The OnTrack Diabetes web-based program for type 2 diabetes and dysphoria self-management: A randomized controlled trial protocol

Cassimatis, Mandy, Kavanagh, David J., Hills, Andrew P., Smith, Anthony C., Scuffham, Paul A., Gericke, Christian, & Parham, Sophie (2015) The OnTrack Diabetes web-based program for type 2 diabetes and dysphoria self-management: A randomized controlled trial protocol. Journal of Medical Internet Research, 4(3), e97.

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Background: The prevalence of type 2 diabetes is rising with the majority of patients practicing inadequate disease self-management. Depression, anxiety, and diabetes-specific distress present motivational challenges to adequate self-care. Health systems globally struggle to deliver routine services that are accessible to the entire population, in particular in rural areas. Web-based diabetes self-management interventions can provide frequent, accessible support regardless of time and location

Objective: This paper describes the protocol of an Australian national randomized controlled trial (RCT) of the OnTrack Diabetes program, an automated, interactive, self-guided Web program aimed to improve glycemic control, diabetes self-care, and dysphoria symptoms in type 2 diabetes patients.

Methods: A small pilot trial is conducted that primarily tests program functionality, efficacy, and user acceptability and satisfaction. This is followed by the main RCT, which compares 3 treatments: (1) delayed program access: usual diabetes care for 3 months postbaseline followed by access to the full OnTrack Diabetes program; (2) immediate program: full access to the self-guided program from baseline onward; and (3) immediate program plus therapist support via Functional Imagery Training (FIT). Measures are administered at baseline and at 3, 6, and 12 months postbaseline. Primary outcomes are diabetes self-care behaviors (physical activity participation, diet, medication adherence, and blood glucose monitoring), glycated hemoglobin A1c (HbA1c) level, and diabetes-specific distress. Secondary outcomes are depression, anxiety, self-efficacy and adherence, and quality of life. Exposure data in terms of program uptake, use, time on each page, and program completion, as well as implementation feasibility will be conducted.

Results: This trial is currently underway with funding support from the Wesley Research Institute in Brisbane, Australia.

Conclusions: This is the first known trial of an automated, self-guided, Web-based support program that uses a holistic approach in targeting both type 2 diabetes self-management and dysphoria. Findings will inform the feasibility of implementing such a program on an ongoing basis, including in rural and regional locations.

Impact and interest:

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ID Code: 79298
Item Type: Journal Article
Refereed: Yes
Keywords: diabetes mellitus, Type 2; depression; anxiety; self care; Internet; Web; online systems; intervention studies; randomized controlled trial; therapy, computer-assisted
DOI: 10.2196/resprot.2813
ISSN: 1439-4456
Subjects: Australian and New Zealand Standard Research Classification > PSYCHOLOGY AND COGNITIVE SCIENCES (170000) > PSYCHOLOGY (170100) > Health Clinical and Counselling Psychology (170106)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Exercise & Nutrition Sciences
Current > Schools > School of Psychology & Counselling
Copyright Owner: Copyright 2015 Mandy Cassimatis, David John Kavanagh, Andrew Paul Hills, Anthony Carl Smith, Paul A Scuffham, Christian Gericke, Sophie Parham. Originally published in JMIR Research Protocols (, 04.08.2015.
Copyright Statement: This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, 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.
Deposited On: 16 Dec 2015 01:57
Last Modified: 16 Dec 2015 21:40

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