Interventions with a duration of 2 - 6 months providing professional-led support with asynchronous and synchronous communication appeared to be associated with significant well-being outcomes .
While the meta-analyses demonstrated nonsignificant results for depression and distress scores , this review has shown that there is a potential for Web-based interventions to improve well-being outcomes in type 2 diabetes .
BACKGROUND Poor diabetes self-care can have a negative impact on psychological well-being and quality of life .
Given the scarcity of traditional psychological support and the barriers to uptake of and attendance at face-to-face education programs , Web-based interventions are becoming a popular approach to provide an additional platform for psychological support in long-term conditions .
However , there is limited evidence to assess the effect of Web-based psychological support in people with type 2 diabetes .
OBJECTIVE This systematic review is the first review to critically appraise and quantify the evidence on the effect of Web-based interventions that aim to improve well-being in people with type 2 diabetes .
Online Diabetes Self-Management Program
OBJECTIVE We hypothesized that people with type 2 diabetes in an online diabetes self-management program  , compared with usual-care control subjects , would 1 ) demonstrate reduced A1C at 6 and 18 months , 2 ) have fewer symptoms , 3 ) demonstrate increased exercise , and 4 ) have improved self-efficacy and patient activation . In addition , participants r and omized to listserve reinforcement would have better 18-month outcomes than participants receiving no reinforcement . RESEARCH DESIGN AND METHODS A total of 761 participants were r and omized to 1 ) the program  , 2 ) the program with e-mail reinforcement , or 3 ) were usual-care control subjects ( no treatment ) . This sample included 110 American Indians/Alaska Natives ( AI/ANs ) . Analyses of covariance models were used at the 6- and 18-month follow-up to compare groups . RESULTS At 6 months , A1C , patient activation , and self-efficacy were improved for program participants compared with usual care control subjects ( P < 0.05 ) . There were no changes in other health or behavioral indicators . The AI/AN program participants demonstrated improvements in health distress and activity limitation compared with usual-care control subjects . The subgroup with initial A1C > 7 % demonstrated stronger improvement in A1C ( P = 0.01 ) . At 18 months , self-efficacy and patient activation were improved for program participants . A1C was not measured . Reinforcement showed no improvement . CONCLUSIONS An online diabetes self-management program is acceptable for people with type 2 diabetes . Although the results were mixed they suggest 1 ) that the program may have beneficial effects in reducing A1C , 2 ) AI/AN population s can be engaged in and benefit from online interventions , and 3 ) our follow-up reinforcement appeared to have no value
Interventions with a duration of 2 - 6 months providing professional-led support with asynchronous and synchronous communication appeared to be associated with significant well-being outcomes .
While the meta-analyses demonstrated nonsignificant results for depression and distress scores , this review has shown that there is a potential for Web-based interventions to improve well-being outcomes in type 2 diabetes .
BACKGROUND Poor diabetes self-care can have a negative impact on psychological well-being and quality of life .
Given the scarcity of traditional psychological support and the barriers to uptake of and attendance at face-to-face education programs , Web-based interventions are becoming a popular approach to provide an additional platform for psychological support in long-term conditions .
However , there is limited evidence to assess the effect of Web-based psychological support in people with type 2 diabetes .
OBJECTIVE This systematic review is the first review to critically appraise and quantify the evidence on the effect of Web-based interventions that aim to improve well-being in people with type 2 diabetes .