What Do Adults with Type 2 Diabetes Want from the “Perfect” App? Results from the Second Diabetes MILES: Australia (MILES-2) Study

Baptista, Shaira; Trawley, Steven; Pouwer, Frans; Oldenburg, Brian; Wadley, Greg; Speight, Jane

doi:10.1089/dia.2019.0086

Cited by 39 publications

(42 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our findings corroborate previous research on the benefits of personalization and tailoring while providing preliminary evidence on how app preferences can be personalized based on a specific user characteristic—diabetes self-management style [ 21 , 26 , 36 , 40 ]. For example, participants expressing more self-directed styles value tools that assist them in making independent, informed decisions about their own care.…”

Section: Discussionsupporting

confidence: 88%

User Experiences With a Type 2 Diabetes Coaching App: Qualitative Study

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background Diabetes self-management apps have the potential to improve self-management in people with type 2 diabetes (T2D). Although efficacy trials provide evidence of health benefits, premature disengagement from apps is common. Therefore, it is important to understand the factors that influence engagement in real-world settings. Objective This study aims to explore users’ real-world experiences with the My Diabetes Coach (MDC) self-management app. Methods We conducted telephone-based interviews with participants who had accessed the MDC self-management app via their smartphone for up to 12 months. Interviews focused on user characteristics; the context within which the app was used; barriers and facilitators of app use; and the design, content, and delivery of support within the app. Results A total of 19 adults with T2D (8/19, 42% women; mean age 60, SD 14 years) were interviewed. Of the 19 interviewees, 8 (42%) had T2D for <5 years, 42% (n=8) had T2D for 5-10 years, and 16% (n=3) had T2D for >10 years. In total, 2 themes were constructed from interview data: (1) the moderating effect of diabetes self-management styles on needs, preferences, and expectations and (2) factors influencing users’ engagement with the app: one size does not fit all. Conclusions User characteristics, the context of use, and features of the app interact and influence engagement. Promoting engagement is vital if diabetes self-management apps are to become a useful complement to clinical care in supporting optimal self-management. Trial Registration Australia New Zealand Clinical Trials Registry CTRN126140012296; URL https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366925&isReview=true

show abstract

Section: Discussionsupporting

confidence: 88%

User Experiences With a Type 2 Diabetes Coaching App: Qualitative Study

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…Despite the growing number of studies using mobile technologies for diabetes management [ 10 , 11 , 15 ], the effectiveness of introducing apps to people with T2DM to support their self-management at large scale remains uncertain given the generally poor quality of apps [ 12 , 13 , 32 ], unmet consumer needs [ 14 ], and studies lacking robust designs with long-term evaluations [ 10 , 15 ]. The MDC program is highly innovative with its conversational element.…”

Section: Discussionmentioning

confidence: 99%

“…Most commercially available apps employ limited use of behavior change techniques and inadequate features, other than self-monitoring [ 12 , 13 ]. Furthermore, people with diabetes expect apps to be engaging; incorporating multiple functions; and covering a broad range of content, including psychological and emotional support [ 14 ]. Although some recent systematic reviews and meta-analyses have indicated a modest effect for app-based interventions to support diabetes self-management [ 10 , 11 , 15 ], there still remains a great deal of uncertainty about their feasibility, acceptability, and effectiveness in the real world [ 10 , 15 - 17 ].…”

Section: Introductionmentioning

confidence: 99%

My Diabetes Coach, a Mobile App–Based Interactive Conversational Agent to Support Type 2 Diabetes Self-Management: Randomized Effectiveness-Implementation Trial

Gong¹,

Baptista²,

Russell³

et al. 2020

J Med Internet Res

Self Cite

View full text Add to dashboard Cite

Background Delivering self-management support to people with type 2 diabetes mellitus is essential to reduce the health system burden and to empower people with the skills, knowledge, and confidence needed to take an active role in managing their own health. Objective This study aims to evaluate the adoption, use, and effectiveness of the My Diabetes Coach (MDC) program, an app-based interactive embodied conversational agent, Laura, designed to support diabetes self-management in the home setting over 12 months. Methods This randomized controlled trial evaluated both the implementation and effectiveness of the MDC program. Adults with type 2 diabetes in Australia were recruited and randomized to the intervention arm (MDC) or the control arm (usual care). Program use was tracked over 12 months. Coprimary outcomes included changes in glycated hemoglobin (HbA1c) and health-related quality of life (HRQoL). Data were assessed at baseline and at 6 and 12 months, and analyzed using linear mixed-effects regression models. Results A total of 187 adults with type 2 diabetes (mean 57 years, SD 10 years; 41.7% women) were recruited and randomly allocated to the intervention (n=93) and control (n=94) arms. MDC program users (92/93 participants) completed 1942 chats with Laura, averaging 243 min (SD 212) per person over 12 months. Compared with baseline, the mean estimated HbA1c decreased in both arms at 12 months (intervention: 0.33% and control: 0.20%), but the net differences between the two arms in change of HbA1c (−0.04%, 95% CI −0.45 to 0.36; P=.83) was not statistically significant. At 12 months, HRQoL utility scores improved in the intervention arm, compared with the control arm (between-arm difference: 0.04, 95% CI 0.00 to 0.07; P=.04). Conclusions The MDC program was successfully adopted and used by individuals with type 2 diabetes and significantly improved the users’ HRQoL. These findings suggest the potential for wider implementation of technology-enabled conversation-based programs for supporting diabetes self-management. Future studies should focus on strategies to maintain program usage and HbA1c improvement. Trial Registration Australia New Zealand Clinical Trials Registry (ACTRN) 12614001229662; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12614001229662

show abstract

“…From the patient perspective, studies have identified that people with T2DM do not believe apps will be useful, resulting in low uptake [12, 16–18]. Recent data from an Australian qualitative study demonstrated that people with T2DM would prefer an app to address the practical aspects of diabetes self-management and to improve, and reduce the cognitive burden of self-management [17]. Further studies using focus groups for app development have highlighted the importance of blood glucose monitoring, dietary tracking, education, interactive content, peer support and realistic goal setting [19–22].…”

Section: Introductionmentioning

confidence: 99%

Mobile phone applications and their use in the self-management of Type 2 Diabetes Mellitus: a qualitative study among app users and non-app users

Jeffrey

Bagala

Creighton

et al. 2019

Diabetol Metab Syndr

156

View full text Add to dashboard Cite

Background Mobile phone applications (apps) have been shown to successfully facilitate the self-management of chronic disease. This study aims to evaluate firstly the experiences, barriers and facilitators to app usage among people with Type 2 Diabetes Mellitus (T2DM) and secondly determine recommendations to improve usage of diabetes apps. Methods Participants were aged ≥ 18 years with a diagnosis of T2DM for ≥ 6 months. Semi-structured phone-interviews were conducted with 16 app and 14 non-app users. Interviews were based on the Technology Acceptance Model, Health Information Technology Acceptance Model (HITAM) and the Mobile Application Rating Scale. Data were analysed using deductive content analysis. Results Most app-users found apps improved their T2DM self-management and health. The recommendation of apps by health professionals, as well as positive interactions with them, improved satisfaction; however, only a minority of patients had practitioners involved in their app use. All non-app users had never had the concept discussed with them by a health professional. Facilitators to app use included the visual representation of trends, intuitive navigation and convenience (for example, discretion and portability). Barriers to app use were participant’s lack of knowledge and awareness of apps as healthcare tools, perceptions of disease severity, technological and health literacy or practical limitations such as rural connectivity. Factors contributing to app use were classified into a framework based on the Health Belief Model and HITAM. Recommendations for future app design centred on educational features, which were currently lacking (e.g. diabetes complications, including organ damage and hypoglycaemic episodes), monitoring and tracking features (e.g. blood glucose level monitoring with trends and dynamic tips and comorbidities) and nutritional features (e.g. carbohydrate counters). Medication reminders were not used by participants. Lastly, participants felt that receiving weekly text-messaging relating to their self-management would be appropriate. Conclusions The incorporation of user-centred features, which engage T2DM consumers in self-management tasks, can improve health outcomes. The findings may guide app developers and entrepreneurs in improving app design and usability. Given self-management is a significant factor in glycaemic control, these findings are significant for GPs, nurse practitioners and allied health professionals who may integrate apps into a holistic management plan which considers strategies outside the clinical environment.

show abstract

What Do Adults with Type 2 Diabetes Want from the “Perfect” App? Results from the Second Diabetes MILES: Australia (MILES-2) Study

Cited by 39 publications

References 29 publications

User Experiences With a Type 2 Diabetes Coaching App: Qualitative Study

User Experiences With a Type 2 Diabetes Coaching App: Qualitative Study

My Diabetes Coach, a Mobile App–Based Interactive Conversational Agent to Support Type 2 Diabetes Self-Management: Randomized Effectiveness-Implementation Trial

Mobile phone applications and their use in the self-management of Type 2 Diabetes Mellitus: a qualitative study among app users and non-app users

Contact Info

Product

Resources

About