Methods
obesity, cancer, renal failure, diabetes
OBESITY, CANCER, RENAL FAILURE, TYPE 2 DIABETES, DISEASES, DIABETES
This is a prospective interventional study on patients with obesity or type 2 diabetes age group of 18–60 years old, where it was conducted during 2019–2020 in Endocrine Unit, Second Propaedeutic Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.Patients were recruited at the Endocrine Unit of the Ddepartment. All the patients who met the eligibility criteria were distributed randomly into 2 groups (control and intervention). Possession of a smart phone and internet access was essential for their inclusion in the protocol. Patients with severe mental diseases and patients with severe commodities like cancer, or renal failure were excluded from the study. The randomization was based on the order of the appointments, with the odd numbers being assigned to the control group and the evens to the intervention group.The measurements of the individuals who participated in the study included the calculation of BMI, current and mean waist circumference, glycosylated hemoglobin, blood pressure, cholesterol, and questionnaires. All the participants were given questionaries concerning quality of life [For the participants in the control group, a traditional health promotion model was followed. Printed materials were sent every 3 months, and in small groups 4 lectures was given at 6th months of the intervention. The clinic’s medical staff performed the lectures, which were approximately 45 min long and included general epidemiological information about diabetes and obesity and the importance of a healthy lifestyle. So the overall implication of the control group participants was calculated to be approximately 24 h a year for both synchronous (lectures) and asynchronous activities (study material).For participants in the intervention group, a health promotion program was created according to the goals of the research. For the purposes of the study a website was developed called The website included two knowledge games: According to the instructions given by the researcher to the intervention group, each patient was required to dedicate at least 15 min twice a week, with a minimum interval of 2 days, to complete the 2 games that were developed (each consisting of 10 questions) as part of the study, and to read the texts posted on the website. The purpose of the games was to provide personalized information to each patient, as incorrect answers in the games would contribute to the creation of a corresponding part of the “wall”. The texts were written by the research team and clinical staff, and the average reading time for each text did not exceed 3 min. In addition to these texts, general information promoting healthy eating, exercise, etc., as well as epidemiological data, were posted on the “wall”. The total engagement of participants in the intervention was approximately 25 h per year.Compliance of participants was monitored weekly through Google Analytics. In case of non-compliance, the principal investigator would send a reminder email or SMS. Access to the specially designed platform was available exclusively to each participant for 12 months and could be used at any time, according to their own preference.In particular, the home page of each participant included:
General articles that were common to the whole group, about a healthy lifestyle, smoking, the importance of physical activity, etc.Customized health information based on the incorrect answers from the games.Personalized tips that emerged from the attitudes and beliefs section.This research protocol was approved by the ethics committee of the University General Hospital “Attikon”, and written consent of the participants was obtained.