Background Self-monitoring of blood glucose levels, food intake, and physical activity supports self-management of patients with type 2 diabetes mellitus (T2DM). There has been an increase in the development and availability of mobile health apps for T2DM. Objective The aim of this study is to explore the actual use of mobile health apps for diabetes among patients with T2DM and the main barriers and drivers among app users and nonusers. Methods An explanatory sequential design was applied, starting with a web-based questionnaire followed by semistructured in-depth interviews. Data were collected between July and December 2020. Questionnaire data from 103 respondents were analyzed using IBM SPSS Statistics (version 25.0). Descriptive statistics were performed for the actual use of apps and items of the Unified Theory of Acceptance and Use of Technology (UTAUT). The UTAUT includes 4 key constructs: performance expectancy (the belief that an app will help improve health performance), effort expectancy (level of ease associated with using an app), social influence (social support), and facilitating conditions (infrastructural support). Differences between users and nonusers were analyzed using chi-square tests for individual items. Independent 2-tailed t tests were performed to test for differences in mean scores per the UTAUT construct. In total, 16 respondents participated in the interviews (10 users and 6 nonusers of apps for T2DM). We performed content analysis using a deductive approach on all transcripts, guided by the UTAUT. Results Regarding actual use, 55.3% (57/103) were nonusers and 44.7% (46/103) were users of apps for T2DM. The main driver for the use of apps was the belief that using apps for managing diabetes would result in better personal health and well-being. The time and energy required to keep track of the data and understand the app were mentioned as barriers. Mean scores were significantly higher among users compared with nonusers of apps for T2DM for the constructs performance expectancy (4.06, SD 0.64 vs 3.29, SD 0.89; P<.001), effort expectancy (4.04, SD 0.62 vs 3.50, SD 0.82; P<.001), social influence (3.59, SD 0.55 vs 3.29, SD 0.54; P=.007), and facilitating conditions (4.22, SD 0.48 vs 3.65, SD 0.70; P<.001). On the basis of 16 in-depth interviews, it was recognized that health care professionals play an important role in supporting patients with T2DM in using apps. However, respondents noticed that their health care professionals were often not supportive of the use of apps for managing diabetes, did not show interest, or did not talk about apps. Reimbursement by insurance companies was mentioned as a missing facilitator. Conclusions Empowering health care professionals’ engagement is of utmost importance in supporting patients with T2DM in the use of apps. Insurance companies can play a role in facilitating the use of diabetes apps by ensuring reimbursement.

Background Mobile health apps are promising tools to help patients with type 2 diabetes mellitus (T2DM) improve their health status and thereby achieve diabetes control and self-management. Although there is a wide array of mobile health apps for T2DM available at present, apps are not yet integrated into routine diabetes care. Acceptability and acceptance among patients with T2DM is a major challenge and prerequisite for the successful implementation of apps in diabetes care. Objective This study provides an in-depth understanding of the perceptions of patients with T2DM before use (acceptability) and after use (acceptance) regarding 4 different mobile health apps for diabetes control and self-management. Methods A descriptive qualitative research design was used in this study. Participants could choose 1 of the 4 selected apps for diabetes control and self-management (ie, Clear.bio in combination with FreeStyle Libre, mySugr, MiGuide, and Selfcare). The selection was based on a systematic analysis of the criteria for (functional) requirements regarding monitoring, data collection, provision of information, coaching, privacy, and security. To explore acceptability, 25 semistructured in-depth interviews were conducted with patients with T2DM before use. This was followed by 4 focus groups to discuss the acceptance after use. The study had a citizen science approach, that is, patients with T2DM collaborated with researchers as coresearchers. All coresearchers actively participated in the preparation of the study, data collection, and data analysis. Data were collected between April and September 2021. Thematic analysis was conducted using a deductive approach using AtlasTi9. Results In total, 25 coresearchers with T2DM participated in this study. Of them, 12 coresearchers tested Clear, 5 MiGuide, 4 mySugr, and 4 Selfcare. All coresearchers participated in semistructured interviews, and 18 of them attended focus groups. Personal health was the main driver of app use. Most coresearchers were convinced that a healthy lifestyle would improve blood glucose levels. Although most coresearchers did not expect that they need to put much effort into using the apps, the additional effort to familiarize themselves with the app use was experienced as quite high. None of the coresearchers had a health care professional who provided suggestions on using the apps. Reimbursement from insurance companies and the acceptance of apps for diabetes control and self-management by the health care system were mentioned as important facilitating conditions. Conclusions The research showed that mobile health apps provide support for diabetes control and self-management in patients with T2DM. Integrating app use in care as usual and guidelines for health care professionals are recommended. Future research is needed on how to increase the implementation of mobile health apps in current care pathways. In addition, health care professionals need to improve their digital skills, and lifelong learning is recommended.

BACKGROUND There is a need to develop and coordinate dementia care plans that utilize technology, for vulnerable groups such as immigrant populations. However, immigrant populations are seldom included in various stages of the development and implementation of health technology which does not optimize technology acceptance. OBJECTIVE This study aimed to gain an in-depth understanding of the acceptance of a virtual personal assistant, called Anne4Care, by immigrant older adults living with dementia in their own homes. METHODS This study used a qualitative descriptive research design with naturalistic inquiry. Thirteen (13) older adults participated in this study. The participants were invited for two interviews. After an introduction of Anne4Care, the first interview examined the lives and needs of participants, their expectations, and previous experiences with assistive technology in daily life. Four months later, the second interview sought to understand facilitators and barriers, suggestions for modifications, and the role of health care professionals. Three semi-structured interviews were conducted with health care professionals to examine the roles and challenges they experienced in the use and implementation of Anne4Care. Content analysis, using NVivo11, was performed on all transcripts. RESULTS All 13 participants had an immigration background. Ten male and three females participated, with ages ranging from 52 to 83 years. Participants were diagnosed with a form of dementia or acquired brain injury. None of the older adult participants knew or used assistive technology at the beginning. They obtained assistance from health care professionals and family caregivers who explained and set-up the technology. Six themes were found to be critical aspects of the acceptance of the virtual personal assistant Anne4Care: (1) personal situation, (2) care, (3) use of Anne4Care, (4) positive aspects of Anne4Care, (5) challenges with Anne4Care and (6) expectations. This assistance at first increased the burden of health care professionals and family. After the initial effort, most health care professionals and family experienced that Anne4Care reduced their tasks and stress. Contributions of Anne4Care included companionship, help with daily tasks and opportunities to communicate in multiple languages. On the other hand, some participants expressed anxiety towards the use of Anne4Care. Furthermore, the platform requires internet connection at home and Anne4Care cannot be used outside the home. CONCLUSIONS Although immigrant older adults living with dementia had no experience with technology, the acceptance of the virtual personal assistant, called Anne4Care, by immigrant older adults living with dementia was rather high. The virtual assistant can be further developed to allow for interactive conversations and for use outside of one’s home. Participation of end-users during various stages of the development and implementation of health technology innovations is of utmost importance to maximize technology acceptance.

BACKGROUND Mobile health apps are promising tools to help patients with type 2 diabetes mellitus (T2DM) to improve their health status and thereby reach diabetes control and self-management. Although there is a wide array of mobile health apps for T2DM available at this moment, apps are not yet integrated in routine diabetes care. Acceptability and acceptance among patients with T2DM is one of the major challenges and is a prerequisite for successful implementation of apps in diabetes care. OBJECTIVE This study gives an in-depth understanding of both the perceptions of T2DM patients before use (acceptability) and after use (acceptance), regarding 4 different mobile health apps for diabetes control and self-management. METHODS A qualitative descriptive research design was applied. Participants could choose 1 of the 4 selected apps for diabetes control and self-management (i.e. Clear Bio in combination with FreeStyle Libre, mySugr, MiGuide, Selfcare). The selection was based on a systematic analysis of criteria for (functional) requirements regarding monitoring, data collection, provision of information, coaching, privacy and security. To explore the acceptability, 25 semi-structured in-depth interviews were conducted with T2DM patients before use. This was followed by 4 focus groups to discuss the acceptance after use. The study had a citizen science approach, i.e. patients with T2DM collaborated with the researchers, as co-researcher. All co-researchers actively participated in the preparation of the study, data-collection and data-analysis. Data were collected between April and September 2021. Thematic analysis was conducted using a deductive approach using AtlasTi9. RESULTS In total, 25 co-researchers with T2DM participated in this study. Twelve co-researchers tested Clear, 5 MiGuide, 4 mySugr, and 4 Selfcare. All co-researchers participated in the semi-structured interviews and 18 of them attended the focus groups. Personal health was the main driver to start using the apps. Most co-researchers were convinced a healthy lifestyle will improve their blood glucose levels. Although most co-researchers did not expect that they had to put much effort into using the apps, the additional effort to familiarize themselves with the app usage was experienced as quite high. None of the co-researchers had a healthcare professional who gave suggestions about using apps. Reimbursement from insurance companies and the acceptance of the apps for diabetes control and self-management by the healthcare system were mentioned as important facilitating conditions. CONCLUSIONS The research showed that mobile health apps provide support for diabetes control and self-management of patients with T2DM. Integrating app use in care as usual and guidelines for healthcare professionals is recommended. Future research on how to increase the implementation of mobile health applications in the current care pathways is needed. In addition, healthcare professionals need to improve their digital skills and life-long-learning is needed.