User-centered design of a web-based self-management site for individuals with type 2 diabetes – providing a sense of control and community

Abstract

BackgroundTo design and test a web-based self-management tool for patients with type 2 diabetes for its usability and feasibility.MethodsAn evidence-based, theory-driven website was created for patients with type 2 diabetes. Twenty-three patients with type 2 diabetes aged ≥ 25 years were recruited from 2 diabetes care centers in Toronto, Canada. We employed focus group methodology to assess acceptability, sustainability, strengths and weaknesses of the self-management website. Based on these results, revisions were made to the website. Three cycles of individual usability testing sessions using cognitive task analysis were conducted with patients with type 2 diabetes. Revisions to the website were made based on results from this testing.ResultsWe identified five themes concerning participants’ experiences of health care and related unmet needs: 1) Desire for information and for greater access to timely and personalized care to gain a sense of control of their disease; 2) Desire for community (sharing experiences with others) to fulfill practical and emotional needs; 3) Potential roles of an online self-management website in self-empowerment, behavior change, self-management and health care delivery; 4) Importance of a patient-centered perspective in presenting content (e.g. common assumptions, medical nomenclature, language, messaging, sociocultural context); 5) Barriers and facilitators to use of a self-management website (including perceived relevance of content, incorporation into usual routine, availability for goal-directed use, usability issues).ConclusionsParticipants outlined a series of unmet health care needs, and stated that they wanted timely access to tailored knowledge about their condition, mechanisms to control and track their disease, and opportunities to share experiences with other patients. These findings have implications for patients with type 2 diabetes of diverse ages, socioeconomic backgrounds, and disease severity, as well as to the design of other computer-based resources for chronic disease management.

A web-based intervention to support self-management of patients with type 2 diabetes mellitus: effect on self-efficacy, self-care and diabetes distress

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Evaluating the Effect of Web-Based Iranian Diabetic Personal Health Record App on Self-Care Status and Clinical Indicators: Randomized Controlled Trial

“…The proper sample size is essential for usability testing, so that research, which found that up to 80% of usability has issues, can be determined with 5 to 8 participants [51]. Based on our usability testing, Jakob Nielsen's general principles for interaction design such as error prevention, consistency and standards, aesthetic and minimalist design, recognition rather than recall, and help and documentation are required to be considered, and which were addressed on our app through iterative refinement process [52]. One of the most important cases in intervention implementation is usability testing [53] but this is often neglected, with up to 60% of diabetes-related websites having a minimum of 4 usability errors.…”

A Conceptual Model on Websites Design Features for Self-Management of Chronic-Diseases Patients

“…Improving access to health information does not just involve citations and references, but the information need to be filtered and synthesized. Information overload from the website potentially could distract people from the website and therefore reduce the website usage [44]. Information on the websites should not only be personalized to health background, but also personalization should be made according to user`s location, culture and language [45].…”

“…Information on the websites should not only be personalized to health background, but also personalization should be made according to user`s location, culture and language [45]. User should be able to see the overview of the website content, and then select more detail information personalized to their individual needs [29], [44]. Personalized websites were evident to increase patients` satisfaction, improve understanding of disease and increase ability to involve in managing diseases [46].…”