{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T20:09:00Z","timestamp":1767211740060},"reference-count":49,"publisher":"Georg Thieme Verlag KG","issue":"03","funder":[{"name":"NIDDK\/NIH","award":["K23DK106511"],"award-info":[{"award-number":["K23DK106511"]}]},{"name":"NIDDK\/NIH","award":["P30DK092986"],"award-info":[{"award-number":["P30DK092986"]}]},{"name":"NCATS\/NIH","award":["UL1TR000445"],"award-info":[{"award-number":["UL1TR000445"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003My Diabetes Care (MDC) is a novel, multifaceted patient portal intervention designed to help patients better understand their diabetes health data and support self-management. MDC uses infographics to visualize and summarize patients' diabetes health data, incorporates motivational strategies, and provides literacy level\u2013appropriate educational resources.<\/jats:p><jats:p>\n          Objectives\u2003We aimed to assess the usability, acceptability, perceptions, and potential impact of MDC.<\/jats:p><jats:p>\n          Methods\u2003We recruited 69 participants from four clinics affiliated with Vanderbilt University Medical Center. Participants were given 1 month of access to MDC and completed pre- and post-questionnaires including validated measures of usability and patient activation, and questions about user experience.<\/jats:p><jats:p>\n          Results\u2003Sixty participants completed the study. Participants' mean age was 58, 55% were females, 68% were Caucasians, and 48% had limited health literacy (HL). Most participants (80%) visited MDC three or more times and 50% spent a total of \u226515\u2009minutes on MDC. Participants' median System Usability Scale (SUS) score was 78.8 [Q1, Q3: 72.5, 87.5] and significantly greater than the threshold value of 68 indicative of \u201cabove average\u201d usability (p\u2009&lt;\u20090.001). The median SUS score of patients with limited HL was similar to those with adequate HL (77.5 [72.5, 85.0] vs. 82.5 [72.5, 92.5]; p\u2009=\u20090.41). Participants most commonly reported the literacy level\u2013appropriate educational links and health data infographics as features that helped them better understand their diabetes health data (65%). All participants (100%) intended to continue to use MDC. Median Patient Activation Measure\u00ae scores increased postintervention (64.3 [55.6, 72.5] vs. 67.8 [60.6, 75.0]; p\u2009=\u20090.01).<\/jats:p><jats:p>\n          Conclusion\u2003Participants, including those with limited HL, rated the usability of MDC above average, anticipated continued use, and identified key features that improved their understanding of diabetes health data. Patient activation improved over the study period. Our findings suggest MDC may be a beneficial addition to existing patient portals.<\/jats:p>","DOI":"10.1055\/s-0041-1730324","type":"journal-article","created":{"date-parts":[[2021,6,30]],"date-time":"2021-06-30T23:10:52Z","timestamp":1625094652000},"page":"539-550","source":"Crossref","is-referenced-by-count":12,"title":["The My Diabetes Care Patient Portal Intervention: Usability and Pre-Post Assessment"],"prefix":"10.1055","volume":"12","author":[{"given":"William","family":"Martinez","sequence":"additional","affiliation":[{"name":"Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States"}]},{"given":"Amber J.","family":"Hackstadt","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Vanderbilt University Medicine Center, Nashville, Tennessee, United States"}]},{"given":"Gerald B.","family":"Hickson","sequence":"additional","affiliation":[{"name":"Center for Patient and Professional Advocacy, Vanderbilt University Medical Center, Nashville, Tennessee, United States"}]},{"given":"Thomas","family":"Knoerl","sequence":"additional","affiliation":[{"name":"Upstate Medical University, State University of New York, Syracuse, New York, United States"}]},{"given":"S. Trent","family":"Rosenbloom","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States"}]},{"given":"Kenneth A.","family":"Wallston","sequence":"additional","affiliation":[{"name":"Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee, United States"}]},{"given":"Tom A.","family":"Elasy","sequence":"additional","affiliation":[{"name":"Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States"}]}],"member":"194","published-online":{"date-parts":[[2021,6,30]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1177\/0145721716689694","article-title":"Diabetes self-management education and support in type 2 diabetes: a joint position statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics","volume":"43","author":"M A Powers","year":"2017","journal-title":"Diabetes Educ"},{"key":"ref2","volume-title":"National Diabetes Statistics Report, 2020","author":"Centers for Disease Control and Prevention","year":"2020"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1111\/hex.12577","article-title":"The association between patient activation and self-care practices: a cross-sectional study of an Australian population with comorbid diabetes and chronic kidney disease","volume":"20","author":"E Zimbudzi","year":"2017","journal-title":"Health Expect"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.pcd.2019.08.009","article-title":"The effectiveness of patient activation intervention on type 2 diabetes mellitus glycemic control and self-management behaviors: a systematic review of RCTs","volume":"14","author":"N Almutairi","year":"2020","journal-title":"Prim Care 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(Amst)"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1378\/chest.14-2559","article-title":"Patient portals: an underused resource for improving patient engagement","volume":"149","author":"B Tulu","year":"2016","journal-title":"Chest"},{"issue":"12","key":"ref9","doi-asserted-by":"crossref","first-page":"e275","DOI":"10.2196\/jmir.4847","article-title":"Barriers and facilitators to online portal use among patients and caregivers in a safety net health care system: a qualitative study","volume":"17","author":"L Tieu","year":"2015","journal-title":"J Med Internet Res"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"S123","DOI":"10.7326\/M19-0876","article-title":"Using electronic health record portals to improve patient engagement: research priorities and best practices","volume":"172","author":"C R Lyles","year":"2020","journal-title":"Ann Intern Med"},{"issue":"01","key":"ref11","first-page":"15","article-title":"Methods for patient-centered interface design of test result display in online portals","volume":"6","author":"D T Nystrom","year":"2018","journal-title":"EGEMS (Wash DC)"},{"issue":"03","key":"ref12","doi-asserted-by":"crossref","first-page":"e26","DOI":"10.2196\/humanfactors.9569","article-title":"A patient-facing diabetes dashboard embedded in a patient web portal: design sprint and usability testing","volume":"5","author":"W Martinez","year":"2018","journal-title":"JMIR Human Factors"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"e000488","DOI":"10.1136\/bmjdrc-2017-000488","article-title":"Patients' perspectives on social and goal-based comparisons regarding their diabetes health status","volume":"6","author":"W Martinez","year":"2018","journal-title":"BMJ Open Diabetes Res Care"},{"issue":"04","key":"ref14","doi-asserted-by":"crossref","first-page":"e86","DOI":"10.2196\/jmir.4067","article-title":"The eHealth Enhanced Chronic Care Model: a theory derivation approach","volume":"17","author":"P M Gee","year":"2015","journal-title":"J Med Internet Res"},{"issue":"02","key":"ref15","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap): a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"P A Harris","year":"2009","journal-title":"J Biomed Inform"},{"issue":"04","key":"ref16","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1177\/0733464812447283","article-title":"The impact of numeracy ability and technology skills on older adults' performance of health management tasks using a patient portal","volume":"33","author":"J Taha","year":"2014","journal-title":"J Appl Gerontol"},{"issue":"01","key":"ref17","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.pec.2007.09.008","article-title":"Preferences for self-management support: findings from a survey of diabetes patients in safety-net health systems","volume":"70","author":"U Sarkar","year":"2008","journal-title":"Patient Educ Couns"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"e47","DOI":"10.1093\/jamia\/ocw098","article-title":"Online patient websites for electronic health record access among vulnerable populations: portals to nowhere?","volume":"24","author":"L Tieu","year":"2017","journal-title":"J Am Med Inform Assoc"},{"key":"ref20","doi-asserted-by":"crossref","DOI":"10.21236\/ADA006655","volume-title":"Derivation of New Readability Formulas (Automated Readability Index, Fog Count and Flesch Reading Ease Formula) for Navy Enlisted Personnel","author":"J P Kincaid","year":"1975"},{"issue":"S 01","key":"ref21","first-page":"S1","article-title":"Introduction: standards of medical care in diabetes-2018","volume":"41","author":"American Diabetes Association","year":"2018","journal-title":"Diabetes Care"},{"issue":"01","key":"ref22","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1177\/0145721715620019","article-title":"The PRIDE (Partnership to Improve Diabetes Education) Toolkit: development and evaluation of novel literacy and culturally sensitive diabetes education materials","volume":"42","author":"K Wolff","year":"2016","journal-title":"Diabetes Educ"},{"issue":"03","key":"ref25","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1007\/s11606-010-1552-1","article-title":"Validation of self-reported health literacy questions among diverse English and Spanish-speaking populations","volume":"26","author":"U Sarkar","year":"2011","journal-title":"J Gen Intern Med"},{"issue":"04","key":"ref26","doi-asserted-by":"crossref","first-page":"e27","DOI":"10.2196\/jmir.8.4.e27","article-title":"eHEALS: the eHealth Literacy Scale","volume":"8","author":"C D Norman","year":"2006","journal-title":"J Med Internet Res"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"3","DOI":"10.2466\/03.CP.3.4","article-title":"Achieving saturation in thematic analysis: Development and refinement of a codebook","volume":"3","author":"H Ando","year":"2014","journal-title":"Compr Psychol"},{"key":"ref28","first-page":"189","volume-title":"SUS: quick and dirty usability scale","author":"J Brooke","year":"1996"},{"issue":"06","key":"ref29","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1080\/10447310802205776","article-title":"An empirical evaluation of the system usability scale","volume":"24","author":"A Bangor","year":"2008","journal-title":"Int J Hum Comput Interact"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"1918","DOI":"10.1111\/j.1475-6773.2005.00438.x","article-title":"Development and testing of a short form of the patient activation measure","volume":"40","author":"J H Hibbard","year":"2005","journal-title":"Health Serv Res"},{"issue":"05","key":"ref31","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1007\/s10865-007-9110-y","article-title":"Psychometric properties of the perceived diabetes self-management scale (PDSMS)","volume":"30","author":"K A Wallston","year":"2007","journal-title":"J Behav Med"},{"issue":"02","key":"ref32","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1177\/016327879601900205","article-title":"Development and validation of the Diabetes Care Profile","volume":"19","author":"J T Fitzgerald","year":"1996","journal-title":"Eval Health Prof"},{"issue":"01","key":"ref33","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1177\/0145721713508824","article-title":"Assessment of a short diabetes knowledge instrument for older and minority adults","volume":"40","author":"S A Quandt","year":"2014","journal-title":"Diabetes Educ"},{"issue":"07","key":"ref34","doi-asserted-by":"crossref","first-page":"943","DOI":"10.2337\/diacare.23.7.943","article-title":"The summary of diabetes self-care activities measure: results from 7 studies and a revised scale","volume":"23","author":"D J Toobert","year":"2000","journal-title":"Diabetes Care"},{"issue":"01","key":"ref35","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1007\/s00125-009-1559-5","article-title":"Short-form measures of diabetes-related emotional distress: the Problem Areas in Diabetes Scale (PAID)-5 and PAID-1","volume":"53","author":"B E McGuire","year":"2010","journal-title":"Diabetologia"},{"issue":"01","key":"ref36","doi-asserted-by":"crossref","first-page":"e32","DOI":"10.2196\/jmir.1924","article-title":"Effects of a web-based intervention for adults with chronic conditions on patient activation: online randomized controlled trial","volume":"14","author":"M Solomon","year":"2012","journal-title":"J Med Internet Res"},{"issue":"01","key":"ref37","doi-asserted-by":"crossref","first-page":"e13","DOI":"10.2196\/humanfactors.5177","article-title":"The usability of diabetes MAP: a web-delivered intervention for improving medication adherence","volume":"3","author":"L A Nelson","year":"2016","journal-title":"JMIR Human Factors"},{"key":"ref38","volume-title":"Basics of Qualitative Research: Grounded Theory Procedures and Techniques","author":"A Strauss","year":"1990"},{"issue":"04","key":"ref40","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1093\/jamia\/ocx140","article-title":"Patient perceptions of receiving test results via online portals: a mixed-methods study","volume":"25","author":"T D Giardina","year":"2018","journal-title":"J Am Med Inform Assoc"},{"issue":"04","key":"ref41","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1055\/s-0039-1697592","article-title":"A systematic review of patient-facing visualizations of personal health data","volume":"10","author":"M R Turchioe","year":"2019","journal-title":"Appl Clin Inform"},{"issue":"06","key":"ref42","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1007\/s11606-019-04832-y","article-title":"The role of health literacy in diabetes knowledge, self-care, and glycemic control: a meta-analysis","volume":"34","author":"L Marciano","year":"2019","journal-title":"J Gen Intern Med"},{"issue":"04","key":"ref43","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1513\/AnnalsATS.201401-032PS","article-title":"Can patient portals reduce health disparities? A perspective from asthma","volume":"11","author":"A J Apter","year":"2014","journal-title":"Ann Am Thorac Soc"},{"issue":"06","key":"ref44","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1089\/pop.2016.0164","article-title":"eHealth literacy: patient engagement in identifying strategies to encourage use of patient portals among older adults","volume":"20","author":"E G Price-Haywood","year":"2017","journal-title":"Popul Health Manag"},{"key":"ref45","first-page":"2055207618797883","article-title":"Older adults using a patient portal: registration and experiences, one year after implementation","volume":"4","author":"G A Wildenbos","year":"2018","journal-title":"Digit Health"},{"issue":"01","key":"ref46","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1097\/CIN.0000000000000476","article-title":"Older adults' experience using patient portals in communities: challenges and opportunities","volume":"37","author":"H Son","year":"2019","journal-title":"Comput Inform Nurs"},{"issue":"01","key":"ref47","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1093\/jamia\/ocv099","article-title":"Quantifying usability: an evaluation of a diabetes mHealth system on effectiveness, efficiency, and satisfaction metrics with associated user characteristics","volume":"23","author":"M Georgsson","year":"2016","journal-title":"J Am Med Inform Assoc"},{"issue":"06","key":"ref48","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1097\/CIN.0000000000000596","article-title":"Usability evaluation of four top-rated commercially available diabetes apps for adults with type 2 diabetes","volume":"38","author":"H NC Fu","year":"2020","journal-title":"Comput Inform Nurs"},{"issue":"02","key":"ref49","doi-asserted-by":"crossref","first-page":"e11462","DOI":"10.2196\/11462","article-title":"Influence of patient characteristics and psychological needs on diabetes mobile app usability in adults with type 1 or type 2 diabetes: crossover randomized trial","volume":"4","author":"H N Fu","year":"2019","journal-title":"JMIR Diabetes"},{"issue":"02","key":"ref50","doi-asserted-by":"crossref","first-page":"e23","DOI":"10.2196\/humanfactors.6029","article-title":"Development and usability of REACH: a tailored theory-based text messaging intervention for disadvantaged adults with type 2 diabetes","volume":"3","author":"L A Nelson","year":"2016","journal-title":"JMIR Human Factors"},{"issue":"04","key":"ref51","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1093\/jamiaopen\/ooz039","article-title":"Policies and procedures governing patient portal use at an academic medical center","volume":"2","author":"B D Steitz","year":"2019","journal-title":"JAMIA Open"},{"issue":"03","key":"ref52","doi-asserted-by":"crossref","first-page":"e71","DOI":"10.2196\/jmir.1603","article-title":"Factors influencing the use of a web-based application for supporting the self-care of patients with type 2 diabetes: a longitudinal study","volume":"13","author":"N Nijland","year":"2011","journal-title":"J Med Internet Res"},{"issue":"05","key":"ref53","doi-asserted-by":"crossref","first-page":"1644","DOI":"10.1016\/j.athoracsur.2015.11.024","article-title":"Adjust for multiple comparisons? 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