time, researchers partnered with NexJ Health Inc. to develop an online platform called NexJ Connected Wellness (NCW) to enable remote monitoring of relevant health indicators (ie: blood glucose, meals, exercise) to support of health behaviour change. During the trials, participants received 6 months of health coaching with access (intervention group) and without access (control group) to NCW. Upon completion of the RCT, patient experience was explored using semi-structured interviews (n=11), and usage patterns of the online platform from n=29 participants were analyzed using association rule algorithm data mining techniques. Primary Outcome: Glycated Hemeglobin (HbA1c) Secondary Outcomes: Weight, BMI, Waist Circumference, satisfaction with life, depression and anxiety, positive and negative affect, and quality of life.

      Finding/Results: Pilot: In the pilot, a total of n=19 participants completed the 6-month trial; n=12 had baseline HbA1c levels >7.0% and these participants demonstrated a mean reduction of 0.43% (P<.05). RCT: In the RCT, n=131 participants were allocated to the intervention (n=67) and control (n=64) groups. Primary outcome data were available for 97 participants (74.0%). There were significant differences in improvements of HbA1c between groups at 3 months (P=.03), but this difference reduced at 6 months as the control group continued to improve, achieving a reduction of 0.81% (P=.001) compared with a reduction of 0.84% (P=.001) in the intervention group. Intervention group participants had significant decreases in weight (P=.006) and waist circumference (P=.01), with both groups reporting improvements in mood, satisfaction with life, and quality of life. Interview: Qualitative data analyses revealed four major themes that describe participant experience: (a) smartphone use in relation to health behaviour change; (b) how client/ health coach relationships were assisted by smartphone use; (c) perceptions of the overall intervention; and (d) ‘frustrations in managing the complexities of T2DM management. Data Mining: Analyses indicated that nearly a third (9/29, 31%) of participants used a single tracker, half (14/29, 48%) used two primary trackers, and the remainder (6/29, 21%) used three primary trackers.

      Conclusion/Implication/Recommendations: Health coaching using an online behaviour change portal helped improve clinical outcomes of a poorly managed T2DM population. The intervention was well received, and data mining usage patterns of the technology revealed connections to health outcomes.

      140 Character Summary: Health coaching using a secure cloud-based behaviour change portal helped improve clinical outcomes of a poorly managed T2DM population.

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