Designing internet-enabled patient education for self-management of T2D diabetes—The case of the Razavi-Khorasan province in Iran

Abstract

Background The number of people with diabetes is estimated to increase to 642 million by 2040, with most having type 2 diabetes. Patients with diabetes require continuous monitoring and possible treatment changes. Patient education is the process of enabling individuals to make informed decisions about their personal health-related behaviours and internet-enabled interventions have the potential to provide support and information to patients with diabetes. Objective The aim of the study was to design a portal prototype based onto two models of care and a contextualised education programme to support the self-management of diabetes patients by involving stakeholders in the Iranian province of Razavi-Khorasan. Methods A Design-Based Research framework was adopted. A qualitative research method was used to analyse interviews with patients and care givers. Mock-ups were developed first and designed with features of user-driven and self-care models of care. The mock-ups also had adaptation features, such as for control of the disease, ability to cure self, and family support. The portal prototype was developed iteratively by building on the mock-ups and evaluated through interviews. The features and elements of the mock-ups and the portal prototype were evaluated in an outpatient diabetes clinic in Mashhad. Results Thirty-three participants were involved in the study. The evaluation of the mock-ups resulted in two themes and seven categories: 1) self-care improvement, including self-care requirements and self-management, and 2) educational usefulness, including medical information, information mode, mobility, interaction, and efficiency. The mock-up evaluation was used as a basis for designing a portal prototype. Next, the portal prototype was evaluated, and three categories emerged from the interview data: 1) user experience, 2) functionality, and 3) interactivity. Participants were not able to prioritise between the two care models. Some functionalities of the portal could benefit from the development within a cultural context to determine differences to the best way to present material. Conclusions A portal prototype has been designed to include two care models to support self-management and functionalities that support aspects of culture-specific diabetes self-care. This study provides guidance on developing an internet-enabled educational portal, aimed at providing support for patients in their social context.

Educational technologies used to promote self-care for people with diabetes mellitus: integrative review

“…In the context of nursing care, they can enhance and qualify care actions, since they help in the process of learning and self-knowledge of the individual regarding their health condition (25) . In the studies identified in this review, the TEs used were: printed technologies (15)(16) ; interactive technologies and mobile applications (18)(19)(20)22) ; telemonitoring (21) ; simulation (17) ; and audiovisual production (14) .…”

“…The use of interactive platforms to build care tools was identified in most of the selected studies (18)(19)22) . Along with the importance of interactivity for care, a systematic review highlighted that access to interactive technologies by people with DM has generated positive impacts on changes in habits and lifestyle.…”

“…However, it is necessary to emphasize that only the international studies (18)(19)(20) of this sample emphasized behavior change and other themes necessary to promote self-care, such as: physical exercise, healthy eating, glycemic control and professional support. In this sense, although scientific productions on DM are frequent in the national context, it was observed that the focus is on preventing complications of the disease.…”

“…Jafari (18) Interviews with target audience to evaluate the prototype / Prototype of interactive portal and educational program…”

“…This content was included in five of the articles (13)(14)(15)(16)(17) , four of which were national publications and derived from methodological studies. In addition, among the four international studies, three addressed themes and content on self-care aimed at changing behavior and adherence to drug treatment, healthy eating, and physical activity (18)(19)(20) .…”