The use of telehealth for diabetes management: a qualitative study of telehealth provider perceptions

BACKGROUND: Monitoring and Messaging Devices (MMDs) are telehealth systems used by patients in their homes, and are designed to promote patient self-management, patient education, and clinical monitoring and follow-up activities. Although these systems have been widely promoted by health care systems, including the Veterans Health Administration, very little information is available on factors that facilitate use of the MMD system, or on barriers to use. METHODS: We conducted in-depth qualitative interviews with clinicians using MMD-based telehealth programs at two Veterans Affairs Medical Centers in the Midwestern United States. RESULTS: Findings suggest that MMD program enrollment is limited by both clinical and non-clinical factors, and that patients have varying levels of program participation and system use. Telehealth providers see MMDs as a useful tool for monitoring patients who are interested in working on management of their disease, but are concerned with technical challenges and the time commitment required to use MMDs. CONCLUSION: Telehealth includes a rapidly evolving and potentially promising range of technologies for meeting the growing number of patients and clinicians who face the challenges of diabetes care, and future research should explore the most effective means of ensuring successful program implementation

Postpartum Exercise Intervention Targeting Diastasis Recti Abdominis

International Journal of Exercise Science 14(3): 400-409, 2021. To examine the effectiveness of an online, 12-week exercise intervention on diastasis recti abdominis (DRA) width and negatively associated health outcomes (i.e. weight and core function). Non-pregnant women who were 6-24 months postpartum and ≥ 18 years of age completed the study. Participants (n = 8) were randomized to intervention (exercise) or control groups; with the intervention group completing three exercise sessions per week virtually. Both groups completed three surveys at baseline, 6-weeks, and 12-weeks. DRA width was measured with nylon calipers at baseline and 12-weeks. Repeated measures analysis of covariance examined Group x Time changes in width of DRA, core function, and weight at 12-weeks; effect sizes (i.e. Cohen’s d) were calculated. An alpha level of 0.05 was used to determine statistical significance. There was a significant Group x Time interaction for two DRA width measurement sites, 2 inches above navel (rest) (p = 0.007, d = 0.67) and 2 inches above navel (active) (p = 0.005, d = 0.69). The Group x Time interaction for weight approached significance (p = 0.06), with a small between group effect size (d = 0.23). The Group x Time interaction for core function was not significant (p = 0.83). Exercise interventions delivered in a virtual setting may be effective for decreasing the severity of DRA in postpartum women. Future research should investigate the impact of similar programs on other aspects of postpartum mental and physical health, activities of daily living, and clinical practice