Feasibility and user experience of the unguided web-based self-help app ‘MyDiaMate’ aimed to prevent and reduce psychological distress and fatigue in adults with diabetes

Abstract

Introduction Psychological distress and fatigue are common in persons with diabetes, adversely affecting quality of life and complicating diabetes self-management. Offering diabetes-specific self-guided cognitive behavioral therapy (CBT) may be helpful for persons with diabetes and mild symptoms of psychological distress and fatigue. We are the first to test the feasibility and user experiences of a web-based self-help app called ‘MyDiaMate’ in adults with type 1 and type 2 diabetes. Methods and materials MyDiaMate was developed in close collaboration with persons with diabetes and professionals, building on elements from existing (guided) diabetes-specific CBT interventions. The study was advertised, offering free access to the app for adults with diabetes for a period of three months. Feasibility and user experiences were tested in a non-randomized study with pre- and post- measurements and interviews in a small sample.. In addition usage of the app was studied using log-data.. Results In total N = 55 adults with diabetes signed up for the study. Mean age was M = 42.7 (SD = 15.6), mostly women ( n = 39, 70.9%), higher educated ( n = 36, 65.5%), and diagnosed with type 1 diabetes ( n = 37, 67.3%). About half reported current or a history of psychological complaints. All the participants completed baseline assessments, and n = 32 participants (58%) completed the follow-up questionnaire. Main reasons for participating in the study were: to preserve or improve mental fitness (40.6%), curiosity (25.0%) and wanting to contribute to research (34.4%). No major technical issues were encountered in accessing or using the app. The app was opened at least once by n = 51 participants, median use of the modules was 28 min (1–80) within a period of 1 to 92 days (median = 10). Almost all participants ( n = 50, 98.0%) opened the basic module ‘Diabetes in balance’, of whom 32 (62.7%) completed this module. ‘My mood’ and ‘My energy’ were opened by n = 40 (78.4%) and n = 32 (62.7%) participants, respectively, and completed by n = 21 (52.5%) and n = 9 (28.1%) of the participants. Of all participants, 40.6% would recommend the app to others living with diabetes. Conclusions This study confirmed the feasibility of MyDiaMate as a diabetes-specific self-guided app for adults wishing to preserve or improve their psychological health. While user experiences were overall positive, further tailoring the content to individual needs and preferences could enhance uptake, usage and appreciation. Future research should explore its effectiveness in a randomized controlled trial.

ISPAD Clinical Practice Consensus Guidelines 2022: Diabetes education in children and adolescents

“… 34 , 53 , 118 Evidence from group discussions with young people suggests that education using these newer technologies is attractive, and there is further scientific data to support its widespread use. 114 , 118 , 119 , 120 , 121 However, there is still a lack of robust data on effectiveness in relation to key outcome parameters. 122 , 123 …”

“…114,[118][119][120][121] However, there is still a lack of robust data on effectiveness in relation to key outcome parameters 122,123. …”

Roles and competencies of the clinical psychologist in adult diabetes care—A consensus report

“…49 The American Diabetes Association in partnership with the American Psychological Association offers a Mental Health Provider Diabetes Education Program for licensed mental health professionals that consists of a 7-hour live course and an additional 5-hour online course. 50 Both courses are interesting examples to further explore and should prove helpful in developing a truly comprehensive, accredited training programme for clinical psychologists working in the field of diabetes that can be implemented across countries. Development and implementation of an accredited programme for 'diabetes psychologists', requires close collaboration between diabetes associations, diabetes psychology interest groups, such as the international PSAD study group, and clinical psychology societies.…”

“…The German Diabetes Association offers a post‐graduate training for psychologists and psychotherapists, consisting of six seminars, coupled with supervision and a substantial number of working hours in a diabetes centre to become a ‘psychodiabetologist’ 49 . The American Diabetes Association in partnership with the American Psychological Association offers a Mental Health Provider Diabetes Education Program for licensed mental health professionals that consists of a 7‐hour live course and an additional 5‐hour online course 50 . Both courses are interesting examples to further explore and should prove helpful in developing a truly comprehensive, accredited training programme for clinical psychologists working in the field of diabetes that can be implemented across countries.…”

Mental health in diabetes care. Time to step up

“…Integrating IMI’s in diabetes care can help to provide psychological support to large groups of patients. Self-guided applications may assist patients in improving healthy coping and prevent symptoms of emotional distress from worsening ( 39 ). Mental vitality is a conditio sine qua non for successful diabetes self-management.…”