Developing a Patient-Centered mHealth App: A Tool for Adolescents With Type 1 Diabetes and Their Parents

Abstract

BackgroundType 1 diabetes (T1D) afflicts approximately 154,000 people under 20 years of age. Three-quarters of adolescents are not achieving glycosylated hemoglobin (HbA1c) targets, which leads to negative health outcomes. Mobile health (mHealth), the use of technology in health, has been used successfully to improve health in many chronic conditions, including diabetes.ObjectiveThe purpose of this study was to use patient-centered research methods to inform and improve the design and functionality of our T1D app, MyT1DHero, and to provide insight for others who are designing a health app for adolescents and parents.MethodsThis study included data from focus groups with participants recruited from the Juvenile Diabetes Research Foundation (JDRF) southeast Michigan’s family network. All data collected during the sessions were audio-recorded, transcribed, and coded.ResultsFour key themes were identified: (1) diabetes is unpredictable, (2) negative and frustrated communication, (3) motivations to use an app, and (4) feedback specific to our app.ConclusionsA patient-centered approach was used to assist in the development of an app for adolescents with T1D. Participants were satisfied with overall app design; customization, interactivity, and tangible rewards were identified as being necessary for continued use. Participants believed the app would help improve the communication between parents and adolescents. Many apps developed in the health context have not used a patient-centered design method or have seen vast improvements in health. This paper offers suggestions to others seeking to develop apps for adolescents and their parents.

Change in Patient Comfort Using Mobile Phones Following the Use of an App to Monitor Tuberculosis Treatment Adherence: Longitudinal Study (Preprint)

“…Other mHealth studies considered the usability and receptiveness of application-based tools using different forms of Likert scales [2,7] or qualitative measures from patient responses [5,6] to find important associations related to application quality and user opinions. These studies assessed a variety of health interventions and most had positive results when investigating topics such as usability [3] and acceptability [2,7].…”

“…These mHealth interventions have been applied to monitoring postoperative care [2,3], diabetes self-management [4,5], smoking cessation [6,7], care and prevention of HIV and other sexually transmitted diseases [8], and more. As these interventions begin to spread throughout healthcare, there has been a growing interest in the response to these applications, including topics such as acceptability and feasibility [2], satisfaction by patients and providers [5], and efficiency [4]. However, there is limited research measuring users' comfort in operating smartphone functions, and whether comfort increases as a result of engagement with these applications.…”

Promoting Self-Care of Diabetic Foot Ulcers through a Mobile Application: A User-Centred Design and Evaluation (Preprint)

“…However, they only express opinions on potential use based on trying out the app with the assistance of a researcher. Such evaluations of technology prototypes through interviews are an important step in a user-centred design process and commonly reported in the health informatics literature, including in the area of diabetes (e.g., [23,[39][40][41][42]). The critical next step is a deployment study where patients and their carers can use and evaluate the app over several weeks or months in their daily lives to evaluate the actual impact on self-care.…”

Proposing an Ecosystem of Digital Health Solutions for Teens With Chronic Conditions Transitioning to Self-Management and Independence: Exploratory Qualitative Study (Preprint)

“…These studies support the use of digital solutions and demonstrate a promising next step in chronic disease management technology. In another case, Holtz et al [7] developed and tested a patient-centered mobile application using focus group interviews with teens having Type-1 Diabetes and their parents. Participants reported that they thought that the mobile application would help to improve communication among family members.…”

“…Researchers from Michigan State University proposed a mobile app, MyT1D Hero, to create a communication platform among teens with type-1 diabetes and their parents to support selfmanagement [7].…”