Factors Affecting Acceptability and Usability of Technological Approaches to Diabetes Self-Management: A Case Study

Vuong, Ann M.; Huber, John C.; Bolin, Jane N.; Ory, Marcia G.; Moudouni, Darcy M.; Helduser, Janet W.; Begaye, Dawn; Bonner, Timethia; Forjuoh, Samuel N.

doi:10.1089/dia.2012.0139

Cited by 45 publications

(36 citation statements)

References 24 publications

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“…The finding strengthens the conclusions in recent studies [66,67] that smartphones would be more suitable platforms for a support tool for self-management of lifestyle-related diseases than contemporary mobile phones or PDAs.…”

Section: Discussionsupporting

confidence: 89%

Long-Term Engagement With a Mobile Self-Management System for People With Type 2 Diabetes

Tatara¹,

Årsand²,

Skrøvseth³

et al. 2013

JMIR Mhealth Uhealth

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BackgroundIn a growing number of intervention studies, mobile phones are used to support self-management of people with Type 2 diabetes mellitus (T2DM). However, it is difficult to establish knowledge about factors associated with intervention effects, due to considerable differences in research designs and outcome measures as well as a lack of detailed information about participants’ engagement with the intervention tool.ObjectiveTo contribute toward accumulating knowledge about factors associated with usage and usability of a mobile self-management application over time through a thorough analysis of multiple types of investigation on each participant’s engagement.MethodsThe Few Touch application is a mobile-phone–based self-management tool for patients with T2DM. Twelve patients with T2DM who have been actively involved in the system design used the Few Touch application in a real-life setting from September 2008 until October 2009. During this period, questionnaires and semistructured interviews were conducted. Recorded data were analyzed to investigate usage trends and patterns. Transcripts from interviews were thematically analyzed, and the results were further analyzed in relation to the questionnaire answers and the usage trends and patterns.ResultsThe Few Touch application served as a flexible learning tool for the participants, responsive to their spontaneous needs, as well as supporting regular self-monitoring. A significantly decreasing (P<.05) usage trend was observed among 10 out of the 12 participants, though the magnitude of the decrease varied widely. Having achieved a sense of mastery over diabetes and experiences of problems were identified as reasons for declining motivation to continue using the application. Some of the problems stemmed from difficulties in integrating the use of the application into each participant’s everyday life and needs, although the design concepts were developed in the process where the participants were involved. The following factors were identified as associated with usability and/or usage over time: Integration with everyday life; automation; balance between accuracy and meaningfulness of data with manual entry; intuitive and informative feedback; and rich learning materials, especially about foods.ConclusionMany grounded design implications were identified through a thorough analysis of results from multiple types of investigations obtained through a year-long field trial of the Few Touch application. The study showed the importance and value of involving patient-users in a long-term trial of a tool to identify factors influencing usage and usability over time. In addition, the study confirmed the importance of detailed analyses of each participant’s usage of the provided tool for better understanding of participants’ engagement over time.

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Section: Discussionsupporting

confidence: 89%

Long-Term Engagement With a Mobile Self-Management System for People With Type 2 Diabetes

Tatara¹,

Årsand²,

Skrøvseth³

et al. 2013

JMIR Mhealth Uhealth

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show abstract

“…As noted in a recent study, persons in the PDA arm discontinued their PDA use primarily because they were frustrated with the device and/or the diabetes pilot software on it [21]. In evaluating this, Vuong et al identified several limitations that may have contributed to the observed frustration, including usability, data loss/errors, and time constraints.…”

Section: Discussionmentioning

confidence: 99%

Effects of diabetes self-management programs on time-to-hospitalization among patients with type 2 diabetes: A survival analysis model

Adepoju

Bolin

Phillips

et al. 2014

Patient Education and Counseling

Self Cite

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Objective This study compared time-to-hospitalization among subjects enrolled in different diabetes self-management programs (DSMP). We sought to determine whether the interventions delayed the occurrence of any acute event necessitating hospitalization. Methods Electronic medical records (EMR) were obtained for 376 adults enrolled in a randomized controlled trial (RCT) of Type 2 diabetes (T2DM) self-management programs. All study participants had uncontrolled diabetes and were randomized into either: personal digital assistant (PDA), Chronic Disease Self-Management Program (CDSMP), combined PDA and CDSMP (COM), or usual care (UC) groups. Subjects were followed for a maximum of two years. Time-to-hospitalization was measured as the interval between study enrollment and the occurrence of a diabetes-related hospitalization. Results Subjects enrolled in the CDSMP-only arm had significantly prolonged time-to-hospitalization (Hazard ratio: 0.10; p = 0.002) when compared to subjects in the control arm. Subjects in the PDA-only and combined PDA and CDSMP arms showed no improvements in comparison to the control arm. Conclusion CDSMP can be effective in delaying time-to-hospitalization among patients with T2DM. Practice implications Reducing unnecessary healthcare utilization, particularly inpatient hospitalization is a key strategy to improving the quality of health care and lowering associated health care costs. The CDSMP offers the potential to reduce time-to-hospitalization among T2DM patients.

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“…Population levels of eHealth literacy change as new technologies emerge and as social values, norms, and environments evolve 68. Therefore, this approach requires the health care provider to be confident and familiar with new technology,67,72 have an understanding of the benefits and risks of each type of technology, and recognize that technology may present an additional burden to the patient 73. The use of eHealth technologies within clinical practice also presents new challenges and unique requirements in regard to data governance (collection, transmission, sharing, and storage of data) relating to health care.…”

Section: Challenges and Facilitators To Using Ehealth Technologies Fomentioning

confidence: 99%

eHealth technologies to support nutrition and physical activity behaviors in diabetes self-management

Rollo¹,

Aguiar²,

Williams³

et al. 2016

DMSO

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Diabetes is a chronic, complex condition requiring sound knowledge and self-management skills to optimize glycemic control and health outcomes. Dietary intake and physical activity are key diabetes self-management (DSM) behaviors that require tailored education and support. Electronic health (eHealth) technologies have a demonstrated potential for assisting individuals with DSM behaviors. This review provides examples of technologies used to support nutrition and physical activity behaviors in the context of DSM. Technologies covered include those widely used for DSM, such as web-based programs and mobile phone and smartphone applications. In addition, examples of novel tools such as virtual and augmented reality, video games, computer vision for dietary carbohydrate monitoring, and wearable devices are provided. The challenges to, and facilitators for, the use of eHealth technologies in DSM are discussed. Strategies to support the implementation of eHealth technologies within practice and suggestions for future research to enhance nutrition and physical activity behaviors as a part of broader DSM are provided.

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Factors Affecting Acceptability and Usability of Technological Approaches to Diabetes Self-Management: A Case Study

Cited by 45 publications

References 24 publications

Long-Term Engagement With a Mobile Self-Management System for People With Type 2 Diabetes

Long-Term Engagement With a Mobile Self-Management System for People With Type 2 Diabetes

Effects of diabetes self-management programs on time-to-hospitalization among patients with type 2 diabetes: A survival analysis model

eHealth technologies to support nutrition and physical activity behaviors in diabetes self-management

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