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My Diabetes Coach, a mobile app–based interactive conversational agent to support type 2 diabetes self-management: randomized effectiveness-implementation trial

Gong, Enying, Baptista, Shaira, Russell, Anthony, Scuffham, Paul, Riddell, Michaela, Speight, Jane, Bird, Dominique, Williams, Emily, Lotfaliany Abrand Abadi, Mojtaba and Oldenburg, Brian 2020, My Diabetes Coach, a mobile app–based interactive conversational agent to support type 2 diabetes self-management: randomized effectiveness-implementation trial, Journal of medical Internet research, vol. 22, no. 11, pp. 1-14, doi: 10.2196/20322.

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Title My Diabetes Coach, a mobile app–based interactive conversational agent to support type 2 diabetes self-management: randomized effectiveness-implementation trial
Author(s) Gong, Enying
Baptista, Shaira
Russell, Anthony
Scuffham, Paul
Riddell, Michaela
Speight, JaneORCID iD for Speight, Jane orcid.org/0000-0002-1204-6896
Bird, Dominique
Williams, Emily
Lotfaliany Abrand Abadi, MojtabaORCID iD for Lotfaliany Abrand Abadi, Mojtaba orcid.org/0000-0001-6594-9004
Oldenburg, Brian
Journal name Journal of medical Internet research
Volume number 22
Issue number 11
Article ID e20322
Start page 1
End page 14
Total pages 14
Publisher JMIR Publications
Place of publication Toronto, Ont.
Publication date 2020-11
ISSN 1438-8871
1438-8871
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Medical Informatics
type 2 diabetes mellitus
self-management
health-related quality of life
digital technology
coaching
mobile phone
Summary Background Delivering self-management support to people with type 2 diabetes mellitus is essential to reduce the health system burden and to empower people with the skills, knowledge, and confidence needed to take an active role in managing their own health. Objective This study aims to evaluate the adoption, use, and effectiveness of the My Diabetes Coach (MDC) program, an app-based interactive embodied conversational agent, Laura, designed to support diabetes self-management in the home setting over 12 months. Methods This randomized controlled trial evaluated both the implementation and effectiveness of the MDC program. Adults with type 2 diabetes in Australia were recruited and randomized to the intervention arm (MDC) or the control arm (usual care). Program use was tracked over 12 months. Coprimary outcomes included changes in glycated hemoglobin (HbA1c) and health-related quality of life (HRQoL). Data were assessed at baseline and at 6 and 12 months, and analyzed using linear mixed-effects regression models. Results A total of 187 adults with type 2 diabetes (mean 57 years, SD 10 years; 41.7% women) were recruited and randomly allocated to the intervention (n=93) and control (n=94) arms. MDC program users (92/93 participants) completed 1942 chats with Laura, averaging 243 min (SD 212) per person over 12 months. Compared with baseline, the mean estimated HbA1c decreased in both arms at 12 months (intervention: 0.33% and control: 0.20%), but the net differences between the two arms in change of HbA1c (−0.04%, 95% CI −0.45 to 0.36; P=.83) was not statistically significant. At 12 months, HRQoL utility scores improved in the intervention arm, compared with the control arm (between-arm difference: 0.04, 95% CI 0.00 to 0.07; P=.04). Conclusions The MDC program was successfully adopted and used by individuals with type 2 diabetes and significantly improved the users’ HRQoL. These findings suggest the potential for wider implementation of technology-enabled conversation-based programs for supporting diabetes self-management. Future studies should focus on strategies to maintain program usage and HbA1c improvement. Trial Registration Australia New Zealand Clinical Trials Registry (ACTRN) 12614001229662; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12614001229662
Language eng
DOI 10.2196/20322
Indigenous content off
Field of Research 08 Information and Computing Sciences
11 Medical and Health Sciences
17 Psychology and Cognitive Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30145191

Document type: Journal Article
Collections: Faculty of Health
School of Psychology
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.