Effects of an e-Coach Program on the Knowledge, Attitude, and Practice of Patients Self-administering Their First Insulin Injection: Quasi-Experimental Study.

Authors

Mengtian Zhang, Lishuang Zhao, Hui Huang, Zaixiang Tang, Liping Tan, Xiaoyan Zhang, Fengmei Tian

Published in

JMIR formative research. Volume 10. Pages e83339. Jul 10, 2026. Epub Jul 10, 2026.

Abstract

The current level of insulin knowledge, attitudes, and practices of patients self-administering their first insulin injection needs to be improved. There is an emerging need to develop a program for patients self-administering their first insulin injection based on the e-coach model derived from the temporal self-regulation theory.
This study aimed to examine the effectiveness of a temporal self-regulation theory-based e-coach program on the knowledge, attitude, and practice of patients self-administering their first insulin injection.
A quasi-experimental research design was used, and the study adhered to the Transparent Reporting of Evaluations with Nonrandomized Designs statement. The study was developed and evaluated in a level IIIA hospital between May 1 and December 1, 2022, in Suzhou, Jiangsu Province, China. The control group received care as usual. The intervention group received a self-regulation program called the e-coach program: the "COACHING" implementation steps. The insulin attitude scores and insulin knowledge-practice scores were compared using repeated-measures ANOVA. In particular, given that baseline blood glucose monitoring frequency differed significantly between the 2 groups, thereby compromising their comparability, a repeated-measures analysis of covariance (ANCOVA) was performed, with monitoring frequency entered as a covariate. This approach was adopted to enhance the scientific rigor of the findings and reduce potential bias.
In total, 86 patients were enrolled; of these, 75 patients were followed up, 40 in the experimental group and 35 in the control group. Repeated-measures ANOVA results revealed statistically significant between-group effects (F1,73=47.67, P<.001), time effects (F2,146=5.02, P=.02), and interaction effects (F2,146=4.75, P=.03) for total insulin knowledge scores in both groups. In both groups, statistically significant between-group effects (F1,73=16.04, P<.001) and interaction effects (F2,146=12.52, P<.001) were observed for total insulin attitude scores, but time effects (F2,146=2.47, P=.11) were not statistically significant. In both groups, statistically significant between-group effects (F1,73=0.66, P=.004) were observed for total insulin practice scores, but time effects (F2,146=1.05, P=.35) and interaction effects (F2,146=2.82, P=.08) were not statistically significant.
The e-coach program based on the TST was effective in improving insulin knowledge and insulin attitude but was not proven effective for insulin practice. A longer follow-up study is needed to uncover its long-term benefits on clinical outcomes.

PMID:
42430231
Bibliographic data and abstract were imported from PubMed on 11 Jul 2026.

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