Abstract
BackgroundDiabetes 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.ObjectiveThis study aims to explore users’ real-world experiences with the My Diabetes Coach (MDC) self-management app.MethodsWe 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.ResultsA 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.ConclusionsUser 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 RegistrationAustralia New Zealand Clinical Trials Registry CTRN126140012296; URL https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366925&isReview=true
Highlights
By 2045, 693 million people will be living with diabetes, the majority with type 2 diabetes (T2D) [1]
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
Promoting engagement is vital if diabetes self-management apps are to become a useful complement to clinical care in supporting optimal self-management
Summary
Background By 2045, 693 million people will be living with diabetes, the majority with type 2 diabetes (T2D) [1]. 1 (page number not for citation purposes) self-management education and ongoing support are critical for establishing and maintaining self-care routines [3]. The uptake of face-to-face educational programs is low because of several factors, including difficulty in attending because of medical, financial, or transport issues; lack of perceived benefits; and shame and stigma [4,5,6,7]. An increasingly common strategy to address these challenges has been to use smartphone apps as a means to deliver diabetes education and self-management support to complement clinical care. Diabetes self-management apps have the potential to improve self-management in people with type 2 diabetes (T2D). It is important to understand the factors that influence engagement in real-world settings
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