Achieving health equity with e-healthystrides©: Patient perspectives of a consumer health information technology application

Abstract

Objective: We describe the implementation, clinical outcomes and participant perspectives for e-Healthystrides©. Setting: Three independent ambulatory clinics and an historic African American (AA) church. Participants: Adults with diagnosed diabetes mellitus type 2. Interventions: e-Healthystrides© health coach facilitated intervention Primary outcome: Acquisition of three new self-management behaviors. Secondary outcomes: Blood pressure, blood glucose, A1c, attrition rate and participant perspectives of e-Healthystrides© Methods: A convergent parallel mixed method design was used in both pilot studies. Results: Two hundred and sixty-four participants, aged ~62±16 years, enrolled. Attrition at 52 weeks varied 50%-90% by site. Low engagement users were defined mainly by anxiety with putting health information online. The primary outcome was achieved in 36% of our participants, with the top 3 self-management behaviors acquired being: reducing risk (24.5%); healthy eating (23.7%); and monitoring (16.4%). Problem solving had the lowest rate of achievement (.91%). Blood pressure improved significantly at all sites at 12 weeks and at clinics A,B,C at 52 weeks. Blood glucose improved at 12 weeks: clinic A (P=.0001), B (P=.003), C (P=.001) and D (P=.03); but, at 52 weeks, only clinics A (P=