DOI: 10.1177/20552076231220791 ISSN: 2055-2076

Investigating the effects of digital foot self-management program on enhancing self-efficacy and self-care behavior among community-dwelling older adults with type 2 diabetes: A randomized controlled trial

Shu-Ming Chen, Chiung-Jung (Jo) Wu
  • Health Information Management
  • Computer Science Applications
  • Health Informatics
  • Health Policy


Diabetic foot self-management intervention programs have been proven to positively influence individuals’ behaviors in preventing diabetic foot ulcers. Using digital technologies to deliver programs can facilitate compliance with diabetes self-management programs. However, few studies have focused on the effects of such digital programs on improving the self-efficacy and behaviors of older adults with type 2 diabetes in the community.


To evaluate the effects of a digital foot self-management program on self-efficacy, self-care behavior, and Hemoglobin A1c levels.


A single-blinded, randomized controlled trial was conducted.


The intervention program comprised a 4-week digital foot care program with one face-to-face education session, phone calls once weekly, and LINE messages (social media) three times per research nurse and a follow-up of three months. Patients in the control group received routine care.


A total of 100 participants ( n = 50 in the control and n = 50 in the intervention groups) completed the study with a mean age of 67.55 (SD = 11.17). The results showed significant improvements in self-efficacy ( F = 2187.24, p < 0.01) and self-care behavior ( F = 614.71, p < 0.01) in foot care between the groups. The Hemoglobin A1c levels showed a 0.41% reduction over time in the experimental group ( t = −3.759; p < 0.01), whereas the control group showed a 0.06% reduction ( t = −0.797, p > 0.05).


The newly developed digital foot self-management program was effective in community-dwelling older adult patients with type 2 diabetes.

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