User Retention and Engagement With a Mobile App Intervention to Support Self-Management in Australians With Type 1 or Type 2 Diabetes (My Care Hub): Mixed Methods Study

Abstract

Background Mobile health apps are commonly used to support diabetes self-management (DSM). However, there is limited research assessing whether such apps are able to meet the basic requirements of retaining and engaging users. Objective This study aimed to evaluate participants’ retention and engagement with My Care Hub, a mobile app for DSM. Methods The study employed an explanatory mixed methods design. Participants were people with type 1 or type 2 diabetes who used the health app intervention for 3 weeks. Retention was measured by completion of the postintervention survey. Engagement was measured using system log indices and interviews. Retention and system log indices were presented using descriptive statistics. Transcripts were analyzed using content analysis to develop themes interpreted according to the behavioral intervention technology theory. Results Of the 50 individuals enrolled, 42 (84%) adhered to the study protocol. System usage data showed multiple and frequent interactions with the app by most of the enrolled participants (42/50, 84%). Two-thirds of participants who inputted data during the first week returned to use the app after week 1 (36/42, 85%) and week 2 (30/42, 71%) of installation. Most daily used features were tracking of blood glucose (BG; 28/42, 68%) and accessing educational information (6/42, 13%). The interview results revealed the app’s potential as a behavior change intervention tool, particularly because it eased participants’ self-care efforts and improved their engagement with DSM activities such as BG monitoring, physical exercise, and healthy eating. Participants suggested additional functionalities such as extended access to historical analytic data, automated data transmission from the BG meter, and periodic update of meals and corresponding nutrients to further enhance engagement with the app. Conclusions The findings of this short-term intervention study suggested acceptable levels of participant retention and engagement with My Care Hub, indicating that it may be a promising tool for extending DSM support and education beyond the confines of a physical clinic.

Efficacy and Acceptability of My Care Hub Mobile App to Support Self-Management in Australians with Type 1 or Type 2 Diabetes

“…The promising result of this pilot MCH app project which shows preliminary efficacy, acceptability (as reported in this study) as well as good level of retention and engagement with the intervention [37] will require further confirmation using long term controlled trials in the future. An adaptive randomized controlled trial design [75] may be best suited due to the rapidly evolving nature of mHealth.…”

“…Details of the study methodology have been fully described in a previous publication [37]. In brief, this pilot study (conducted in August to October 2019) employed a mixed-method sequential explanatory design, where participants accessed the intervention over a three-week period and communicated their perceptions through surveys and interviews.…”

The “Worktivity” mHealth intervention to reduce sedentary behaviour in the workplace: a feasibility cluster randomised controlled pilot study

“…Participants ignoring digital intervention content sent to encourage SB reduction has been reported elsewhere [37]. Mobile app usage tends to have a natural time course with evidence suggesting that mobile app usage is initially high but follows a sharp decline in as little as three weeks [43]. This highlights the engagement struggles that are inherent in [44].…”

Evaluating a Strengths-Based mHealth Tool (MyStrengths): Explorative Feasibility Trial

“…A decline in use over time is, however, typical in eHealth and mHealth [ 97 ]. In their study of a mHealth tool for diabetes management, Adu and Colleagues [ 98 ] found that use steeply declined when reminders were disabled after 2 of the 3 weeks of the trial period. As also supported by participants during the interviews, it is likely that notifications or reminders from the MyStrengths apps could thus have contributed to maintaining user engagement both in terms of duration and frequency of use.…”