Motivating people to sustain healthy lifestyles using persuasive technology: A pilot study of Korean Americans with prediabetes and type 2 diabetes.

There was no control group or random allocation, so the study cannot show that hSHIP caused the changes. Participants received several components at once, including digital messages, community health worker coaching, goal setting, skills training, home monitoring, and medication review, so the effect of any single component cannot be separated. It was a single-center study in one Korean American community, and high retention and adherence may not transfer to other settings. Not all outcomes were significant at every time point: weight in the prediabetes group at 6 months, systolic blood pressure except the moderate diabetes group at 6 months, diastolic blood pressure in the prediabetes group at 6 months, and total cholesterol changes were mixed. Medication stopping or reducing was done after consultation with primary care doctors, so it cannot be credited to the program alone. The sample had limited English proficiency but relatively high education and home ownership, so results may not apply to less resourced or non-Korean-speaking groups.

The authors declared no conflict of interest.

Do not conclude the digital program caused the A1C reductions. The study had no control group, and participants also received community health worker coaching, goal setting, skills training, home monitoring, and medication review with their doctors.