The effect of mHealth program on behavior modification and health outcomes among patients with diabetes: A randomized controlled trial study


technology-based intervention
mobile health application
diabetes mellitus
health promotion
behavior modification

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Firdaus, M. K. Z. H., Jittanoon, P., Boonyasopun, U., & Che Hasan, M. K. (2023). The effect of mHealth program on behavior modification and health outcomes among patients with diabetes: A randomized controlled trial study. Belitung Nursing Journal, 9(5), 437–447.
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Accepted for publication: 2023-09-23
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Background: Mobile health presents a promising alternative in the digital era. Mobile health apps (mHealth), when combined with the concept of self-management, are considered one of the methods for incorporating technology-based interventions into the healthcare system.

Objective: This study aimed to determine the effect of mHealth (specifically, the Diabetic Care App) on foot care behavior, dietary behavior, foot condition, and fasting blood glucose levels among patients with uncontrolled diabetes mellitus.

Methods: A single randomized controlled trial was conducted at a government-run primary clinic in Northern Malaysia, involving 58 patients with uncontrolled diabetes who were assigned to two groups. The intervention group received the Diabetic Care App, attended a 2-hour face-to-face session, and was included in a WhatsApp group, while the control group received standard care. Relevant assessments were conducted for both groups in Week 1 and Week 5. The study was conducted from February 2020 to November 2020, and parametric and non-parametric statistics were used for data analysis.

Results: Pretest-posttest comparisons in both groups revealed significant findings for foot care behavior (p <0.01), dietary behavior (p <0.01), and foot condition (p <0.01), except for fasting blood glucose levels. In inter-group comparisons, a significant difference was observed only in foot care behavior (p <0.01) and dietary behavior (p <0.01).

Conclusion: The results indicate that technology-based interventions are beneficial for modifying behavior, specifically in terms of foot care and dietary behavior, in this study. The study highlights the applicability of mHealth for nurses in patient education and self-management of chronic conditions. Future research should explore app utilization among patients with chronic conditions.


Clinical trial registration number: NCT04260100

(registered at

Supporting Agencies

This work was supported by the Higher Education Research Promotion and Thailand’s Education Hub for the Southern region of ASEAN Countries Project Office of the Higher Education Commission


Copyright (c) 2023 Mohd Khairul Zul Hasymi Firdaus, Piyanuch Jittanoon, Umaporn Boonyasopun, Muhammad Kamil Che Hasan

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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Declaration of Conflicting Interest

The authors declare there is no conflict of interest.


The authors would like to thank the clinic and participants for their valuable time spent on this study.

Authors’ Contributions

MKZF: conceptualized, literature search, designed, analyzed, and drafted the study according to the format. PJ: contributed to conceptualization and analysis, reviewed and supported concepts with intellectual content and literature search. UB: supported with intellectual content and literature search. MKCH: supported with intellectual content, drafted and inspected the final draft of the manuscript. All authors substantially contributed with equal efforts until approval of the final.

Data Availability

Available upon reasonable request with the corresponding author.

Declaration of Use of AI in Scientific Writing

Nothing to disclose.


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