DSpace Community:

Culturally adapted digital cognitive behavioral therapy for insomnia in South Korea-a double-blind randomized controlled trial

2026-06-01T00:00:00Z

Title: Culturally adapted digital cognitive behavioral therapy for insomnia in South Korea-a double-blind randomized controlled trial Authors: Kabbani, Abdallah; Passler, Mona; Park, Kyungmee; Lee, Eun; Lee, Yujin; Jansen, Marc; Moon, Daa Un Abstract: Culturally adapted digital cognitive behavioral therapy for insomnia (dCBT-I) has the potential to enhance engagement and treatment outcomes, yet its efficacy compared to patient education (PE) remains understudied. This multicenter, double-blind, randomized controlled trial evaluated dCBT-I versus a PE application in individuals with chronic insomnia in South Korea. The primary outcome was Insomnia Severity Index (ISI) scores. Secondary and exploratory outcomes included sleep diary measures, self-reported scales assessing sleep quality, maladaptive sleep-related beliefs, daytime sleepiness, anxiety, and depressive symptoms. Of 52 participants (mean [SD] age, 38.6 [12.4] years; 64% female), 27 were randomized to digital cognitive behavioral therapy for insomnia (dCBT-I) and 25 to patient education (PE). Post-intervention data were available for 50 participants (dCBT-I: n = 25; PE: n = 25). Further exploratory 3-month follow-up data were available for 25 participants in the dCBT-I group. Both groups showed significant within-group improvements in ISI scores, with no significant between-group differences. The dCBT-I group demonstrated greater improvements in sleep quality (PSQI: Cohen = 1.02, P = .012) and maladaptive sleep-related beliefs (DBAS-16: Cohen d = 1.24, P = .003). Sleep diary data indicated significant reductions in sleep onset latency (Cohen d =-0.15, P = .005) and increases in sleep efficiency (Cohen d = 0.16, P = .003) in the dCBT-I group. Adherence to dCBT-I was high (89% completed all modules), and satisfaction ratings were higher than in the PE group. While both interventions improved insomnia severity, dCBT-I provided additional benefits in sleep-related outcomes, supporting the feasibility and potential clinical utility of this culturally adapted intervention. Clinical Trial Registration: https://clinicaltrials.gov/study/NCT05822999, ClinicalTrials.gov (NCT05822999).

Single-arm longitudinal study to assess changes in insula functional connectivity following a mobile-based lifestyle intervention in adults with metabolic abnormalities

2026-02-01T00:00:00Z

Title: Single-arm longitudinal study to assess changes in insula functional connectivity following a mobile-based lifestyle intervention in adults with metabolic abnormalities Authors: Lee, Deokjong; Park, Kyung Mee; Kim, Jihye; Ko, Sin Young; Lee, Byeonghee; Park, Chae Jung; Kim, Kyoung Min; Park, Jin Young Abstract: Backgrounds: Mobile-based lifestyle intervention has been widely used to improve behavior for obesity and overweight. This study targeting adults with metabolic abnormalities aims to identify neural correlates related to weight loss due to mobile-based lifestyle intervention. Methods: We conducted 8 weeks of mobile-based lifestyle intervention for 37 adults with metabolic abnormalities, including overweight. Participants underwent physical measurements, blood tests, psychometric questionnaires, and resting-state functional magnetic resonance imaging (fMRI) scans before and after the mobilebased intervention. For the resting-state fMRI, brain regions that showed changes in functional connectivity (FC) before and after mobile-based intervention were explored. Seed-based FC analysis was performed focusing on the subregions of the insular cortex. Results: Participants significantly reduced body mass index (BMI) after mobile-based intervention. The degree of BMI reduction was significantly correlated with compliance with the intervention. In resting fMRI, FC of the posterior insula with the bilateral inferior parietal lobule and the left ventrolateral prefrontal cortex were enhanced after mobile-based intervention. The increase in FC between the posterior insula and the inferior posterior lobule showed a significant correlation with the decrease in binge eating scale scores. Conclusion: The mobile-based lifestyle intervention significantly reduced weight and alleviated binge eating in adults with metabolic abnormalities. FC enhancement between the posterior insula and the frontoparietal regions was also observed after mobile-based lifestyle intervention. The relationship between these FC changes and strengthening weight control through mobile-based lifestyle intervention should be investigated through future research.

Impact of Hospitalist-Led Care on Glycemic Control Among Hospitalized Adults with Diabetes in Korea

2026-01-01T00:00:00Z

Title: Impact of Hospitalist-Led Care on Glycemic Control Among Hospitalized Adults with Diabetes in Korea Authors: Lee, Soohyun; Kim, Jaewoong; Shin, Areum; Jo, Sunhee; Kim, Chul Sik; Kyong, Taeyoung; 이수현 Abstract: Background/Objectives: Hyperglycemia in hospitalized patients is associated with an increased risk of complications, morbidity, mortality, and healthcare costs, regardless of a prior diagnosis of diabetes. The hospitalist system can improve various outcomes, including length of stay, medical costs, patient satisfaction, and mortality rates. However, the effects of hospitalist care on blood glucose control in hospitalized patients remain unclear. This study aimed to assess the specific effects of hospitalist services on blood glucose control in hospitalized patients, with a focus on hyperglycemia management and patient outcomes. Methods: This retrospective study reviewed the electronic medical records of patients diagnosed with diabetes at Yonsei Severance Hospital in Yongin, between March 2020 and February 2022. It included adults aged >= 20 years who were hospitalized and had undergone blood glucose measurements during hospitalization. Glycemic control was assessed using hemoglobin A1c, and the blood glucose levels were measured four times daily during hospitalization. Variability was quantified using the coefficient of variation and compared between hospitalist-led and traditional specialty care groups, over a 14-day hospitalization period. Results: Despite a higher baseline risk profile, patients receiving hospitalist-led care experienced significantly more stable glycemic variability over time (p = 0.002), suggesting better inpatient glucose management than those receiving traditional specialty care. Conclusions: Hospitalist-led care was associated with more stable glycemic variability over time in hospitalized patients with diabetes, despite a higher baseline burden of comorbidities and poorer glycemic control at admission.

Impact of Adherence to Digital Cognitive Behavioral Therapy for Insomnia Effectiveness

2025-10-01T00:00:00Z

Title: Impact of Adherence to Digital Cognitive Behavioral Therapy for Insomnia Effectiveness Authors: Lee, Suonaa; Park, Kyung Mee; Lee, Do Hyun; Choi, Eun Chae; Lee, Yujin; Lee, Eun Abstract: Purpose: Although digital cognitive behavioral therapy for insomnia (dCBT-I) offers a promising solution to the accessibility limitations of traditional face-to-face CBT-I, few studies have examined dCBT-I against a sham app and adherence issues remain. This study assessed the efficacy of dCBT-I compared with a sham app and investigated whether adherence predicts sleep outcomes. Materials and Methods: In this combined analysis of two multicenter, double-blind, sham-controlled randomized controlled trials, 120 patients with insomnia were randomized to use the dCBT-I app (n=60) or a sham app (n=60). The primary outcome was the change in sleep efficiency (SE) from baseline after the 6-week intervention. The relationship between adherence to sleep restriction therapy (SRT) and sleep outcomes post-intervention was assessed. Results: After adjusting for age, sex, sleep medication use, and baseline levels of each outcome variable, the dCBT-I group demonstrated better treatment outcomes than the sham app group, with significant improvements of 7.69% in SE [95% confidence interval (CI), 3.09% to 12.30%; p=0.001], -16.77 minutes in sleep onset latency (95% CI, -31.48 to -2.06 minutes; p=0.026), and -0.97 in dysfunctional beliefs about sleep (95% CI, -1.46 to -0.48; p<0.001) from baseline. Poorer adherence to SRT was associated with reduced SE (p=0.006) and increased nighttime wakefulness (p=0.002) after controlling for age, sex, years of education, and the baseline value of each outcome variable. Conclusion: This combined analysis demonstrates the efficacy of dCBT-I in improving sleep outcomes compared with a sham app and highlights the role of adherence to SRT in enhancing treatment efficacy. The two studies were registered with ClinicalTrials.gov (NCT05822999,NCT05809544).