Use of Track Health Function of the MyHealthevet Personal Health Record

Use of the Track Health Function of the MyHealtheVet Personal Health Record

This study was a pilot 3-month clinical trial that investigated the feasibility, effectiveness, and acceptability of using the Track Health function of the Veterans Health Administration's patient health record for effecting a more positive physical activity (PA) and dietary intake lifestyle in a sample of 38 overweight and obese Veterans with prediabetes. Baseline and three-month post-intervention outcomes were measured in two main domains: objective (e.g., weight) and subjective (e.g., self-efficacy).

Study Overview

• Status: Completed
• Conditions: Prediabetic State
• Intervention / Treatment: Behavioral: patient health record

Detailed Description

This was a pilot clinical trial that used a single-group design to test the feasibility, effectiveness, and acceptability of using the Track Health (TH) function of My HealtheVet, the VA's patient health record (PHR), as a tool for effecting a more positive physical activity (PA) and dietary intake lifestyle in overweight and obese Veterans with prediabetes. Baseline and three-month post-intervention outcomes were measured in two main domains: objective (PA as measured by an accelerometer, diet, weight, abdominal circumference, BMI, and blood pressure) and subjective (self-efficacy, intent to adhere to lifestyle change, and patient activation). Assessments, including screening on inclusion and exclusion criteria, physiological measurements, administration of questionnaires, and training on use of two critical features of the TH function--the use of Journals to enter dietary and PA data and the use of Vitals + Readings to enter weight and track physiological measures--took place place across four visits to the study site, which was the Veterans Administration Medical Center in Miami. The investigators hypothesized that this PHR-based intervention would demonstrate improvements and increases, respectively in the objective and subjective domain measures. The investigators also hypothesized that engagement by study participants with MHV would be demonstrated through meeting target criteria regarding making entries into this PHR's TH function, and that participants would be satisfied with the intervention.

• Study Type: Interventional
• Enrollment (Actual): 47
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Florida
    • Miami, Florida, United States, 33125
      • Miami VA Healthcare System, Miami, FL

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Veterans with diagnosis of prediabetes (HbA1c 5.7-6.4%, fasting plasma glucose 100-125 mg/dL or oral glucose tolerance test 140-199 mg/dL)
• English speaking
• Access to the Internet
• Body mass index (BMI) of 25-42 kg/m and a sedentary lifestyle (not being physically active three days per week for 20 minutes each time for the previous six months and not performing regular resistance exercise)
• Able to engage in a regular program of mild-to-moderate intensity physical activity but were not currently following a weight loss diet or participating in an intervention trial

Exclusion Criteria:

• Cognitively impaired (Mini-Cog greater than or equal to 3)
• Depressed (PHQ-2 less than or equal to 3)
• Vision or hearing disorders
• Have been diagnosed with diabetes mellitus, uncontrolled hypertension, or cardiovascular disease
• Currently pregnant or nursing.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: patient health record; The study intervention involved the provision to study participants of targeted instruction and practice on use of the Track Health function of the VA's patient health record known as My HealthyVet.

Behavioral: patient health record; The study intervention involved the provision to study participants of targeted instruction and practice on use of two features of the Track Health (TH) function of the VA's patient health record (PHR) known as My HealthyVet (MHV) -- Journals and Vitals + Readings -- as a basis for promoting positive physical activity (PA) and dietary lifestyles. Seven interactive multimedia instructional modules were developed by the study team. These modules demonstrated on a computer screen how to enter PA and diet information into the Journals feature; how to add weight data into the Vitals + Readings feature; how to view these and other measures in tabular and graphical formats over different time frames; and the concept of possible cause-effect links between behavioral lifestyle and physiological outcome data. Participants were directed to enter food intake, PA, and weight information a specified number of times per week over the 3-month study period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change From Baseline Weight	measured in lbs.	Baseline, 3 months
Body Mass Index	Measured in kg/m^2	baseline, 3 months
Change From Baseline Abdominal Circumference	measured in inches	baseline, 3 months
Change From Baseline Energy Expenditure	measured in kcal using an accelerometer	baseline, 3 months
Change From Baseline Dietary Intake	24-hour dietary recall; the Nutrition Data System for Research used to compute kcal	baseline, 3 months
Systolic and Diastolic Blood Pressure		baseline, 3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change From Baseline Physical Activity Self-efficacy	an 18-item exercise self-efficacy questionnaire (confidence in one's ability to exercise) exercises); scale range: 0 - 100. Higher scores indicate increased self-efficacy.	baseline, 3 months
Change From Baseline Diet Self-efficacy	a single 7-point item questionnaire (confidence in one's ability to adhere to a healthy diet). Scale range: 1 - 7. Higher numbers indicate less self-efficacy.	baseline, 3 months
Change in Intent to Perform Physical Activity	A single 7-point item, ranging from 1 - 7, with lower values indicating increased intent to perform physical activity	baseline, 3 months
Change in Intent to Adhere to Diet	A single 7-point item, ranging from 1-7. Lower scores indicate an increased intent to adhere to diet	baseline, 3 months
Change in Patient Activation	A 22-item scale that captures various domains of patient activation; scale range: 0 - 100, higher scores indicate greater activation	baseline, 3 months

Collaborators and Investigators

• Sponsor: VA Office of Research and Development
• Collaborators: Miami VA Healthcare System
• Investigators: Principal Investigator: Joseph Sharit, PhD, Miami VA Healthcare System, Miami, FL

Publications and helpful links

General Publications

• Sharit J, Idrees T, Andrade AD, Anam R, Karanam C, Valencia W, Florez H, Ruiz JG. Use of an online personal health record's Track Health function to promote positive lifestyle behaviors in Veterans with prediabetes. J Health Psychol. 2018 Apr;23(5):681-690. doi: 10.1177/1359105316681065. Epub 2016 Dec 5.

Study record dates

Study Major Dates

• Study Start (Actual): July 1, 2014
• Primary Completion (Actual): September 30, 2015
• Study Completion (Actual): September 30, 2015

Study Registration Dates

• First Submitted: September 28, 2016
• First Submitted That Met QC Criteria: September 30, 2016
• First Posted (Estimate): October 3, 2016

Study Record Updates

• Last Update Posted (Actual): August 7, 2018
• Last Update Submitted That Met QC Criteria: July 30, 2018
• Last Verified: July 1, 2018

More Information

Terms related to this study

• Keywords: Veterans; prediabetes; lifestyle; patient health record
• Additional Relevant MeSH Terms: Glucose Metabolism Disorders; Metabolic Diseases; Endocrine System Diseases; Diabetes Mellitus; Prediabetic State
• Other Study ID Numbers: PPO 13-135