The Systematic Design of a Behavioural Mobile Health Application for the Self-Management of Type 2 Diabetes

• Published in: Canadian journal of diabetes Vol. 40; no. 1; pp. 95 - 104
• Main Authors: Goyal, Shivani, MSc, Morita, Plinio, PhD, Lewis, Gary F., MD, Yu, Catherine, MD, MHSc, Seto, Emily, PhD, PEng, Cafazzo, Joseph A., PhD, PEng
• Format: Journal Article
• Language: English
• Published: Canada Elsevier Inc 01.02.2016
• Subjects: A1c; activité physique; Behavior Therapy - trends; Biomedical Research; blood glucose; Combined Modality Therapy; conception de logiciels; diabetes mellitus; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - therapy; diabète sucré; Diet, Diabetic; Diet, Reducing; Endocrinology & Metabolism; glycémie; Humans; Hyperglycemia - prevention & control; Hypoglycemic Agents - therapeutic use; Life Style; lifestyle; mesures incitatives; Mobile Applications; mobile health; mode de vie; Models, Psychological; Motivation; Motor Activity; Other; Overweight - complications; Overweight - diet therapy; Overweight - therapy; Patient Compliance; poids corporel; Precision Medicine - trends; prise en charge autonome; Research Design; régime alimentaire; santé mobile; Self Care - trends; self-management; Social Media; Telemedicine - trends; Weight Loss; blood glucose; conception de logiciels; santé mobile; mode de vie; mesures incitatives; diabetes mellitus; prise en charge autonome; self-management; régime alimentaire; lifestyle; diabète sucré; A1c; mobile health; activité physique; glycémie; poids corporel
• ISSN: 1499-2671; 2352-3840
• DOI: 10.1016/j.jcjd.2015.06.007

Abstract Patients with diabetes often face serious complications due to limited self-management skills, the inability to adhere to care regimens, and psychosocial factors. Although regular self-monitoring of blood glucose is known to benefit patients receiving insulin therapy, its role in patients not treated with insulin has been unclear. However, recent studies have demonstrated that structured self-monitoring of blood glucose can significantly benefit patients who are not taking insulin, facilitating improved self-awareness and clinical decision making. We hypothesize that effective self-management by patients with type 2 diabetes who do not need insulin requires a behavioural intervention that enables the association between lifestyle behaviours, such as dietary intake and physical activity, and overall glycemic control. Mobile health applications (apps), coupled with wireless medical peripheral devices, can facilitate self-monitoring; deliver tailored, actionable knowledge; elicit positive behaviour changes and promote effective self-management of diabetes. Although existing apps incorporate tracking and feedback from healthcare providers, few attempt to elicit positive behaviour changes for the purposes of developing patients' self-care skills. The purpose of this article is to present a systematic approach to the design and development a diabetes self-management mobile app, which included 1) a scoping review of literature; 2) the development of an overarching theoretical approach and 3) validation of the app features through user-centred design methods. The resulting app, bant II, facilitates 1) self-monitoring of blood glucose, physical activity, diet and weight; 2) identification of glycemic patterns in relation to lifestyle; 3) remedial decision making and 4) positive behaviour change through incentives.