JMIR Publications

ABSTRACT

Background:

Despite more than 1,100 diabetes mobile applications (apps) are available, few apps are used widely related to limited usability or application of a behavior theory in app design.

Objective:

Guided by Self-Determination Theory, this study assessed the usability of diabetes apps and whether usability was associated with patient characteristics and psychological needs for competence, autonomy, and connectivity important for health behavior motivation.

Methods:

Using a crossover randomized design, 92 adults with type 1 or 2 diabetes tested two Android apps (mySugr and OnTrack) for tasks including data entry, blood glucose (BG) reporting, and data sharing. Multivariable linear regression models examined associations between patient characteristics, psychological needs, user satisfaction and performance (task time, success, and accuracy).

Results:

Higher user satisfaction was observed for patients with less education and for those reporting more competence, autonomy, or connectivity with a healthcare provider (P < .05). User performance was associated with age, sex, education, and diabetes duration. Older patients required more time and had less successful task completion. Men needed more time and technical support than women. A high school education or less and a diabetes duration of 10+ years were associated with lower task accuracy (P < .01).

Conclusions:

Diabetes app usability was associated with psychological needs that are important for motivation. To enhance patient motivation to use diabetes apps for self-management, clinicians should address competence, autonomy, and connectivity by teaching BG pattern recognition and lifestyle planning, customizing BG targets, and reviewing home-monitored data via email. Older male users and those with less education and greater diabetes duration may benefit from patient-centered app training and ongoing technical support.