BACKGROUND: Patient engagement and electronic Health technologies (eHealth) play important roles in the self-management of type 2 diabetes mellitus (T2DM), yet few studies have examined the relationship between eHealth use and patient engagement in this population.

OBJECTIVES: To evaluate the role of eHealth in patient engagement (i.e., patient activation, preventive behaviors) and health outcomes among adults with T2DM.

METHODS: Data were obtained from the 2019 US National Health and Wellness Survey, a nationally representative survey of health in the general adult population. Included were adults (18+ years) with a self-reported physician diagnosis of T2DM. Variables included socio-demographics (e.g., race/ethnicity, income), eHealth use, patient activation (Patient Activation Measure [PAM], which evaluates patients’ willingness and ability to manage their own health), preventive behaviors for T2DM (e.g., dietary changes, exercise), and health outcomes (e.g., comorbidities, hypoglycemic events, HbA1c/blood glucose levels). Respondents were categorized by level of eHealth use (0, 1, or ≥2 technologies). Chi-square tests and one-way ANOVAs were used to evaluate the relationship between eHealth use and other study variables.

RESULTS: Analyses included N=5942 adults diagnosed with T2DM. Greater eHealth use (0 vs. 1 vs. ≥2 technologies) was associated with greater patient activation (PAM=62.3 vs. 62.7 vs. 64.5), more frequent exercise (5.1 vs. 6.6 vs. 8.1 days/month), more preventive behaviors (2.5 vs. 2.9 vs. 3.2 total behaviors), and lower BMI (33.4 vs. 32.9 vs. 32.4 kg/m²) (all, p<0.01). Greater eHealth use was also associated with higher self-reported HbA1c levels (7.0% vs. 7.0% vs. 7.3%), a greater number of comorbidities (4.1 vs. 4.2 vs. 4.6), and a higher likelihood of having experienced a hypoglycemic event in the past year (60.4% vs. 66.6% vs. 69.2%) (all, p<0.001). all, p<0.001).

CONCLUSIONS: eHealth use is positively associated with patient activation and preventive lifestyle behaviors. Findings suggest that experiencing adverse health outcomes may motivate patients to use more eHealth technologies.