Testers logged into the website 4.5 times in the first month but had fallen to 3 times by month 6
Jenni Connelly, MSc, PhD
Results of a new study indicate that although diabetes-specific websites can effectively promote physical activity to manage type 2 diabetes (T2D), access to those sites is not associated with any increase in physical activity in patients.
Investigators speculated that this low level of engagement among patients may the result of a lack of inclusion of health professionals or diabetes patients in the development of the sites and online tools.
“The Internet gives patient more opportunity to investigate their own condition, but the information they access isn’t always up-to-date or accurate,” Jenni Connelly, MSc, PhD, lead author of the study, member of the Physiology, Exercise and Nutrition Research Group, and the faculty of Health Science and Sport at the University of Stirling in the United Kingdom, told MD Magazine. “In the UK, we are doing a lot of work with the NHS to co-design information where health professionals can point their patients. Some of these have an interactive component allowing patients to change behavior, such as dietary and physical activity changes.”
Connelly and her team created a physical activity website that incorporated ideas about concepts and features from focus groups of diabetes patients and health care professionals.
The site was put through a 6-month study of 3 groups: A control group received written advice about physical activity and diabetes; another group only looked at the information online; and the third group found information online and also had access to interactive features such as activity logs, individualized expert tips, and suggestions for setting incremental goals.
“People know they need more physical activity, but want personalized advice specific to them,” Connelly said. “For example, ‘What is the best exercise to lower my blood glucose or increase my insulin sensitivity?’ An effective quick fix, so to speak. The interactive components—in the case of my study, a physical activity map and monitoring tools—were not as successful as people who were aware of where the opportunities to be active were and knew how much activity they were doing. They needed diabetes-specific information to ensure the most effective changes, something that wasn’t already available, even from their health professional.”
The study had 31 participants testing the website, and 61% (n =19) were male. Testers logged into the website 4.5 times in the first month but had fallen to 3 times by month 6.
Results saw an increase in moderate-to-vigorous physical activity in the group that received its information via the website alone (mean 134.6 [SD, 123.9] to mean 154.9 [SD, 144.2] min), and the control group (mean 118.9 [SD, 103.8] to mean 126.1 [SD, 93.4] min). However, activity decreased in the group who had access to the site and its interactive tools (mean 131.9 [SD, 126.2] to mean 116.8 [SD, 107.4] min).
“I think part of the issue is people aren’t aware of the relationship between diabetes and inactivity, as it doesn’t have such a straightforward link as you find with diet and diabetes,” Connelly said. “Health professionals and personal trainers don’t know enough to give diabetes-specific advice to each individual who seeks help. We need something to aid health professionals and personal trainers to give quick, personal, and safe physical activity advice suited to each individual, something that is incredibly difficult to work out in a short time frame.”
As for future goals for web-based programs and apps, Connelly said, “We discussed having an app or tool which people could enter physical activity and diabetes-related information, which could be then accessed by [their] health professional in their diabetes review. However, this has had mixed reviews—people with diabetes didn’t want their doctor to be able to access all of their information in case they got into ‘trouble’ for poor management.”
“However, they were happy to have a tool that personal trainers could use to help give specific physical activity advice. We are in the middle of trying to create this and trial it with personal trainers,” she said.