The Danish healthcare system seems responsive to health across different population groups. We found no systematic pattern of inequity in use of free-of-charge healthcare services, but for dentists, who require co-payment, we found inequity among immigrants and descendents compared with ethnic Danes.
BackgroundNumerous mobile applications have been developed to support diabetes-self-management. However, the majority of these applications lack a theoretical foundation and the involvement of people with diabetes during development. The aim of this study was to develop and test a mobile application (app) supporting diabetes self-management among people with newly diagnosed type 2 diabetes using design thinking.MethodsThe app was developed and tested in 2015 using a design-based research approach involving target users (individuals newly diagnosed with type 2 diabetes), research scientists, healthcare professionals, designers, and app developers. The research approach comprised three major phases: inspiration, ideation, and implementation. The first phase included observations of diabetes education and 12 in-depth interviews with users regarding challenges and needs related to living with diabetes. The ideation phrase consisted of four interactive workshops with users focusing on app needs, in which ideas were developed and prioritized. Finally, 14 users tested the app over 4 weeks; they were interviewed about usability and perceptions about the app as a support tool.ResultsA multifunctional app was useful for people with newly diagnosed type 2 diabetes. The final app comprised five major functions: overview of diabetes activities after diagnosis, recording of health data, reflection games and goal setting, knowledge games and recording of psychological data such as sleep, fatigue, and well-being. Users found the app to be a valuable tool for support, particularly for raising their awareness about their psychological health and for informing and guiding them through the healthcare system after diagnosis.ConclusionsThe design thinking processes used in the development and implementation of the mobile health app were crucial to creating value for users. More attention should be paid to the training of professionals who introduce health apps.Trial registration: Danish Data Protection Agency: 2012-58-0004. Registered 6 February 2016.
BackgroundPsychosocial and behavioural aspects of diabetes may differ according to diabetes type. This study compared people with type 1 and type 2 diabetes with respect to social relations (cohabitation status, contact with the social network and social support) and health behaviours (diet and physical activity). Furthermore, we examined whether potential differences in health behaviour between people with type 1 and type 2 diabetes were influenced by education level and social relations.MethodsWe conducted two cross-sectional surveys consisting of people with type 2 diabetes (N = 1081) and type 1 diabetes (N = 2419) from a specialist diabetes clinic. Gender-stratified stepwise multiple regression models assessed differences by diabetes type and other variables of interest.ResultsSignificant associations were found between diabetes type and social network, social support and health behaviour. No differences were observed regarding cohabitation status. People with type 2 diabetes were less physically active, less likely to follow recommended diet (men), had fewer contacts with family and friends and were less certain of counting on help in case of severe illness than people with type 1 diabetes. No impact of education level, social network and social support were observed concerning differences in health behaviours by diabetes type; however, in women, the association between physical activity and diabetes type was not significant after adjustment for social relations and education level.ConclusionsPeople with type 2 diabetes had less contact with the social network, less certainty about support in case of severe illness and fewer healthy behaviours than people with type 1 diabetes. It may be important to draw attention to differences in health behaviours and social relations between people with type 1 and type 2 diabetes in diabetes care, patient education and support initiatives.
The relationship between migration and health is complex, yet, immigrant-related inequalities in health are largely influenced by socioeconomic position. Drawing upon previous findings, this paper discusses issues to consider when measuring and applying socioeconomic position in quantitative immigrant health research. When measuring socioeconomic position, it is important to be aware of four aspects: (1) there is a lack of clarity about how socioeconomic position should be measured; (2) different types of socioeconomic position may be relevant to immigrants compared with the native-born population; (3) choices of measures of socioeconomic position in quantitative analyses often rely on data availability; and (4) different measures of socioeconomic position have different effects in population groups. Therefore, caution should be used in the collection, presentation, analyses, and interpretation of data and researchers need to display their proposed conceptual models and data limitations as well as apply different approaches for analyses.
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