scholarly journals A Mobile App to Improve Self-Management of Individuals With Type 2 Diabetes: Qualitative Realist Evaluation

2018 ◽  
Vol 20 (3) ◽  
pp. e81 ◽  
Author(s):  
Laura Desveaux ◽  
James Shaw ◽  
Marianne Saragosa ◽  
Charlene Soobiah ◽  
Husayn Marani ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Realist Evaluation ◽  
Mobile App ◽  
Self Management

scholarly journals A Mobile App to Improve Self-Management of Individuals With Type 2 Diabetes: Qualitative Realist Evaluation

2017 ◽  
Author(s):  
Laura Desveaux ◽  
James Shaw ◽  
Marianne Saragosa ◽  
Charlene Soobiah ◽  
Husayn Marani ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Realist Evaluation ◽  
Mobile App ◽  
Self Management

scholarly journals 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 (Preprint)

2020 ◽  
Author(s):  
Mary D Adu ◽  
Usman H Malabu ◽  
Aduli EO Malau-Aduli ◽  
Aaron Drovandi ◽  
Bunmi S Malau-Aduli
Keyword(s):  
Type 2 Diabetes ◽  
Mixed Methods ◽  
Mobile App ◽  
Self Management ◽  
Promising Tool ◽  
Extended Access ◽  
Explanatory Mixed Methods ◽  
Mobile Health Apps

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.

scholarly journals Understanding the mechanisms generating outcomes in a Danish peer support intervention for socially vulnerable people with type 2-diabetes: a realist evaluation

2021 ◽  
Author(s):  
Stine Dandanell Garn ◽  
Charlotte Glümer ◽  
Sarah Fredsted Villadsen ◽  
Gritt Marie Hviid Malling ◽  
Ulla Christensen
Keyword(s):  
Type 2 Diabetes ◽  
Peer Support ◽  
Contextual Factors ◽  
Healthcare Services ◽  
Realist Evaluation ◽  
Self Management ◽  
Support Intervention ◽  
Vulnerable People ◽  
Peer Support Intervention

Abstract Background: Despite increasing use and positive effects of peer support interventions, little is known about how they produce outcomes. Thus, it is essential not only to measure outcomes, but also to identify the mechanisms by which they are generated. Using a realist evaluation approach, we aimed to identify the mechanisms generating outcomes in a Danish peer support intervention for socially vulnerable people with type 2-diabetes (peers). By investigating how the peers interacted in the intervention, we further examined how peers’ individual contextual factors facilitated or hindered the mechanisms in operation. Methods: We used a multi-method case-study design (n=9). Data included semi-structured interviews with four key groups of informants (peer, peer supporter, project manager and a diabetes nurse) for each case (n=25). Furthermore, we collected survey data from peers both before and after participation (n=9). The interview data were analysed using a systematic text condensation, and the Intervention-context-actor-mechanism-outcome framework was used to structure the analysis. Results: We identified two groups of mechanisms that improved diabetes self-management and the use of healthcare services (outcomes): ‘perceived needs and readiness’ and ‘encouragement and energy’. However, the mechanisms only generated the intended outcomes among peers with a stable occupation and financial situation, a relatively good health condition, and sufficient energy (all defined as contextual factors). Independent of these contextual factors, ‘experience of social and emotional support’ was identified as a mechanism within all peers that increased self-care awareness (defined as output). Dependent on whether the contextual factors facilitated or hindered the mechanisms to generate outcomes, we categorised the peers into those who achieved outcomes and those who did not. Conclusions: We identified two groups of mechanisms that improved the peers’ diabetes self-management and use of healthcare services. The mechanisms only generated the intended outcomes if peers’ individual contextual factors facilitated an active interaction with the elements of the intervention. However, independent of these contextual factors, a third group of mechanisms increased self-care awareness among all peers. We highlight the importance of contextual awareness of the target groups in the design and evaluation of peer support interventions for socially vulnerable people with type 2-diabetes. Trial registration : ClinicalTrials.gov, Retrospective Registration (01/20/2021), registration number NCT04722289, https://clinicaltrials.gov/ct2/show/NCT04722289?term=The+Together+on+Diabetes+Intervention+-+a+Realist+Evaluation%2C&draw=2&rank=1 Keywords: Complex Intervention, Realist evaluation, Mechanisms, Context, Peer support, Diabetes self-management, Healthcare services, Inequality

scholarly journals Mobile App for Improved Self-Management of Type 2 Diabetes: Multicenter Pragmatic Randomized Controlled Trial

10.2196/10321 ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. e10321 ◽  
Author(s):  
Payal Agarwal ◽  
Geetha Mukerji ◽  
Laura Desveaux ◽  
Noah M Ivers ◽  
Onil Bhattacharyya ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Mobile App ◽  
Self Management ◽  
Pragmatic Randomized Controlled Trial ◽  
Randomized Controlled

scholarly journals Understanding the mechanisms generating outcomes in a Danish peer support intervention for socially vulnerable people with type 2-diabetes: a realist evaluation

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Stine Dandanell Garn ◽  
Charlotte Glümer ◽  
Sarah Fredsted Villadsen ◽  
Gritt Marie Hviid Malling ◽  
Ulla Christensen
Keyword(s):  
Type 2 Diabetes ◽  
Peer Support ◽  
Contextual Factors ◽  
Healthcare Services ◽  
Realist Evaluation ◽  
Self Management ◽  
Support Intervention ◽  
Vulnerable People ◽  
Peer Support Intervention

Abstract Background Despite an increasing use and positive effects of peer support interventions, little is known about how the outcomes are produced. Thus, it is essential not only to measure outcomes, but also to identify the mechanisms by which they are generated. Using a realist evaluation approach, we aimed to identify the mechanisms generating outcomes in a Danish peer support intervention for socially vulnerable people with type 2-diabetes (peers). By investigating the participating peers’ interactions, we furthermore examined how their individual contextual factors either facilitated or hindered the mechanisms in operation. Methods We used a multi-method case-study design (n = 9). Data included semi-structured interviews with four key groups of informants (peer, peer supporter, project manager, and a diabetes nurse) for each case (n = 25). Furthermore, we collected survey data from peers both before and after participation (n = 9). The interview data were analysed using a systematic text condensation, and the Intervention-context-actor-mechanism-outcome framework was used to structure the analysis. Results We identified 2 groups of mechanisms that improved diabetes self-management and the use of healthcare services (outcomes): ‘perceived needs and readiness’ and ‘encouragement and energy’. However, the mechanisms only generated the intended outcomes among peers with a stable occupation and financial situation, a relatively good health condition, and sufficient energy (all defined as contextual factors). Independent of these contextual factors, ‘experience of social and emotional support’ was identified as a mechanism within all peers that increased self-care awareness (defined as output). Dependent on whether the contextual factors facilitated or hindered the mechanisms to generate outcomes, we categorised the peers into those who achieved outcomes and those who did not. Conclusions We identified two groups of mechanisms that improved the peers’ diabetes self-management and use of healthcare services. The mechanisms only generated the intended outcomes if peers’ individual contextual factors facilitated an active interaction with the elements of the intervention. However, independent of these contextual factors, a third group of mechanisms increased self-care awareness among all peers. We highlight the importance of contextual awareness of the target groups in the design and evaluation of peer support interventions for socially vulnerable people with type 2-diabetes. Trial registration ClinicalTrials.gov, Retrospective Registration (20 Jan 2021), registration number NCT04722289.

scholarly journals Smartphone-Based mHealth and Internet of Things for Diabetes Control and Self-Management

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Abolfazl Mehbodniya ◽  
A. Suresh Kumar ◽  
Kantilal Pitambar Rane ◽  
Komal Kumar Bhatia ◽  
Bhupesh Kumar Singh
Keyword(s):  
Type 2 Diabetes ◽  
Mobile Phone ◽  
Self Care ◽  
Mobile App ◽  
Self Management ◽  
The Internet ◽  
Diabetic Patients ◽  
Life Years ◽  
Diabetes Patients

In patients with chronic diseases condition, mobile health monitoring facility proves to play a significant role in providing significant assistance toward personal management. This research examined the use of smartphones by diabetes patients and their intentions to apply them for self-care and monitoring as well as management. This cross-sectional survey-based study was conducted in Jul-Aug 2021 with 200 diabetic patients (especially type 2) who were visiting specialized clinics and hospitals of Gujrat state, India. A validated questionnaire survey was designed to collect data, which included questions about demographics, information pertaining to other, use of cellphones, the Internet, and the intention to implement smartphones for diabetes monitoring, self-care, and self-management. A highest number of studied participants have mobile phone (97.5%) and smartphones (87%) and access the Internet on daily basis (83.5%). Younger participants were more inclined to use smartphone apps and have also shown more interest for continuous use in the future ( p < 0.01 ). The majority of participants used apps for nutritional planning (85.5%), to monitor glucose control (76.5%), and for scheduling of diabetes appointments on the calendar (90.5%). Recommendations to use mobile app by doctors or healthcare profession were reported by 20.5% of the participants and attitude and future intention to use mobile apps were reported by the majority of participants. The majority of type 2 diabetes patients choose to use their cellphones and the internet or mobile phone reminder system for medication as well as to plan their diets, monitor their blood sugar levels, and communicate with their doctors. The findings of this research can be used to develop strategies and implement mHealth-based therapies to assist patients with type 2 diabetes to efficiently manage their health and might contribute to reducing patients’ out-of-pocket expenditure as well as reducing disability-adjusted life years (DAILY) attributed by DM.

scholarly journals Understanding the Mechanisms Generating Outcomes in a Danish Peer support Intervention for Socially Vulnerable People with type 2-Diabetes: A Realist Evaluation

2021 ◽  
Author(s):  
Stine Dandanell Garn ◽  
Charlotte Glümer ◽  
Sarah Fredsted Villadsen ◽  
Gritt Marie Hviid Malling ◽  
Ulla Christensen
Keyword(s):  
Type 2 Diabetes ◽  
Peer Support ◽  
Contextual Factors ◽  
Healthcare Services ◽  
Realist Evaluation ◽  
Self Management ◽  
Support Intervention ◽  
Vulnerable People ◽  
Peer Support Intervention

Abstract Background: Despite increasing use and positive effects of peer support interventions, little is known about how they produce outcomes. Thus, it is essential not only to measure outcomes, but also to identify the mechanisms by which they are generated. Using a realist evaluation approach, we aimed to identify the mechanisms generating outcomes in a Danish peer support intervention for socially vulnerable people with type 2-diabetes (peers). By investigating how the peers interacted in the intervention, we further examined how peers’ individual contextual factors facilitated or hindered the mechanisms in operation.Methods: We used a multi-method case-study design (n=9). Data included semi-structured interviews with four key groups of informants (peer, peer supporter, project manager and a diabetes nurse) for each case (n=25). Furthermore, we collected survey data from peers both before and after participation (n=9). The interview data were analysed using a systematic text condensation, and the Intervention-context-actor-mechanism-outcome framework was used to structure the analysis.Results: We identified two groups of mechanisms that improved diabetes self-management and the use of healthcare services (outcomes): ‘perceived needs and readiness’ and ‘encouragement and energy’. However, the mechanisms only generated the intended outcomes among peers with a stable occupation and financial situation, a relatively good health condition, and sufficient energy (all defined as contextual factors). Independent of these contextual factors, ‘experience of social and emotional support’ was identified as a mechanism within all peers that increased self-care awareness (defined as output). Dependent on whether the contextual factors facilitated or hindered the mechanisms to generate outcomes, we categorised the peers into those who achieved outcomes and those who did not. Conclusions: We identified two groups of mechanisms that improved the peers’ diabetes self-management and use of healthcare services. The mechanisms only generated the intended outcomes if peers’ individual contextual factors facilitated an active interaction with the elements of the intervention. However, independent of these contextual factors, a third group of mechanisms increased self-care awareness among all peers. We highlight the importance of contextual awareness of the target groups in the design and evaluation of peer support interventions for socially vulnerable people with type 2-diabetes.Trial registration: ClinicalTrials.gov, Retrospective Registration (01/20/2021), registration number NCT04722289, https://clinicaltrials.gov/ct2/show/NCT04722289?term=The+Together+on+Diabetes+Intervention+-+a+Realist+Evaluation%2C&draw=2&rank=1

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

2020 ◽  
Author(s):  
Enying Gong ◽  
Shaira Baptista ◽  
Anthony Russell ◽  
Paul Scuffham ◽  
Michaela Riddell ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Controlled Trial ◽  
Care Program ◽  
Mobile App ◽  
Self Management ◽  
Management Support ◽  
Conversational Agent ◽  
Home Setting ◽  
And Control

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, <i>Laura</i>, 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 (HbA<sub>1c</sub>) 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 <i>Laura</i>, averaging 243 min (SD 212) per person over 12 months. Compared with baseline, the mean estimated HbA<sub>1c</sub> 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 HbA<sub>1c</sub> (−0.04%, 95% CI −0.45 to 0.36; <i>P</i>=.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; <i>P</i>=.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 HbA<sub>1c</sub> improvement. CLINICALTRIAL Australia New Zealand Clinical Trials Registry (ACTRN) 12614001229662; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12614001229662

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

10.2196/20322 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e20322
Author(s):  
Enying Gong ◽  
Shaira Baptista ◽  
Anthony Russell ◽  
Paul Scuffham ◽  
Michaela Riddell ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Controlled Trial ◽  
Mobile App ◽  
Trial Registration ◽  
Self Management ◽  
Management Support ◽  
Conversational Agent ◽  
Home Setting ◽  
And Control

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

scholarly journals Community-Driven Priorities in Smartphone Application Development: Leveraging Social Networks to Self-Manage Type 2 Diabetes in a Low-Income African American Neighborhood

2019 ◽  
Vol 16 (15) ◽  
pp. 2715 ◽  
Author(s):  
Pamela J. Surkan ◽  
Kathryne S. Mezzanotte ◽  
Laura M. Sena ◽  
Larry W. Chang ◽  
Joel Gittelsohn ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Social Networks ◽  
African American ◽  
Low Income ◽  
Family Members ◽  
Mobile App ◽  
Self Management ◽  
Future Research ◽  
Application Development

Social networks have the potential to enhance Type 2 Diabetes Mellitus (T2DM) self-management. We used qualitative methods to study if and how mobile application (app) functions that mobilize social resources to improve T2DM management would be desired in a low-income African American community. Data were collected through community discussions and in-depth interviews with 78 participants in 2016–2018. Participants included individuals with self-reported pre-diabetes, T2DM, close family members or friends of a T2DM patient, and healthcare providers. Open-ended questions solicited information about challenges with T2DM management and gathered ideas on features of a mobile app that could address them. Data were transcribed and thematically coded by two coders using Atlas-ti. Regarding types of app functions, main themes included: (1) the importance of having support in diabetes self-care; (2) using informal networks to help to each other; and (3) monitoring one another through an app. Suggested app features included reminders for and transportation to medical visits, sharing information and exercise companionship, and providing opportunities for monitoring by friends/family members, especially in case of emergencies. Participants viewed an app as a potential vehicle for reinforcing accomplishments in T2DM self-management. Future research should implement and test an app with these features in this or similar communities.

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