Toward Diabetes Device Development That Is Mindful to the Needs of Young People Living With Type 1 Diabetes: A Data- and Theory-Driven Qualitative Study

Nicola Brew-Sam; Anne Parkinson; Madhur Chhabra; Adam Henschke; Ellen Brown; Lachlan Pedley; Elizabeth Pedley; Kristal Hannan; Karen Brown; Kristine Wright; Christine Phillips; Antonio Tricoli; Christopher J Nolan; Hanna Suominen; Jane Desborough

doi:10.2196/43377

Toward Diabetes Device Development That Is Mindful to the Needs of Young People Living With Type 1 Diabetes: A Data- and Theory-Driven Qualitative Study

JMIR Diabetes. 2023 Jan 25:8:e43377. doi: 10.2196/43377.

Authors

Nicola Brew-Sam¹, Anne Parkinson¹, Madhur Chhabra¹, Adam Henschke², Ellen Brown¹, Lachlan Pedley¹, Elizabeth Pedley^{1

3}, Kristal Hannan¹, Karen Brown^{1

3}, Kristine Wright^{1

3}, Christine Phillips⁴, Antonio Tricoli^{5

6}, Christopher J Nolan^{4

7

8}, Hanna Suominen^{9

10}, Jane Desborough¹

Affiliations

¹ National Centre for Epidemiology and Population Health, College of Health and Medicine, The Australian National University, Canberra, Australia.
² Philosophy Section, Faculty of Behavioural, Management, and Social Sciences, University of Twente, Enschede, Netherlands.
³ The Centenary Hospital for Women and Children, Canberra Health Services, Canberra, Australia.
⁴ School of Medicine and Psychology, College of Health and Medicine, The Australian National University, Canberra, Australia.
⁵ Nanotechnology Research Laboratory, Faculty of Engineering, The University of Sydney, Sydney, Australia.
⁶ Nanotechnology Research Laboratory, Research School of Chemistry, College of Science, The Australian National University, Canberra, Australia.
⁷ The John Curtin School of Medical Research, College of Health and Medicine, The Australian National University, Canberra, Australia.
⁸ Department of Endocrinology and Diabetes, Canberra Health Services, Canberra, Australia.
⁹ School of Computing, College of Engineering, Computing and Cybernetics, The Australian National University, Canberra, Australia.
¹⁰ Department of Computing, University of Turku, Turku, Finland.

PMID: 36696176
PMCID: PMC9947809
DOI: 10.2196/43377

Abstract

Background: An important strategy to understand young people's needs regarding technologies for type 1 diabetes mellitus (T1DM) management is to examine their day-to-day experiences with these technologies.

Objective: This study aimed to examine young people's and their caregivers' experiences with diabetes technologies in an exploratory way and relate the findings to the existing technology acceptance and technology design theories. On the basis of this procedure, we aimed to develop device characteristics that meet young people's needs.

Methods: Overall, 16 in-person and web-based face-to-face interviews were conducted with 7 female and 9 male young people with T1DM (aged between 12 and 17 years) and their parents between December 2019 and July 2020. The participants were recruited through a pediatric diabetes clinic based at Canberra Hospital. Data-driven thematic analysis was performed before theory-driven analysis to incorporate empirical data results into the unified theory of acceptance and use of technology (UTAUT) and value-sensitive design (VSD). We used the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist for reporting our research procedure and findings. In this paper, we summarize the key device characteristics that meet young people's needs.

Results: Summarized interview themes from the data-driven analysis included aspects of self-management, device use, technological characteristics, and feelings associated with device types. In the subsequent theory-driven analysis, the interview themes aligned with all UTAUT and VSD factors except for one (privacy). Privacy concerns or related aspects were not reported throughout the interviews, and none of the participants made any mention of data privacy. Discussions around ideal device characteristics focused on reliability, flexibility, and automated closed loop systems that enable young people with T1DM to lead an independent life and alleviate parental anxiety. However, in line with a previous systematic review by Brew-Sam et al, the analysis showed that reality deviated from these expectations, with inaccuracy problems reported in continuous glucose monitoring devices and technical failures occurring in both continuous glucose monitoring devices and insulin pumps.

Conclusions: Our research highlights the benefits of the transdisciplinary use of exploratory and theory-informed methods for designing improved technologies. Technologies for diabetes self-management require continual advancement to meet the needs and expectations of young people with T1DM and their caregivers. The UTAUT and VSD approaches were found useful as a combined foundation for structuring the findings of our study.

Keywords: UTAUT; data- and theory-driven analysis; improved device design; type 1 diabetes mellitus; unified theory of acceptance and use of technology; value-sensitive design; young people.

©Nicola Brew-Sam, Anne Parkinson, Madhur Chhabra, Adam Henschke, Ellen Brown, Lachlan Pedley, Elizabeth Pedley, Kristal Hannan, Karen Brown, Kristine Wright, Christine Phillips, Antonio Tricoli, Christopher J Nolan, Hanna Suominen, Jane Desborough. Originally published in JMIR Diabetes (https://diabetes.jmir.org), 25.01.2023.