Exploring the Constituent Elements of a Successful Mobile Health Intervention for Prediabetic Patients in King Saud University Medical City Hospitals in Saudi Arabia: Cross-sectional Study

Abstract

Background Self-management of prediabetic patients is crucial since they are at high risk of developing type 2 diabetes. Mobile health (mHealth) apps could contribute to potentially reducing the burden of diabetes by supporting the self-management of prediabetic patients. Objective This study aimed to explore the constituent elements of a successful mHealth intervention for prediabetic patients in King Saud University Medical City (KSUMC) hospitals in Saudi Arabia using the Centre for eHealth Research (CeHRes) roadmap. Methods This study used the CeHRes roadmap as a developmental guideline for proposing mHealth app features for self-management of prediabetic patients and was performed in 3 phases with one round in each phase. First, a contextual inquiry was conducted via an online self-administered questionnaire for both health care providers and patients. Second, the value specification phase elaborated on the outcomes from the contextual inquiry phase. Finally, prototype user design was performed in cocreation with end users. The design phase was also conducted via an online self-administered questionnaire to evaluate the proposed features of mHealth apps by prediabetic patients. Results A total of 20 health care providers participated in the study. The results revealed that the most powerful intervention for prediabetes was a combination of medication, physical activity, and healthy diet plans (12/20, 60%). Furthermore, the most common challenge faced by prediabetes patients was patient adherence to healthy diet and physical activity recommendations (10/20, 50%). Almost all patients believed that mHealth apps would be useful for prediabetic patients. A total of 48 prediabetic patients participated in the study. The results indicated that the most powerful intervention for prediabetic patients is a combination of healthy diet and physical activity plans (21/48, 44%), and the most frequent challenge that may lead the patients to discontinue the current intervention was the commitment to a physical activity plan (35/48, 75%). Furthermore, 15% (17/48) of patients use well-being and health apps to manage their current health status. The most common difficulties faced by the patients were navigating app features (mean 2.02 [SD 1.7]) followed by the app language (mean 1.88 [SD 2.0]); these difficulties occurred at a significantly higher rate among those with secondary or lower educational levels as compared to undergraduate and postgraduate levels (P<.05). Finally, the features proposed in the prototype design scored more than 2.5 points higher and indicate the need for these features to be included in the mHealth app. Conclusions This study aimed to provide real-world insights into the development of an mHealth app for a diabetes prevention intervention by involving both health care providers and prediabetic patients in KSUMC hospitals. Therefore, the proposed app, which comprises all necessary features, may aid patients with prediabetes in self-management and making changes in their lifestyle.

Developing mHealth to the Context and Valuation of Injured Patients and Professionals in Hospital Trauma Care: Qualitative and Quantitative Formative Evaluations

“…The findings of our study add to the existing literature aimed at overcoming barriers to the successful development and implementation of eHealth initiatives that followed the CeHRes road map [ 16 , 20 , 33 - 40 ]. Previous studies have addressed a wide range of eHealth initiatives such as the development of a web-based intervention for depression [ 37 ], a computerized clinical decision support system for patients with type 2 diabetes [ 36 ], an mHealth intervention for patients with prediabetes [ 33 ], and a digital training tool to support oncologists in the skill of information provision [ 40 ]. However, only one earlier study addressed a more traumatic oriented topic [ 38 ].…”

Implementation Science Perspectives on Implementing Telemedicine Interventions for Hypertension or Diabetes Management: Scoping Review

“…Using the Unified Theory of Acceptance and Use of Technology, the authors explored predictors of intention to use the app [ 52 ]. Alshehri and Alshaikh [ 53 ] explored the implementation of an app for patients with prediabetes in Saudi Arabia using questionnaires with 48 patients and 20 HCPs. The study found that most patients thought the app would be useful for patients with prediabetes [ 53 ].…”

“…Alshehri and Alshaikh [ 53 ] explored the implementation of an app for patients with prediabetes in Saudi Arabia using questionnaires with 48 patients and 20 HCPs. The study found that most patients thought the app would be useful for patients with prediabetes [ 53 ].…”

“…Patient needs and resources refers to the extent to which patient needs are known and prioritized by the organization [ 44 ]. Intervention implementation was successful if it included personalized information, provided discussion forums, ensured patients’ convenience in accessing care, integrated culturally relevant diet and exercise plans, and leveraged family or friend engagement [ 45 , 47 , 48 , 50 , 51 , 53 , 59 , 60 , 65 , 67 , 68 , 78 ]. In contrast, intervention implementation was difficult when there was a lack of patient support from HCPs; technical support was unavailable; and linguistic, cultural, or transportation needs of individuals, especially disadvantaged groups, were unmet [ 47 , 48 , 50 , 56 , 62 , 68 , 77 , 79 ].…”

“…In addition, some patients did not trust web-based health care services and lacked an understanding of telemedicine and diseases [ 60 , 68 , 69 , 78 , 79 ]. In contrast, 31% (11/35) of the studies reported that patients believed that using technology was supportive, convenient, encouraging, and helpful for their health and for keeping up with the times [ 46 , 50 , 53 , 55 , 59 , 63 , 67 , 74 ].…”