Strengths and Limitations
T2DM, diabetes
DISEASE, DIABETES
The major strength of this study is that the eHealth family-based intervention used content usually delivered as part of in-person health education, as set out in the National Standard for Basic Public Health Services. The dropout rate of participants was very low (only 3 pairs of participants).However, this study also has some limitations. First, the sample was small and only included patients enrolled in 1 city. Future studies should include larger samples from multiple sources. Second, the intervention time was 1 year, and we did not perform continuous follow-up of the patients with T2DM and their family members. Consequently, we could only conclude whether the intervention was effective over a period of time; we could not confirm its long-term effects. Third, participant compliance was not comprehensively documented; for example, we did not determine how long or how often patients with T2DM or their family members read the intervention articles. Fourth, due to a reduced workforce and funding restrictions, we did not collect data at 6 months. Restrictions also prevented us from collecting some indicators that were included in the protocol, such as weight, height, waist circumference, hip circumference, blood pressure, and BMI.Additionally, during the process of intervention implementation, we revised the inclusion and exclusion criteria that were published in the protocol to remove “no history of diabetes” for the family members and add “never participated in other, similar research.” We made this revision because the study aimed to find an intervention program that is suitable for the real world. After the protocol was developed, we came to understand that the family members of patients with T2DM can also develop T2DM. If we had recruited participants based on the inclusion and exclusion criteria in the protocol, a large number of suitable participants would have been lost, because T2DM is a common disease in older adults. The patients with T2DM were often older people whose family members were a spouse, their child, or a son- or daughter-in-law; the mean age of these family members was greater than 45 years. In addition, to avoid influence from other research, we required that the family members had not participated in other research that was similar to our study.