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Exploration of Users' Perspectives and Needs and Design of a Type 1 Diabetes Management Mobile App: Mixed-Methods Study.

ABSTRACT: With the popularity of mobile phones, mobile apps have great potential for the management of diabetes, but the effectiveness of current diabetes apps for type 1 diabetes mellitus (T1DM) is poor. No study has explored the reasons for this deficiency from the users' perspective.The aims of this study were to explore the perspectives and needs of T1DM patients and diabetes experts concerning a diabetes app and to design a new T1DM management mobile app.A mixed-methods design combining quantitative surveys and qualitative interviews was used to explore users' needs and perspectives. Experts were surveyed at 2 diabetes conferences using paper questionnaires. T1DM patients were surveyed using Sojump (Changsha ran Xing InfoTech Ltd) on a network. We conducted semistructured, in-depth interviews with adult T1DM patients or parents of child patients who had ever used diabetes apps. The interviews were audio-recorded, transcribed, and coded for theme identification.The expert response rate was 63.5% (127/200). The respondents thought that the reasons for app invalidity were that patients did not continue using the app (76.4%, 97/127), little guidance was received from health care professionals (HCPs; 73.2%, 93/127), diabetes education knowledge was unsystematic (52.8%, 67/127), and the app functions were incomplete (44.1%, 56/127). A total of 245 T1DM patient questionnaires were collected, of which 21.2% (52/245) of the respondents had used diabetes apps. The reasons for their reluctance to use an app were limited time (39%, 20/52), complicated operations (25%, 13/52), uselessness (25%, 13/52), and cost (25%, 13/52). Both the experts and patients thought that the most important functions of the app were patient-doctor communication and the availability of a diabetes diary. Two themes that were useful for app design were identified from the interviews: (1) problems with patients' diabetes self-management and (2) problems with current apps. In addition, needs and suggestions for a diabetes app were obtained. Patient-doctor communication, diabetes diary, diabetes education, and peer support were all considered important by the patients, which informed the development of a prototype multifunctional app.Patient-doctor communication is the most important function of a diabetes app. Apps should be integrated with HCPs rather than stand-alone. We advocate that doctors follow up with their patients using a diabetes app. Our user-centered method explored comprehensively and deeply why the effectiveness of current diabetes apps for T1DM was poor and what T1DM patients needed for a diabetes app and provided meaningful guidance for app design.

SUBMITTER: Zhang Y

PROVIDER: S-EPMC6231832 | biostudies-other | 2018 Sep

REPOSITORIES: biostudies-other

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Exploration of Users' Perspectives and Needs and Design of a Type 1 Diabetes Management Mobile App: Mixed-Methods Study.

Zhang Yiyu Y Li Xia X Luo Shuoming S Liu Chaoyuan C Liu Fang F Zhou Zhiguang Z

JMIR mHealth and uHealth 20180921 9

<h4>Background</h4>With the popularity of mobile phones, mobile apps have great potential for the management of diabetes, but the effectiveness of current diabetes apps for type 1 diabetes mellitus (T1DM) is poor. No study has explored the reasons for this deficiency from the users' perspective.<h4>Objective</h4>The aims of this study were to explore the perspectives and needs of T1DM patients and diabetes experts concerning a diabetes app and to design a new T1DM management mobile app.<h4>Metho ...[more]

PMID: 30249580

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Project description:BackgroundAdolescent obesity remains a significant public health issue within the United States. Mobile application technology growth and popularity offer new opportunities for research and health improvement. The development of a consolidated mobile health application (mHealth app) for adolescents on these platforms has the potential to improve health outcomes. Thus, this study describes the co-development process working with adolescent users. The aims are as follows: (I) to explore the visual design and functional requirements when developing the CommitFit mHealth app, (II) to uncover the gamification techniques that incentivize adolescents to set and achieve healthy lifestyle goals, and (III) to identify adolescent expectations when using the CommitFit mHealth application.MethodsIn this mixed method study, we used semi-structured interviews/task analysis and surveys of adolescents (aged 13 to 15 years) to understand their user requirements and design preferences during the development of the CommitFit mHealth app. Interviews were conducted online, via Zoom. The survey included the user design industry-standard System Usability Scale (SUS) paired with a supplemental questionnaire on the specific features and functionalities of the CommitFit mHealth app. Participants were recruited from the electronic health record from the University of Missouri Healthcare system.ResultsTen adolescents, aged 13 to 15 years (average of 13.6 years), were interviewed and surveyed to explore adolescent preferences with visual app design and functionality. Our inductive thematic analysis found that adolescents preferred colorful, user-friendly interfaces paired with gamification in the CommitFit mHealth app. Our analysis of SUS survey data validated our user-centered and human-system design and adolescents confirmed their design, feature, and functionality preferences. Overall, adolescent users were able to confirm their preference to have educational resources, goal recommendations, leaderboard, points, reminders, and an avatar in the app.ConclusionsAdolescent feedback is crucial in the successful development of our adolescent-targeted mHealth app, CommitFit. Adolescents preferred vibrant colors, easy-to-use interface, gamification, customizable and personalized, and mature graphics. Adolescents were especially motivated by gamification techniques to maintain their interest in the application and their health behavior goals. Additional research is now needed to explore the clinical effectiveness of the CommitFit mHealth app, as a health and lifestyle intervention.

Project description:BACKGROUND:Mobile phone applications (apps) offer motivation and support for self-management of diabetes mellitus (DM), but their use is limited by high attrition due to insufficient consideration of end-users perspectives and usability requirements. This study aimed to examine app usage and feature preferences among people with DM, and explore their recommendations for future inclusions to foster engagement with diabetes apps. METHODS:The study was conducted internationally on adults with type 1 or type 2 DM using online questionnaire (quantitative) to investigate usage and preferences for app features that support diabetes self-management and semi structured telephone interview (qualitative) to explore suggestions on fostering engagement and specific educational information for inclusion into diabetes apps. Survey and interview data were analysed using descriptive/ inferential statistics and inductive thematic analysis respectively. RESULTS:A total of 217 respondents with type 1 DM (38.25%) or type 2 DM (61.8%), from 4 continents (Australia, Europe, Asia and America) participated in the survey. About half of the respondents (48%) use apps, mainly with features for tracking blood glucose (56.6%), blood pressure (51.9%) and food calories (48.1%). Preferred features in future apps include nutrient values of foods (56.7%), blood glucose (54.8%), physical exercise tracker (47%), health data analytics (42.9%) and education on diabetes self-management (40.6%). Irrespective of the type of DM, participants proposed future apps that are user friendly, support healthy eating, provide actionable reminders and consolidate data across peripheral health devices. Participants with type 1 DM recommended customised features with news update on developments in the field of diabetes. Nominated specific educational topics included tips on problem solving, use of insulin pump therapy, signs of diabetes complication and transitioning from paediatric into adult care. CONCLUSIONS:The study has highlighted patients' perspectives on essential components for inclusion in diabetes apps to promote engagement and foster better health outcomes.

Project description:BackgroundNovel approaches in mobile mental health (mHealth) apps that make use of Artificial Intelligence (AI), Ecological Momentary Assessments, and Ecological Momentary Interventions have the potential to support young people in the achievement of mental health and wellbeing goals. However, little is known on the perspectives of young people and mental health experts on this rapidly advancing technology. This study aims to investigate the subjective needs, attitudes, and preferences of key stakeholders towards an AI-informed mHealth app, including young people and experts on mHealth promotion and prevention in youth.MethodsWe used a convergent parallel mixed-method study design. Two semi-structured online focus groups (n = 8) and expert interviews (n = 5) to explore users and stakeholders perspectives were conducted. Furthermore a representative online survey was completed by young people (n = 666) to investigate attitudes, current use and preferences towards apps for mental health promotion and prevention.ResultsSurvey results show that more than two-thirds of young people have experience with mHealth apps, and 60% make regular use of 1-2 apps. A minority (17%) reported to feel negative about the application of AI in general, and 19% were negative about the embedding of AI in mHealth apps. This is in line with qualitative findings, where young people displayed rather positive attitudes towards AI and its integration into mHealth apps. Participants reported pragmatic attitudes towards data sharing and safety practices, implying openness to share data if it adds value for users and if the data request is not too intimate, however demanded transparency of data usage and control over personalization. Experts perceived AI-informed mHealth apps as a complementary solution to on-site delivered interventions in future health promotion among young people. Experts emphasized opportunities in regard with low-threshold access through the use of smartphones, and the chance to reach young people in risk situations.ConclusionsThe findings of this exploratory study highlight the importance of further participatory development of training components prior to implementation of a digital mHealth training in routine practice of mental health promotion and prevention. Our results may help to guide developments based on stakeholders' first recommendations for an AI-informed mHealth app.

Project description:BackgroundThe COVID-19 pandemic has impacted the lives of expectant parents and parents of young babies, with disruptions in health care provision and loss of social support.ObjectiveThis study investigated the impact of the COVID-19 pandemic and its associated lockdown on this population through the lens of users of the UK National Health Service-approved pregnancy and parenting smartphone app, Baby Buddy. The study aims were threefold: to gain insights into the attitudes and experiences of expectant and recent parents (with babies under 24 weeks of age) during the COVID-19 pandemic; to investigate whether Baby Buddy is meeting users' needs during this time; and to identify ways to revise the content of Baby Buddy to better support its users now and in future.MethodsA mixed methods study design combining a web-based survey with semistructured telephone interviews among Baby Buddy users in the United Kingdom was applied. Data were collected from April 15 to mid-June 2020, corresponding to weeks 4-13 of the lockdown in the United Kingdom.ResultsA total of 436 expectant (n=244, 56.0%) and recent (n=192, 44.0%) parents responded to the web-based survey, of which 79.1% (n=345) were aged 25-39 years and 17.2% (n=75) spoke English as their second language. Of the 436 respondents, 88.5% (386/436) reported increased levels of anxiety around pregnancy, birth, and being a new parent, and 58.0% (253/436) were concerned about their emotional and mental health. Of the 244 pregnant respondents, 43.4% (n=106) were concerned about their physical health. Telephone interviews with 13 pregnant women and 19 recent parents revealed similarly increased levels of anxiety due to reduced health care provision and loss of support from friends and family. Although a minority of respondents identified some positive outcomes of lockdown, such as family bonding, many telephone interviewees reported feeling isolated, disregarded, and overwhelmed. Recent parents were particularly anxious about the impact of the lockdown on their baby's development and socialization. Many interviewees were also concerned about their physical health as a consequence of both limited access to face-to-face medical appointments and their own poorer dietary and physical activity behaviors. Across both samples, 97.0% (423/436) of respondents reported that Baby Buddy was currently helping them, with many commenting that its role was even more important given the lack of face-to-face support from health care and parenting organizations. Greater speed in updating digital content to reflect changes due to the pandemic was suggested.ConclusionsThe COVID-19 pandemic has created heightened anxiety and stress among expectant parents and those with a young baby, and for many, lockdown has had an adverse impact on their physical and mental well-being. With reductions in health care and social support, expectant and new parents are increasingly relying on web-based resources. As a free, evidence-based app, Baby Buddy is well positioned to meet this need. The app could support its users even more by actively directing them to the wealth of existing content relevant to their concerns and by adding content to give users the knowledge and confidence to meet new challenges.

Project description:BackgroundDespite many health benefits of physical activity, nearly a third of the world's adult population is insufficiently active. Technological interventions, such as mobile apps, wearable trackers, and Web-based social networks, offer great promise in promoting physical activity, but little is known about users' acceptability and long-term engagement with these interventions.ObjectiveThe aim of this study was to understand users' perspectives regarding a mobile social networking intervention to promote physical activity.MethodsParticipants, mostly university students and staff, were recruited using purposive sampling techniques. Participants were enrolled in a 6-month feasibility study where they were provided with a wearable physical activity tracker (Fitbit Flex 2) and a wireless scale (Fitbit Aria) integrated with a social networking mobile app (named "fit.healthy.me"). We conducted semistructured, in-depth qualitative interviews and focus groups pre- and postintervention, which were recorded and transcribed verbatim. The data were analyzed in Nvivo 11 using thematic analysis techniques.ResultsIn this study, 55 participants were enrolled; 51% (28/55) were females, and the mean age was 23.6 (SD 4.6) years. The following 3 types of factors emerged from the data as influencing engagement with the intervention and physical activity: individual (self-monitoring of behavior, goal setting, and feedback on behavior), social (social comparison, similarity and familiarity between users, and participation from other users in the network), and technological. In addition, automation and personalization were observed as enhancing the delivery of both individual and social aspects. Technological limitations were mentioned as potential barriers to long-term usage.ConclusionsSelf-regulatory techniques and social factors are important to consider when designing a physical activity intervention, but a one-size-fits-all approach is unlikely to satisfy different users' preferences. Future research should adopt innovative research designs to test interventions that can adapt and respond to users' needs and preferences throughout time.

Project description:BackgroundReporting of medication errors is one of the essential mechanisms to identify risky health care systems and practices that lead to medication errors. Unreported medication errors are a real issue; one of the identified causes is a burdensome medication error reporting system. An anonymous and user-friendly mobile app for reporting medication errors could be an alternative method of reporting medication error in busy health care settings.ObjectiveThe objective of this paper is to report usability testing of the Medication Error Reporting App (MERA), a mobile app for reporting medication errors anonymously.MethodsQuantitative and qualitative methods were employed involving 45 different testers (pharmacists, doctors, and nurses) from a large tertiary hospital in Malaysia. Quantitative data was retrieved using task performance and rating of MERA and qualitative data were retrieved through focus group discussions. Three sessions, with 15 testers each session, were conducted from January to March 2018.ResultsThe majority of testers were pharmacists (23/45, 51%), female (35/45, 78%), and the mean age was 36 (SD 9) years. A total of 135 complete reports were successfully submitted by the testers (three reports per tester) and 79.2% (107/135) of the reports were correct. There was significant improvement in mean System Usability Scale scores in each session of the development process (P<.001) and mean time to report medication errors using the app was not significantly different between each session (P=.70) with an overall mean time of 6.7 (SD 2.4) minutes. Testers found the app easy to use, but doctors and nurses were unfamiliar with terms used especially medication process at which error occurred and type of error. Although, testers agreed the app can be used in the future for reporting, they were apprehensive about security, validation, and abuse of feedback featured in the app.ConclusionsMERA can be used to report medication errors easily by various health care personnel and it has the capacity to provide feedback on reporting. However, education on medication error reporting should be provided to doctors and nurses in Malaysia and the security of the app needs to be established to boost reporting by this method.

Dataset Information

Exploration of Users' Perspectives and Needs and Design of a Type 1 Diabetes Management Mobile App: Mixed-Methods Study.

Publications

Exploration of Users' Perspectives and Needs and Design of a Type 1 Diabetes Management Mobile App: Mixed-Methods Study.

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