Document Type


Publication Date




Publication Title

JMIR mHealth and uHealth




e40420 (1-16)


Background: Intervention based on family support and risk perception can enhance type 2 diabetes mellitus (T2DM) patients’ self-care activities. In addition, eHealth education is considered to improve family members’ support for patients with T2DM. However, there is little evidence from rigorously designed studies on the effectiveness of an intervention combining these approaches.

Objective: This randomized controlled trial (RCT) aimed to assess the effectiveness of an eHealth family-based health education intervention for patients with T2DM to improve their glucose control, risk perception, and self-care behaviors.

Methods: This single-center, 2-parallel-group RCT was conducted between 2019 and 2020. Overall, 228 patients were recruited from Jiading District, Shanghai, and randomly divided into intervention and control groups. The intervention group received an eHealth family intervention based on community management via WeChat, whereas the control group received usual care. The primary outcome was the glycated hemoglobin (HbA1c) level of the patients with T2DM, and the secondary outcomes were self-management behavior (general and specific diet, exercise, blood sugar testing, foot care, and smoking), risk perception (risk knowledge, personal control, worry, optimism bias, and personal risk), and family support (supportive and nonsupportive behaviors). A 2-tailed paired-sample t test was used to compare the participants at baseline and follow-up within the control and intervention groups. An analysis of covariance was used to measure the intervention effect.

Results: In total, 225 patients with T2DM were followed up for 1 year. After intervention, they had significantly lower HbA1c values (β=–.69, 95% CI –0.99 to –0.39; PP=.003), special diet (β=.71, 95% CI 0.34 to 1.09; PP=.04), foot care (β=1.82, 95% CI 1.23 to 2.42; PPPP=.001), optimism bias (β=.26, 95% CI 0.09 to 0.43; P=.003), and supportive behaviors (β=5.52, 95% CI 4.03 to 7.01; P<.001).

Conclusions: The eHealth family-based intervention improved glucose control and self-care activities among patients with T2DM by aiding the implementation of interventions to improve T2DM risk perceptions among family members. The intervention is generalizable for patients with T2DM using health management systems in community health centers.

Trial Registration: Chinese Clinical Trial Registry ChiCTR1900020736;


© 2023 Yuheng Feng, Yuxi Zhao, Linqi Mao, Minmin Gu, Hong Yuan, Jun Lu, Qi Zhang, Qian Zhao, Xiaohong Li.

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mHealth and uHealth, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.

Original Publication Citation

Feng, Y., Zhao, Y., Mao, L., Gu, M., Yuan, H., Lu, J., Zhang, Q., Zhao, Q., & Li, X. (2023). The effectiveness of an eHealth family-based intervention program in patients with uncontrolled type 2 diabetes mellitus (T2DM) in the community via WeChat: Randomized controlled trial. JMIR mHealth and uHealth, 11, 1-16, Article e40420.