Exploration of Users' Perspectives and Needs and Design of a Type 1 Diabetes Management Mobile App: Mixed-Methods Study

Yiyu Zhang; Xia Li; Shuoming Luo; Chaoyuan Liu; Fang Liu; Zhiguang Zhou

doi:10.2196/11400

Exploration of Users' Perspectives and Needs and Design of a Type 1 Diabetes Management Mobile App: Mixed-Methods Study

JMIR Mhealth Uhealth. 2018 Sep 21;6(9):e11400. doi: 10.2196/11400.

Authors

Yiyu Zhang^#^{1

2

3}, Xia Li^#^{1

2

3}, Shuoming Luo^{1

2

3}, Chaoyuan Liu⁴, Fang Liu¹, Zhiguang Zhou^{1

2

3}

Affiliations

¹ Department of Metabolism and Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, China.
² Key Laboratory of Diabetes Immunology, Ministry of Education, Changsha, China.
³ National Clinical Research Center for Metabolic Diseases, Changsha, China.
⁴ Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China.

^# Contributed equally.

PMID: 30249580
PMCID: PMC6231832
DOI: 10.2196/11400

Abstract

Background: With the popularity of mobile phones, mobile apps have great potential for the management of diabetes, but the effectiveness of current diabetes apps for type 1 diabetes mellitus (T1DM) is poor. No study has explored the reasons for this deficiency from the users' perspective.

Objective: The aims of this study were to explore the perspectives and needs of T1DM patients and diabetes experts concerning a diabetes app and to design a new T1DM management mobile app.

Methods: A mixed-methods design combining quantitative surveys and qualitative interviews was used to explore users' needs and perspectives. Experts were surveyed at 2 diabetes conferences using paper questionnaires. T1DM patients were surveyed using Sojump (Changsha ran Xing InfoTech Ltd) on a network. We conducted semistructured, in-depth interviews with adult T1DM patients or parents of child patients who had ever used diabetes apps. The interviews were audio-recorded, transcribed, and coded for theme identification.

Results: The expert response rate was 63.5% (127/200). The respondents thought that the reasons for app invalidity were that patients did not continue using the app (76.4%, 97/127), little guidance was received from health care professionals (HCPs; 73.2%, 93/127), diabetes education knowledge was unsystematic (52.8%, 67/127), and the app functions were incomplete (44.1%, 56/127). A total of 245 T1DM patient questionnaires were collected, of which 21.2% (52/245) of the respondents had used diabetes apps. The reasons for their reluctance to use an app were limited time (39%, 20/52), complicated operations (25%, 13/52), uselessness (25%, 13/52), and cost (25%, 13/52). Both the experts and patients thought that the most important functions of the app were patient-doctor communication and the availability of a diabetes diary. Two themes that were useful for app design were identified from the interviews: (1) problems with patients' diabetes self-management and (2) problems with current apps. In addition, needs and suggestions for a diabetes app were obtained. Patient-doctor communication, diabetes diary, diabetes education, and peer support were all considered important by the patients, which informed the development of a prototype multifunctional app.

Conclusions: Patient-doctor communication is the most important function of a diabetes app. Apps should be integrated with HCPs rather than stand-alone. We advocate that doctors follow up with their patients using a diabetes app. Our user-centered method explored comprehensively and deeply why the effectiveness of current diabetes apps for T1DM was poor and what T1DM patients needed for a diabetes app and provided meaningful guidance for app design.

Keywords: diabetes mellitus, type 1; mobile applications; qualitative research; surveys and questionnaires.

©Yiyu Zhang, Xia Li, Shuoming Luo, Chaoyuan Liu, Fang Liu, Zhiguang Zhou. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 21.09.2018.