Abstract:
BACKGROUND:Most patients with diabetes mellitus (DM) are followed by primary care physicians, who often lack knowledge or confidence to prescribe insulin properly. This contributes to clinical inertia and poor glycemic control. Effectiveness of traditional continuing medical education (CME) to solve that is limited, so new approaches are required. Electronic games are a good option, as they can be very effective and easily disseminated. OBJECTIVE:The objective of our study was to assess applicability, user acceptance, and educational effectiveness of InsuOnline, an electronic serious game for medical education on insulin therapy for DM, compared with a traditional CME activity. METHODS:Primary care physicians (PCPs) from South of Brazil were invited by phone or email to participate in an unblinded randomized controlled trial and randomly allocated to play the game InsuOnline, installed as an app in their own computers, at the time of their choice, with minimal or no external guidance, or to participate in a traditional CME session, composed by onsite lectures and cases discussion. Both interventions had the same content and duration (~4 h). Applicability was assessed by the number of subjects who completed the assigned intervention in each group. Insulin-prescribing competence (factual knowledge, problem-solving skills, and attitudes) was self-assessed through a questionnaire applied before, immediately after, and 3 months after the interventions. Acceptance of the intervention (satisfaction and perceived importance for clinical practice) was also assessed immediately after and 3 months after the interventions, respectively. RESULTS:Subjects' characteristics were similar between groups (mean age 38, 51.4% [69/134] male). In the game group, 69 of 88 (78%) completed the intervention, compared with 65 of 73 (89%) in the control group, with no difference in applicability. Percentage of right answers in the competence subscale, which was 52% at the baseline in both groups, significantly improved immediately after both interventions to 92% in the game group and to 85% in control (P<.001). After 3 months, it remained significantly higher than that at the baseline in both groups (80% in game, and 76% in control; P<.001). Absolute increase in competence score was better with the game (40%) than with traditional CME (34%; P=.01). Insulin-related attitudes were improved both after the game (significant improvement in 4 of 9 items) and after control activity (3 of 9). Both interventions were very well accepted, with most subjects rating them as "fun or pleasant," "useful," and "practice-changing." CONCLUSIONS:The game InsuOnline was applicable, very well accepted, and highly effective for medical education on insulin therapy. In view of its flexibility and easy dissemination, it is a valid option for large-scale CME, potentially helping to reduce clinical inertia and to improve quality of care for DM patients. TRIAL REGISTRATION:Clinicaltrials.gov NCT001759953; https://clinicaltrials.gov/ct2/show/NCT01759953 (Archived by WebCite at http://www.webcitation.org/6oeHoTrBf).
journal_name
J Med Internet Resjournal_title
Journal of medical Internet researchauthors
Diehl LA,Souza RM,Gordan PA,Esteves RZ,Coelho ICdoi
10.2196/jmir.6944subject
Has Abstractpub_date
2017-03-09 00:00:00pages
e72issue
3eissn
1439-4456issn
1438-8871pii
v19i3e72journal_volume
19pub_type
杂志文章,随机对照试验abstract::Analogous to checklists of recommendations such as the CONSORT statement (for randomized trials), or the QUORUM statement (for systematic reviews), which are designed to ensure the quality of reports in the medical literature, a checklist of recommendations for authors is being presented by the Journal of Medical Inte...
journal_title:Journal of medical Internet research
pub_type: 社论
doi:10.2196/jmir.6.3.e34
更新日期:2004-09-29 00:00:00
abstract:BACKGROUND:Mobile phone use and the adoption of healthy lifestyle software apps ("health apps") are rapidly proliferating. There is limited information on the users of health apps in terms of their social demographic and health characteristics, intentions to change, and actual health behaviors. OBJECTIVE:The objective...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/jmir.5604
更新日期:2017-04-19 00:00:00
abstract:BACKGROUND:Alcohol misuse is a major social and public health issue in Australia, with an estimated cost to the community of Aus $30 billion per annum. Until recently, a major barrier in addressing this significant public health issue is the fact that the majority of individuals with alcohol use disorders and alcohol m...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/jmir.9605
更新日期:2018-05-17 00:00:00
abstract:BACKGROUND:Improvements in mobile telecommunication technologies have enabled clinicians to collect patient-reported outcome (PRO) data more frequently, but there is as yet limited evidence regarding the frequency with which PRO data can be collected via smartphone applications (apps) in breast cancer patients receivin...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/jmir.3421
更新日期:2014-05-23 00:00:00
abstract:BACKGROUND:Automated virtual reality exposure therapies (VRETs) are self-help treatments conducted by oneself and supported by a virtual therapist embodied visually and/or with audio feedback. This simulates many of the nonspecific relational elements and common factors present in face-to-face therapy and may be a mean...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/16660
更新日期:2020-03-24 00:00:00
abstract::This paper concerns the use of the Internet in the research process, from identifying research issues through qualitative research, through using the Web for surveys and clinical trials, to pre-publishing and publishing research results. Material published on the Internet may be a valuable resource for researchers des...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,评审
doi:10.2196/jmir.4.2.e13
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND:Mental health problems are highly prevalent among college students. Most students with poor mental health, however, do not receive professional help. Internet-based self-help formats may increase the utilization of treatment. OBJECTIVE:The aim of this randomized controlled trial was to evaluate the efficacy...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,随机对照试验
doi:10.2196/jmir.9293
更新日期:2018-04-23 00:00:00
abstract:BACKGROUND:Qualitative research methods are increasingly being used across disciplines because of their ability to help investigators understand the perspectives of participants in their own words. However, qualitative analysis is a laborious and resource-intensive process. To achieve depth, researchers are limited to ...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/jmir.9702
更新日期:2018-06-29 00:00:00
abstract:BACKGROUND:Sleepio is a proven digital sleep improvement program based on cognitive behavioral therapy techniques. Users have the option to join an online community that includes weekly expert discussions, peer-to-peer discussion forums, and personal message walls. OBJECTIVE:The aim of this study was to conduct an onl...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/jmir.5654
更新日期:2016-04-25 00:00:00
abstract:BACKGROUND:Stress-related disorders are associated with significant suffering, functional impairment, and high societal costs. Internet-based cognitive behavioral therapy (ICBT) is a promising treatment for stress-related disorders but has so far not been subjected to health economic evaluation. OBJECTIVE:The objectiv...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,随机对照试验
doi:10.2196/14675
更新日期:2019-09-13 00:00:00
abstract:BACKGROUND:Connected health has created opportunities for leveraging health data to deliver preventive and personalized health care services. The increasing number of personal devices and advances in measurement technologies contribute to an exponential growth in digital health data. The practices for sharing data acro...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/14537
更新日期:2019-11-27 00:00:00
abstract:BACKGROUND:Given the recognized importance of preventing poor dietary behaviors during adolescence, we need a better understanding of college students' dietary behaviors. Studies have found that individual factors and electronic health (eHealth) literacy may affect one's dietary behaviors. However, few studies have ful...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/13140
更新日期:2019-11-26 00:00:00
abstract:BACKGROUND:There is no functional pharmacovigilance system in Cambodia to our knowledge. Mobile phone-based tools, such as short message service (SMS) text messages, are increasingly used for surveillance purposes. OBJECTIVE:To pilot-test the FrontlineSMS mobile phone-based tool for notification of adverse events, usi...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/jmir.2477
更新日期:2013-04-16 00:00:00
abstract:BACKGROUND:Brief motivational interviewing (MI) can contribute to reductions in morbidity and mortality related to coronary artery disease, through health behavior change. Brief MI, unlike more intensive interventions, was proposed to meet the needs of clinicians with little spare time. While the provision of face-to-f...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/jmir.6298
更新日期:2016-08-18 00:00:00
abstract:BACKGROUND:Major depression accounts for the greatest burden of all diseases globally. The peak onset of depression occurs between adolescence and young adulthood, and for many individuals, depression displays a relapse-remitting and increasingly severe course. Given this, the development of cost-effective, acceptable,...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,评审
doi:10.2196/jmir.3304
更新日期:2014-09-16 00:00:00
abstract:BACKGROUND:Informed consent is one of the key elements in biomedical research. The introduction of electronic informed consent can be a way to overcome many challenges related to paper-based informed consent; however, its novel opportunities remain largely unfulfilled due to several barriers. OBJECTIVE:We aimed to pro...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/19129
更新日期:2020-10-08 00:00:00
abstract:BACKGROUND:A majority of adolescents report the use of some form of social media, and many prefer to communicate via social networking sites. Social media may offer new opportunities in diabetes management, particularly in terms of how health care teams provide tailored support and treatment to adolescents with diabete...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/12149
更新日期:2019-05-30 00:00:00
abstract:BACKGROUND:Youth mental health is a significant public health concern due to the high prevalence of mental health problems in this population and the low rate of those affected seeking help. While it is increasingly recognized that prevention is better than cure, most youth prevention programs have utilized interventio...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,随机对照试验
doi:10.2196/jmir.3176
更新日期:2014-06-04 00:00:00
abstract:BACKGROUND:People with type 2 diabetes mellitus (T2DM) often experience mental health symptoms that exacerbate illness and increase mortality risk. Access to psychological support is low in people with T2DM. Detection of depression is variable in primary care and can be further hampered by mental health stigma. Electro...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/16729
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Despite the significant effect of computerized physician order entry (CPOE) in reducing nonintercepted medication errors among neonatal inpatients, only a minority of hospitals have successfully implemented such systems. Physicians' resistance and users' frustration seem to be two of the most important barri...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/jmir.1284
更新日期:2010-02-26 00:00:00
abstract:BACKGROUND:Home telemonitoring figures among the various solutions that could help attenuate some of the problems associated with aging populations, rates of chronic illness, and shortages of health professionals. OBJECTIVE:The primary aim of this study was to further our understanding of the clinical effects associat...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,评审
doi:10.2196/jmir.1357
更新日期:2010-06-16 00:00:00
abstract:BACKGROUND:The police attend numerous domestic violence events each year, recording details of these events as both structured (coded) data and unstructured free-text narratives. Abuse types (including physical, psychological, emotional, and financial) conducted by persons of interest (POIs) along with any injuries sus...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/13067
更新日期:2019-03-12 00:00:00
abstract:BACKGROUND:With advances in technology, the adoption of wearable devices has become a viable adjunct in poststroke rehabilitation. Regaining ambulation is a top priority for an increasing number of stroke survivors. However, despite an increase in research exploring these devices for lower limb rehabilitation, little i...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,评审
doi:10.2196/jmir.5891
更新日期:2016-10-07 00:00:00
abstract:BACKGROUND:Efficiently sharing health data produced during standard care could dramatically accelerate progress in cancer treatments, but various barriers make this difficult. Not sharing these data to ensure patient privacy is at the cost of little to no learning from real-world data produced during cancer care. Furth...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/16810
更新日期:2020-03-20 00:00:00
abstract:BACKGROUND:A 2012 World Health Organization report recognizes betel nut use as an urgent public health threat faced by the Western Pacific region. However, compared with other addictive substances, little is known about how betel nuts are depicted on social media platforms. In particular, image-based social media platf...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/13954
更新日期:2020-07-09 00:00:00
abstract:BACKGROUND:Influenza is a viral respiratory disease capable of causing epidemics that represent a threat to communities worldwide. The rapidly growing availability of electronic "big data" from diagnostic and prediagnostic sources in health care and public health settings permits advance of a new generation of methods ...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/jmir.7101
更新日期:2017-06-15 00:00:00
abstract::Information on the costs and benefits of eHealth interventions is needed, not only to document value for money and to support decision making in the field, but also to form the basis for developing business models and to facilitate payment systems to support large-scale services. In the absence of solid evidence of it...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,评审
doi:10.2196/jmir.4521
更新日期:2015-11-09 00:00:00
abstract:BACKGROUND:Digital health has become an advancing phenomenon in the health care systems of modern societies. Over the past two decades, various digital health options, technologies, and innovations have been introduced; many of them are still being investigated and evaluated by researchers all around the globe. However...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/10477
更新日期:2019-12-19 00:00:00
abstract:BACKGROUND:Patients attempt to make appropriate decisions based on their own knowledge when choosing a doctor. In this process, the first question usually faced is that of how to obtain useful and relevant information. This study investigated the types of information sources that are used widely by patients in choosing...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/20910
更新日期:2020-09-16 00:00:00
abstract:BACKGROUND:Intensive interventions targeting diet and physical activity are effective for weight reduction but are costly. Tailored, computer-generated, step-count feedback may provide an intensive and affordable way to increase the physical activity of people at high risk for cardiovascular disease. OBJECTIVE:The obj...
journal_title:Journal of medical Internet research
pub_type: 临床试验,杂志文章,多中心研究
doi:10.2196/jmir.7.5.e56
更新日期:2005-11-17 00:00:00