Abstract
BackgroundType 2 diabetes mellitus (T2DM) affects approximately 10% of the US population, disproportionately afflicting African Americans. Smartphone apps have emerged as promising tools to improve diabetes self-management, yet little is known about the use of this approach in low-income minority communities.ObjectiveThe goal of the study was to explore which features of an app were prioritized for people with T2DM in a low-income African American community.MethodsBetween February 2016 and May 2018, we conducted formative qualitative research with 78 participants to explore how a smartphone app could be used to improve diabetes self-management. Information was gathered on desired features, and app mock-ups were presented to receive comments and suggestions of improvements from smartphone users with prediabetes and T2DM, their friends and family members, and health care providers; data were collected from six interactive forums, one focus group, and 15 in-depth interviews. We carried out thematic data analysis using an inductive approach.ResultsAll three types of participants reported that difficulty with accessing health care was a main problem and suggested that an app could help address this. Participants also indicated that an app could provide information for diabetes education and self-management. Other suggestions included that the app should allow people with T2DM to log and track diabetes care–related behaviors and receive feedback on their progress in a way that would increase engagement in self-management among persons with T2DM.ConclusionsWe identified educational and tracking smartphone features that can guide development of diabetes self-management apps for a low-income African American population. Considering those features in combination gives rise to opportunities for more advanced support, such as determining self-management recommendations based on data in users’ logs.
Highlights
MethodsAs of 2020, an estimated 34.2 million people (10.5%) had diabetes and it was the seventh leading cause of death in the United States [1]
We identified educational and tracking smartphone features that can guide development of diabetes self-management apps for a low-income African American population
A study of almost exclusively Black and Hispanic participants suggested that individuals living with chronic conditions like type 2 diabetes mellitus (T2DM) have been turning toward technology to help with diet, exercise, and weight loss [5]
Summary
MethodsAs of 2020, an estimated 34.2 million people (10.5%) had diabetes and it was the seventh leading cause of death in the United States [1]. To avoid complications, living with diabetes involves constant self-management, including exercise, healthy eating, glucose monitoring, and adherence to medications [2]. Low-income African Americans and other minority populations face structural barriers to self-management, such as transportation-related issues, poor health literacy, and limited access to health services [3,4]. A study of almost exclusively Black and Hispanic participants suggested that individuals living with chronic conditions like type 2 diabetes mellitus (T2DM) have been turning toward technology to help with diet, exercise, and weight loss [5]. Common features of current diabetes apps include encouraging self-management activities via reminders; collecting, storing, and displaying behavioral data on the user’s physical activity, nutritional intake, and medication adherence; offering educational information on diet, nutrition, and lifestyle; and, to a lesser degree, enabling social media connections to other app users. Smartphone apps have emerged as promising tools to improve diabetes self-management, yet little is known about the use of this approach in low-income minority communities
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