Perceptions of Using Multiple Mobile Health Devices to Support Self‐Management Among Adults With Type 2 Diabetes: A Qualitative Descriptive Study

Abstract

This study identified facilitators and barriers pertaining to the use of multiple mobile health (mHealth) devices (Fitbit Alta® fitness tracker, iHealth® glucometer, BodyTrace® scale) that support self-management behaviors in individuals with type 2 diabetes mellitus (T2DM). Design: This qualitative descriptive study presents study participants' perceptions of using multiple mobile devices to support T2DM self-management. Additionally, this study assessed whether participants found visualizations, generated from each participant's health data as obtained from the three separate devices, useful and easy to interpret. Methods: Semistructured interviews were completed with a convenience sample of participants (n = 20) from a larger randomized control trial on T2DM self-management. Interview questions focused on participants' use of three devices to support T2DM self-management. A study team member created data visualizations of each interview participant's health data using RStudio. Results: We identified two themes from descriptions of study participants: feasibility and usability. We identified one theme about visualizations created from data obtained from the mobile devices. Despite some challenges, individuals with T2DM found it feasible to use multiple mobile devices to facilitate engagement in T2DM self-management behaviors. Discussion: As mHealth devices become increasingly popular for diabetes self-management and are integrated into care delivery, we must address issues associated with the use of multiple mHealth devices and the use of aggregate data to support T2DM self-management. Clinical Relevance: Real-time patient-generated health data that are easily accessible and readily available can assist T2DM self-management and

Experiences of activity monitoring and perceptions of mobile Health among working individuals with hip and knee osteoarthritis

“…In this study, the participants' described the importance of having a step goal to strive for. That is also shown in other qualitative studies reporting experiences from individuals with OA, arthritis, and type 2 diabetes (33,39,53).…”

Experiences of activity monitoring and perceptions of digital support among working individuals with hip and knee osteoarthritis – a focus group study

“…Correspondingly, a qualitative study reported that patients with OA or inflammatory arthritis described that the WAT reinforced their motivation and helped them to reach their activity goal [36]. The importance of having a step goal to strive for is also shown in other qualitative studies reporting experiences from individuals with OA, arthritis, and type 2 diabetes [36,42,57]. The participants in this study also experienced that the WAT made them aware of how many steps per day that was optimal for them to avoid worsening of pain.…”

Analyzing the Effectiveness of mHealth to Manage Diabetes Mellitus Among Adults Over 50: A Systematic Literature Review

“… RCT Damayanti et al 47 Older adults, average age 61, 50% male, SMS Improved diet, exercise, blood-glucose testing, and foot care Improved blood-glucose testing, and foot care Quasi-experimental Fu et al 48 Older adults mHealth apps and SMS Improved self-management behaviors Improved self-management behaviors Qualitative Jia et al 49 Older adults mHealth enabled hierarchical diabetes management Overall improvement of HbA1C, but no statistically significant differences in weight changes. Improved HbA1C RCT Lee et al 50 Older adults mHealth apps and coaching Improved self-management behaviors Improved HbA1C RCT Lewinski et al 51 Older adults mHealth No control group Not reported Qualitative Li et al 52 Older adults mHealth app and wearable sensor Intervention group showed larger increase in cardiopulmonary endurance, larger decrease in body fat percentage Increase in cardiopulmonary endurance, decrease in body fat percentage RCT Montero et al 53 Older adults, average age 56.1, 81% Black, 62% female Cellular remote monitoring, Biotel system dashboard + telemedicine visits Statistically significant difference in HbA1C levels between groups as well as user confidence in self-management Improvement in HbA1C True experiment Prabhu et al …”

“…This theme appeared 26/31 (84%) of the occurrences. 29 , 32 , 33 , 35–39 , 41–58 Four other observations were identified, but they could not be fit into themes: “Activity on app increased for those recently diagnosed with diabetes”, “users were dissatisfied with usefulness”, “travel savings were greatly appreciated because the mHealth app prevented them from driving into the clinic”, and “users requested larger fonts and simplified data visualizations.” 30 , 34 , 40 , 52 …”

“… 29 , 31 , 34 , 37–48 , 50–58 Cost of device appeared 22/76 (29%) of the occurrences. 35 , 36 , 38 , 39 , 41–48 , 51 , 52 , 54–58 Must own a text-enabled cell phone 18 , 35–39 , 42 , 43 , 45 , 46 , 48 or a smart cell phone each occurred 11/76 (14%). 41 , 47 , 50–58 Manual entry of data discourages use of the app appeared 2/76 (3%) of the occurrences.…”