・背景：慢性病盛行率正在迅速增加，健康促進模式已轉向以「患者為中心」的健康管理和自我效能提升。物聯網（IoT）的量測設備和移動應用管理系統已成為收集和分析個人數據並用以改善個人健康成效的關鍵自我管理工具。然而，基於雲端與網絡的干預對個體行為改變背後的自我效能和關鍵動機因素的確切影響尚未確定。

・目的：本研究目的是深入了解對於新診斷糖尿病患者（2型糖尿病）的自我管理效能，並分析以人為中心之多元化角度的健康促進行為暨關聯影響，進而檢查臨床數據結果對於物聯網和移動健康應用功能的交互影響因子成效。

・方法：該研究使用電子健康數據庫（n = 3128）的數據。採用實驗組（n = 121）與隨機對照組進行試驗，並確定患者對健康促進計劃（n = 62）和移動自我管理教育（n = 28）的偏好。跨理論模型被用作觀察自我管理行為以改善個體健康的框架，計劃行為理論被用於評估個人目標，執行，結果和個人偏好。移動應用管理系統用於確定個人化的健康促進乾預措施，並應用這些干預措施來改善患者自我管理和自我效能。

・結果：透過移動應用管理以動態問卷方式進行干預前和乾預後評估。動態問卷執行方法用於追踪和監測收案後6至18個月的患者行為變化；與血壓（收縮壓 ≥ 120mmHg）和體重指數（≥ 23kg / m 2）相關的高風險參與者表現出很高自我改變動機，並在自我管理知識評估中取得高分（n = 49，95％CI -0.26％至-0.24％，P < .052）。行動管理介入的病例組臨床結果略好於對照組（糖化血紅蛋白平均值 -1.25％，95％CI 6.36至7.47，P < .002）。此外，86％ (42 / 49) 的參與者通過移動應用管理與雲端量測技術提高了他們的健康知識且女性的行為改變依從率高於男性。此外，個人性格特徵屬於穩健和支配者，其飲食和健康干預遵從度相對更高 (83％，81 / 98)。大多數參與者 (71％，70 /98) 對健康飲食、運動和監測較關注（分別為30％，21％和20％）。

・結論：在移動應用管理系統的健康干預後，發現整體遵從度更高。基於患者特徵，與健康促進計畫相關的口碑傳播和社交媒體，各種干預策略可用於增加個人自我效能和改善臨床結果。日後再進行的相關研究，應確定最有影響力的關連因子，和最有效的依從性管理之相關應用及技術。

・關鍵詞：二型糖尿病、自我管理、健康知識素養、患者參與及介入、口碑

・Background: The prevalence of chronic disease is increasing rapidly. Health promotion models have shifted toward patient-centered care and self-efficacy. Devices and mobile app in the Internet of Things (IoT) have become critical self-management tools for collecting and analyzing personal data to improve individual health outcomes. However, the precise effects of Web-based interventions on self-efficacy and the related motivation factors behind individuals’ behavioral changes have not been determined.

・Objective: The objective of this study was to gain insight into patient’s self-efficacy with newly diagnosed diabetes (type 2 diabetes mellitus) and analyze the association of patient-centered health promotion behavior and to examine the implications of the results for IoT and mobile health mobile app features.

・Methods: The study used data from the electronic health database (n = 3128). An experimental design (n = 121) and randomized controlled trials were employed to determine patient preferences in the health promotion program (n = 62) and mobile self-management education (n = 28). The transtheoretical model was used as a framework for observing self-management behavior for the improvement of individual health, and the theory of planned behavior was used to evaluate personal goals, execution, outcome, and personal preferences. A mobile app was used to determine individualized health promotion interventions and to apply these interventions to improve patients’ self-management and self-efficacy.

・Results: Mobile questionnaires were administered for pre- and postintervention assessment through mobile app. A dynamic questionnaire allocation method was used to follow up and monitor patient behavioral changes in the subsequent 6 to 18 months. Participants at a high risk of problems related to blood pressure (systolic blood pressure ≥120 mm Hg) and body mass index (≥23 kg/m2) indicated high motivation to change and to achieve high scores in the self-care knowledge assessment (n=49, 95% CI −0.26% to −0.24%, P<.052). The associated clinical outcomes in the case group with the mobile-based intervention were slightly better than in the control group (glycated hemoglobin mean −1.25%, 95% CI 6.36 to 7.47, P<.002). In addition, 86% (42/49) of the participants improved their health knowledge through the mobile-based app and information and communications technology. The behavior-change compliance rate was higher among the women than among the men. In addition, the personal characteristics of steadiness and dominance corresponded with a higher compliance rate in the dietary and wellness intervention (83%, 81/98). Most participants (71%, 70/98) also increased their attention to healthy eating, being active, and monitoring their condition (30%, 21%, and 20%, respectively).

・Conclusions: The overall compliance rate was discovered to be higher after the mobile app–based health intervention. Various intervention strategies based on patient characteristics, health care–related word-of-mouth communication, and social media may be used to increase self-efficacy and improve clinical outcomes. Additional research should be conducted to determine the most influential factors and the most effective adherence management techniques.

・Keywords: type 2 diabetes mellitus; self-management; health literacy; patient engagement; intervention; word-of-mouth

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