BACKGROUND Type 2 diabetes is becoming more prevalent around the world, including in Singapore. Diabetes education programs have been proven to be effective in improving health outcomes and diabetes self-management skills. Several effective approaches to diabetes education in patients with type 2 diabetes have been established, including the use of mobile health applications. Despite strong evidence of their efficacy, these apps are not always well-utilized or accepted by the target population. End-user feedback is essential for designing a feasible and acceptable app that can improve outcomes for chronic disease populations. OBJECTIVE We applied a mixed-methods, end-user-engaged approach to co-design an education app prototype for patients with type 2 diabetes to explore their perceptions, acceptance and usability of the prototype, as well their diabetes experience and perspectives on digital diabetes education. METHODS The study was conducted between August 2021 and January 2022. Participants were eight diabetic patients recruited from diabetes management Facebook groups. A total of six data points were collected: four web-based surveys and two structured interviews via Zoom. Descriptive statistics and thematic analyses of discussion and iterative feedback on the app prototype were used to assess perceptions of living with diabetes, attitudes toward digital diabetes education, and acceptance of the prototype. RESULTS The data collected were grouped into 3 deductive themes: (1) challenges of living with diabetes, (2) validation, acceptability, and usability of diabetes education app prototype, and (3) perspectives on digital diabetes education. The first theme highlighted the importance and burden of solitary accountability, translating knowledge into practice, and developing pragmatic self-consciousness. The second indicated that the diabetes education app prototype is acceptable, with information being the key, power of appearance, ambivalent and polarized opinions toward the chatbot, and potential impact of the app on self-management. The third theme comprised the necessity of utilizing a variety of information seeking strategies and recommendations for desired content and app qualities, including accessibility, adaptability, autonomy, evidence-based, gamification, guidance, integration, personalization, and up-to-date. CONCLUSIONS Our findings could be used for the development of apps to address the health needs of patients with type 2 diabetes. They also add context for understanding type 2 diabetes patients in Singapore, including challenges in self-management and perspectives on diabetes education.

Background Type 2 diabetes (T2D) is a growing global health concern, including in Singapore. Diabetes education programs have been shown to be effective in improving health outcomes and diabetes self-management skills. Mobile health apps have emerged as useful tools for diabetes education; however, their use and acceptance by the target population remain inconsistent. Therefore, end-user participation in the design and development of a mobile health app is crucial for designing an acceptable app that can improve outcomes for populations with a chronic disease. Objective The objective of this study was to apply an end-user participatory approach to co-design a diabetes education app prototype for people living with T2D by exploring their perceptions, acceptance, and usability of an app prototype, as well as their diabetes experience and perspectives on digital diabetes education. Methods A total of 8 people with T2D, who were recruited from diabetes management Facebook groups, participated in 4 web-based surveys via Qualtrics and 2 structured interviews via Zoom (Zoom Video Communications, Inc) between August 20, 2021, and January 28, 2022. Descriptive statistics and thematic analyses of the discussion and iterative feedback on the app prototype were used to assess the participants’ perceptions of living with T2D, attitudes toward digital diabetes education, and acceptance of the prototype. Results Analyses of the surveys and interview data revealed 3 themes: challenges of living with T2D; validation, acceptability, and usability of the diabetes education app prototype; and perspectives on digital diabetes education. In the first theme, participants highlighted the importance of solitary accountability, translating knowledge into practice, and developing pragmatic self-consciousness. The second theme indicated that the diabetes education app prototype was acceptable, with information and appearance being key; revealed ambivalent and polarized opinions toward the chatbot; and confirmed potential impact of the app on diabetes self-management skills and practice. The third theme comprised the necessity of using a variety of information-seeking strategies and recommendations for desired content and app qualities, including accessibility, adaptability, autonomy, evidence-based design and content, gamification, guidance, integration, personalization, and up-to-date content. The findings were used to reiterate the app design. Conclusions Despite a small sample size, the study demonstrated the feasibility of engaging and empowering people living with T2D to consider digital therapeutics for diabetes self-management skills and practice. Participants gave rather positive feedback on the design and content of the app prototype, with some recommendations for improvements. The findings suggest that incorporating end-user feedback into app design can lead to the creation of feasible and acceptable tools for diabetes education, potentially improving outcomes for populations with a chronic disease. Further research is needed to test the impact of the refined diabetes education app prototype on diabetes self-management skills and practice and quality of life.

Background Digital education has expanded since the COVID-19 pandemic began. A substantial amount of recent data on how students learn has become available for learning analytics (LA). LA denotes the “measurement, collection, analysis, and reporting of data about learners and their contexts, for purposes of understanding and optimizing learning and the environments in which it occurs.” Objective This scoping review aimed to examine the use of LA in health care professions education and propose a framework for the LA life cycle. Methods We performed a comprehensive literature search of 10 databases: MEDLINE, Embase, Web of Science, ERIC, Cochrane Library, PsycINFO, CINAHL, ICTP, Scopus, and IEEE Explore. In total, 6 reviewers worked in pairs and performed title, abstract, and full-text screening. We resolved disagreements on study selection by consensus and discussion with other reviewers. We included papers if they met the following criteria: papers on health care professions education, papers on digital education, and papers that collected LA data from any type of digital education platform. Results We retrieved 1238 papers, of which 65 met the inclusion criteria. From those papers, we extracted some typical characteristics of the LA process and proposed a framework for the LA life cycle, including digital education content creation, data collection, data analytics, and the purposes of LA. Assignment materials were the most popular type of digital education content (47/65, 72%), whereas the most commonly collected data types were the number of connections to the learning materials (53/65, 82%). Descriptive statistics was mostly used in data analytics in 89% (58/65) of studies. Finally, among the purposes for LA, understanding learners’ interactions with the digital education platform was cited most often in 86% (56/65) of papers and understanding the relationship between interactions and student performance was cited in 63% (41/65) of papers. Far less common were the purposes of optimizing learning: the provision of at-risk intervention, feedback, and adaptive learning was found in 11, 5, and 3 papers, respectively. Conclusions We identified gaps for each of the 4 components of the LA life cycle, with the lack of an iterative approach while designing courses for health care professions being the most prevalent. We identified only 1 instance in which the authors used knowledge from a previous course to improve the next course. Only 2 studies reported that LA was used to detect at-risk students during the course’s run, compared with the overwhelming majority of other studies in which data analysis was performed only after the course was completed.