Developing and testing an integrated patient mHealth and provider dashboard application system for type 2 diabetes management among Medicaid-enrolled pregnant individuals based on a user-centered approach: Mixed-methods study

Abstract

Background A tailored and integrated technology solution (patient mHealth application and provider dashboard) can provide a 360° view of Medicaid-enrolled patients with type 2 diabetes (T2D) during pregnancy that could improve health outcomes and address health inequities. Objectives To develop a set of user specifications for the mHealth and dashboard applications, develop prototypes based on user needs, and collect initial impressions of the prototypes to subsequently develop refined tools that are ready for deployment. Methods Study activities followed a double-diamond framework with a participatory design mindset. Activities were divided into two phases focused on a qualitative inquiry about participant needs and values (phase 1) and design, development, and usability testing of low and high-fidelity prototypes (phase 2). Results We identified themes that exemplified pregnancy experience among Medicaid-enrolled individuals with T2D. Patients ( n = 7) and providers ( n = 7) expressed a core set of expectations for the mHealth and dashboard applications. Participants provided feedback to improve the mHealth and dashboard. For both applications, participants reported scores for the NASA Task load Survey (TLX) that were in the 20th percentile of national TLX scores. Conclusions Digital health tools have the ability to transform health care among Medicaid-enrolled patients with T2D during pregnancy, with the goal of managing their blood glucose levels, which is a precursor to experiencing a successful pregnancy and birth. Distilling patient and provider needs and preferences—then using them, along with prior studies and theory, to develop applications—holds great potential in tackling complicated health care issues.

Mobile-based program improves healthy eating of ulcerative colitis patients: A pilot study

“…Prior investigations have also revealed that engaging in co-creation with the targeted end-users can significantly enhance the adoption of such a novel smartphone application. 42 , 43 …”

Multicomponent provider–patient intervention to improve glycaemic control in Medicaid-insured pregnant individuals with type 2 diabetes: clinical trial protocol for the ACHIEVE study

“…Medicaid-insured pregnant individuals with T2D and their healthcare providers, including both physicians and nurses, clinical social workers and CHWs, have collaboratively worked with the study team in designing the mHealth app and dashboard interface by providing feedback about the intervention prototype via structured interviews over multiple iterations. 31 Additional testing of the integrated system and tools (ie, patient mHealth app and provider dashboard) to address usability and patient/provider centeredness will be conducted prior to the randomised controlled trial (RCT).…”

“…Electronic data linked to patients’ mHealth apps can allow the care team to actively engage with patients in their care and help them to achieve treatment goals. 31 32 In addition, continuous glucose monitoring (CGM) is a personal mobile technology that allows identification of precise, individualised patterns of dysglycaemia. 33 CGM has been shown to improve glycaemic control and decrease the risk of adverse pregnancy outcomes for individuals with type 1 diabetes, 34 but its impact among pregnant individuals with T2D remains largely unstudied.…”

“…mHealth apps include access to digital information, reminders and convenient communication modes with healthcare providers. Electronic data linked to patients’ mHealth apps can allow the care team to actively engage with patients in their care and help them to achieve treatment goals 31 32. In addition, continuous glucose monitoring (CGM) is a personal mobile technology that allows identification of precise, individualised patterns of dysglycaemia 33.…”

mHealth applications are they the future or another burden for our patients?

“…and evaluating health literacy in mHealth (8). It is long known that health literacy is related to health outcomes (4,5). Other scoping reviews have indicated health literacy problems in specific areas such as genomic health information (9).…”