Twelve-month outcomes of an Internet-based diabetes self-management support program

Russell E. Glasgow, Deanna Kurz, Diane King, Jennifer M. Dickman, Andrew J. Faber, Eve Halterman, Tim Woolley, Deborah J. Toobert, Lisa A. Strycker, Paul A. Estabrooks, Diego Osuna, Debra Ritzwoller

Research output: Contribution to journalArticlepeer-review

152 Scopus citations


Objective: Internet-based programs offer potential for practical, cost-effective chronic illness self-management programs. Methods: We report 12-month results of an Internet-based diabetes self-management program, with and without additional support, compared to enhanced usual care in a 3-arm practical randomized trial. Patients (n= 463) were randomized: 77.3% completed 12-month follow-up. Primary outcomes were changes in health behaviors of healthy eating, physical activity, and medication taking. Secondary outcomes were hemoglobin A1c, body mass index, lipids, blood pressure, and psychosocial factors. Results: Internet conditions improved health behaviors significantly vs. usual care over the 12-month period (d for effect size = .09-.16). All conditions improved moderately on biological and psychosocial outcomes. Latinos, lower literacy, and higher cardiovascular disease risk patients improved as much as other participants. Conclusions: The Internet intervention meets the reach and feasibility criteria for a potentially broad public health impact. However, 12-month magnitude of effects was small, suggesting that different or more intensive approaches are necessary to support long-term outcomes. Research is needed to understand the linkages between intervention and maintenance processes and downstream outcomes. Practice implications: Automated self-management interventions should be tailored and integrated into primary care; maintenance of patient self-management can be enhanced through links to community resources.

Original languageEnglish (US)
Pages (from-to)81-92
Number of pages12
JournalPatient Education and Counseling
Issue number1
StatePublished - Apr 2012


  • Diabetes
  • Internet intervention
  • Multiple behavior change
  • Pragmatic trial
  • RCT
  • Self-management

ASJC Scopus subject areas

  • General Medicine


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