Abstract
BackgroundMobile health technologies have advanced to now allow monitoring of the acute physiological responses to lifestyle behaviours. Our aim was to explore how people engaged with real-time feedback on their physical activity and glucose levels over several weeks.MethodsSemi-structured interviews with 26 participants (61.5% female, 56.6 years) at moderate-to-high risk of developing type 2 diabetes were conducted. Interviews were completed after participants took part in an intervention comprising a flash glucose monitor (Freestyle Libre) and a physical activity monitor (Fitbit Charge 2). Purposive sampling ensured representation of ages, genders and group allocations.ResultsInductive thematic analysis revealed how individuals intuitively used, interpreted and acted on feedback from wearable technologies. Six key themes emerged: triggers of engagement with the technologies, links between behaviour and health, lack of confidence, changes to movement behaviours, changes to diet and barriers to lifestyle behaviour change.ConclusionsOur findings demonstrate that accessing behavioural and physiological feedback can increase self-awareness of how lifestyle impacts short-term health. Some participants noticed a link between the feedback presented by the two devices and changed their behaviour but many did not. Training and educational support, as well as efforts to optimize how feedback is presented to users, are needed to sustain engagement and behaviour change. Extensions of this work to involve people with diabetes are also warranted to explore whether behavioural and physiological feedback in parallel can encourage better diabetes self-management.Trial registrationISRCTN Registry, ISRCTN17545949, 12/05/2017, prospectively registered.
Highlights
Mobile health technologies have advanced to allow monitoring of the acute physiological responses to lifestyle behaviours
Our aim was to explore how people at risk of type 2 diabetes engaged with real-time feedback on their physical activity and glucose levels over several weeks
This paper is written in accordance with the Standards for Reporting Qualitative Research (SRQR) [16] and the Consolidated Criteria for Reporting Qualitative Research (COREQ) [17]
Summary
Mobile health technologies have advanced to allow monitoring of the acute physiological responses to lifestyle behaviours. Our aim was to explore how people engaged with real-time feedback on their physical activity and glucose levels over several weeks. Prevention is of paramount importance and efficacy trials have shown that programs focusing on lifestyle modification can contribute to reducing diabetes risk [2]. Programs in Finland and China have helped people to sustain healthy lifestyle changes to diet and physical activity for at least a year [3, 4]. Findings from the UK’s National Diabetes Prevention Program have shown successful referral rates [5] and that the program can promote health messages in a social setting [6]. It is important to consider how people at risk are supported outside of such programs, both during the programme duration (in-between sessions delivered) and after the programme ends
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