Growth of the Internet has sparked more and more health care programs for chronic diseases. One study described a pilot phase of an Internet program to help adolescents moving to adult-centered medical care. The online program consisted of information on diabetes, goal-setting exercises with personal feedback, role-playing, group discussions, taking control activities, and communication skills training to improve interactions with health care professionals. Low-income young adults with diabetes were recruited from two inner-city clinics, and given recycled desktop computers and dial-up Internet service. They also received encouragement and computer use reminders from a diabetes educator. During a 6-month intervention period, the investigators checked on participant utilization of the Internet program.
The results indicated that participants logged onto the program 4,445 times, with the discussion board receiving the greatest activity (2,256 total posted and read messages). Participants used the program most frequently at night, with an overall gradual decline in computer use over the 6-month period. To help maintain utilization, the diabetes educator placed a total of 439 telephone calls over 6 months (15-38 calls per participant).

Comments: The study showed the Internet was able to meet the informational and social needs of adolescents and young adults with diabetes. You would expect the hits on the Internet to decrease over time as the participants required less and less information. That is what occurred. The approach has considerable promise for the future. However, a weakness suggested by the authors was that involvement by patients relied heavily upon reminders and encouragement from a diabetes educator and immediate family members. This raises the question as to whether self-management skills were emphasized in the program. For this reason, it is suggested that future programs include a major stress on self-management in order to insure that patients learn to take more care for their diabetes.

B.S. Gerber et al. Evaluation of an Internet diabetes self-management training program for adolescents and young adults. Diabetes Technology Therapy, 2007;9:60-67.