@文章{信息:doi/10.2196/11267，作者=“Griauzde, Dina和Kullgren, Jeffrey T和Liestenfeltz, Brad和Ansari, Tahoora和Johnson, Emily H和Fedewa, Allison和Saslow, Laura R和Richardson, Caroline和Heisler, Michele”，标题=“一个基于手机的项目促进糖尿病前期成年人的健康行为，他们拒绝参加免费的糖尿病预防项目:混合方法试点随机对照试验”，期刊=“JMIR Mhealth Uhealth”，年=“2019”，月=“Jan”，日=“09”，卷=“7”，号=“1”，页=“e11267”，关键词=“自主动机”;行为改变;移动健康;移动电话;前驱糖尿病;预防;背景:尽管有证据表明糖尿病预防计划(DPPs)可以延缓或预防2型糖尿病(T2DM)的进展，但很少有糖尿病前期患者参加该计划。这可能部分是因为许多糖尿病前期患者预防2型糖尿病的自主动机(即来自内部来源的动机)水平较低。目的:本研究旨在检验移动健康(mHealth)干预的可行性和可接受性，该干预旨在提高先前拒绝参与免费dpp的糖尿病前期成人的自主动机和健康行为。 In addition, the study aims to examine changes in autonomous motivation among adults offered 2 versions of the mHealth program compared with an information-only control group. Methods: In this 12-week, parallel, 3-arm, mixed-methods pilot randomized controlled trial, participants were randomized to (1) a group that received information about prediabetes and strategies to prevent T2DM (control); (2) a group that received a mHealth app that aims to increase autonomous motivation among users (app-only); or (3) a group that received the app plus a physical activity tracker and wireless-enabled digital scale for self-monitoring (app-plus). Primary outcome measures included rates of intervention uptake (number of individuals enrolled/number of individuals assessed for eligibility), retention (number of 12-week survey completers/number of participants), and adherence (number of device-usage days). The secondary outcome measure was change in autonomous motivation (measured using the Treatment Self-Regulation Questionnaire), which was examined using difference-in-difference analysis. Furthermore, we conducted postintervention qualitative interviews with participants. Results: Overall, 28{\%} (69/244) of eligible individuals were randomized; of these, 80{\%} (55/69) completed the 12-week survey. Retention rates were significantly higher among app-plus participants than participants in the other 2 study arms combined (P=.004, $\chi$2). No significant differences were observed in adherence rates between app-only and app-plus participants (43 days vs 37 days; P=.34). Among all participants, mean autonomous motivation measures were relatively high at baseline (6.0 of 7.0 scale), with no statistically significant within- or between-group differences in follow-up scores. In qualitative interviews (n=15), participants identified reasons that they enjoyed using the app (eg, encouraged self-reflection), reasons that they did not enjoy using the app (eg, did not consider personal circumstances), and strategies to improve the intervention (eg, increased interpersonal contact). Conclusions: Among individuals with prediabetes who did not engage in free DPPs, this mHealth intervention was feasible and acceptable. Future work should (1) examine the effectiveness of a refined intervention on clinically relevant outcomes (eg, weight loss) among a larger population of DPP nonenrollees with low baseline autonomous motivation and (2) identify other factors associated with DPP nonenrollment, which may serve as additional potential targets for interventions. Trial Registration: ClinicalTrials.gov NCT03025607; https://clinicaltrials.gov/ct2/show/NCT03025607 (Archived by WebCite at http://www.webcitation.org/73cvaSAie) ", issn="2291-5222", doi="10.2196/11267", url="http://mhealth.www.mybigtv.com/2019/1/e11267/", url="https://doi.org/10.2196/11267", url="http://www.ncbi.nlm.nih.gov/pubmed/30626566" }