JMIR Publications

ABSTRACT

Background:

Smartphones have been actively used in various ways for diabetes self-care (DSC). Smartphone apps can manage lifestyle factors such as diet, exercise, and medication without time or place restrictions. A systematic review has found these apps to be effective in reducing blood glucose. However, the existing apps were developed and evaluated without a theoretical framework to explain the process of changes in DSC behaviors.

Objective:

We examined the effectiveness of the DSC app that we developed by measuring differences in DSC factors between before and after using the app with the information–motivation–behavioral skills (IMB) DSC model.

Methods:

We conducted a single-group pre- and postintervention study with a convenience sample of diabetes patients. Thirty-eight adult diabetes patients who had an Android smartphone were recruited. After conducting a preliminary survey of those who agreed to participate in the study, we provided them with a manual and a tutorial video about the DSC app. The app has functions for education, recommendations, writing a diary, recording, goal setting, sharing, communication, feedback, and interfacing with glucometer, and it was applied for 4 weeks. We measured the general characteristics of participants, their history of DSC app usage, IMB-DSC factors, and blood glucose levels. The IMB-DSC factors of information, personal motivation, social motivation, behavioral skills, and behaviors were measured using an assessment tool consisted of 87 items extracted from the DKT (Diabetes Knowledge Test), DAS-3 (third version of the Diabetes Attitude Scale), DFBC (Diabetes Family Behavior Checklist), and D-SMART (Diabetes Self-Management Assessment Report Tool).

Results:

The mean age of the participants was 43.9 years. Thirty participants (78.9%) had type 2 diabetes and eight (21.1%) had type 1 diabetes. The most frequently used app function was recording, which was used by 34 (89.5%) participants. DSC behaviors (p=.016) and DSC social motivation (p=.046) differed significantly between pre- and postintervention, but there was no significant difference in DSC information (p=.86), DSC personal motivation (p=.57), or DSC behavioral skills (p=.89) between before and after using the DSC app.

Conclusions:

DSC social motivation was improved with our DSC app by sharing experiences and sympathizing with other diabetes patients. DSC behaviors was improved with the DSC app by providing an interface with a glucometer that removes the effort of manual input. DSC personal motivation and DSC behavioral skills were improved with additional offline interventions such as reflective listening and simulation. The obtained results indicate that our DSC app is effective at improving DSC behavior.