A Mobile- and Web-Based Health Intervention Program for Diabetes and Prediabetes Self-Management (BetaMe/Melon): Process Evaluation Following a Randomized Controlled Trial

Abstract

Background Technology-assisted self-management programs are increasingly recommended to patients with long-term conditions such as diabetes. However, there are a number of personal and external factors that affect patients’ abilities to engage with and effectively utilize such programs. A randomized controlled trial of a multi-modal online program for diabetes self-management (BetaMe/Melon) was conducted in a primary care setting, and a process evaluation was completed at the end of the study period. Objective This process evaluation aimed to examine the utilization patterns of BetaMe/Melon, identify which components participants found most (and least) useful, and identify areas of future improvement. Methods Process evaluation data were collected for intervention arm participants from 3 sources: (1) the mobile/web platform (to identify key usage patterns over the 16-week core program), (2) an online questionnaire completed during the final study assessment, and (3) interviews conducted with a subset of participants following the study period. Participants were classified as “actively engaged” if any usage data was recorded for the participant (in any week), and patterns were reported by age, gender, ethnicity, and diabetes/prediabetes status. The online questionnaire asked participants about the usefulness of the program and whether they would recommend BetaMe/Melon to others according to a 5-point Likert Scale. Of 23 invited participants, 18 participated in a digitally recorded, semistructured telephone interview. Interview data were thematically analyzed. Results Out of the 215 participants, 198 (92%) received an initial health coaching session, and 160 (74%) were actively engaged with the program at some point during the 16-week core program. Engagement varied by demographic, with women, younger participants, and ethnic majority populations having higher rates of engagement. Usage steadily declined from 50% at Week 0 to 23% at Week 15. Participants ranked component usefulness as education resources (63.7%), health coaches (59.2%), goal tracking (48.8%), and online peer support (42.1%). Although 53% agreed that the program was easy to use, 64% would recommend the program to others. Interview participants found BetaMe/Melon useful overall, with most identifying beneficial outcomes such as increased knowledge, behavioral changes, and weight loss. Barriers to engagement were program functionality, internet connectivity, incomplete delivery of all program components, and participant motivation. Participants suggested a range of improvements to the BetaMe/Melon program. Conclusions The program was generally well received by participants; active engagement was initially high, although it declined steadily. Maintaining participant engagement over time, individualizing programs, and addressing technical barriers are important to maximize potential health benefits from online diabetes self-management programs. Trial Registration Australian New Zealand Clinical Trial Registry ACTRN12617000549325; https://tinyurl.com/y622b27q

Implementation of Online Hospitals and Factors Influencing the Adoption of Mobile Medical Services in China: Cross-Sectional Survey Study

“…Moreover, mobile medical services of online hospitals are different from other mobile health care support applications. In their initial stage of promotion and operation, we should pay attention to the public’s expectations of, and willingness to use, these services [ 15 , 16 ]. Through the extension and application of the UTAUT model, we aim to determine the factors influencing willingness to use these services and the relationship between them; our research will fill this gap in the field of mobile medicine.…”

Virtual Reality for Sedation During Atrial Fibrillation Ablation in Clinical Practice: Observational Study

“…Connected devices are dramatically changing many aspects in health care [4][5][6][7]. While in cardiology, the majority of devices are intended to monitor heart rhythm, others have a therapeutic purpose [8][9][10].…”

A Tailored Gender-Sensitive mHealth Weight Loss Intervention (I-GENDO): Development and Process Evaluation

“…Given that higher engagement in mHealth interventions is usually associated with better outcomes [22,24,118], we propose that the samples in future studies should be more balanced with regard to gender and implement gender-sensitive feasibility and usability testing. Overall, the compliance with the app (90/109, 82.6%) and satisfaction with the app (86/100, 86%) were high and comparable with those of other mHealth interventions [99][100][101]119]. The usability of the app was rated with 71% (5.0/7.0 points) satisfaction.…”

“…The compliance with the app was satisfactory (90/109, 82.6%) and comparable with other studies. Signal et al [ 99 ] developed an eHealth intervention for prediabetes and diabetes self-management. They reported that 74% of the participants were actively engaged (ie, any use data were detected at any time throughout the 16-week intervention).…”