Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Nov 16, 2019
Date Accepted: Jun 3, 2020
Date Submitted to PubMed: Jul 17, 2020
Identification of Type 2 Diabetes Management Mobile App Features and Engagement Strategies: A Modified Delphi Approach
ABSTRACT
Background:
Diabetes is a significant public health issue. Saudi Arabia has the highest prevalence of Type-2 diabetes mellitus (T2DM) in the Arab world. Currently, it is 31.6% of the general population, and the prevalence of T2DM is predicted to rise to 45.36% by 2030. Mobile health (mHealth) offers improved and cost-effective care to people with T2DM. However, the efficiency of engagement strategies and utility features of this technology need to be standardized and reviewed according to stakeholders’ and experts’ perspectives.
Objective:
The main objective of this study was to identify the most agreed upon features for T2DM self-management mobile apps; the secondary objective was to identify the most agreed upon strategies that prompt users to use these apps.
Methods:
In this study, a four-round modified Delphi method was applied by experts in the domain of diabetes care.
Results:
Eleven experts with a mean age of 47.09+11.70 consented to participate in the study. Thirty-six app features were generated. Overall, the group of experts displayed weak agreement (Kendall’s W=0.275) in their ranking of intervention components (χ2 = 106.017; P <0.001). The top five features included insulin dose adjustment according to carbohydrate counting and blood glucose readings (5.36), alert caregiver for abnormal/critical readings (6.09), nutrition education (12.45), contacts for guidance if required (12.64), and offer patient-specific education tailored to the user’s goals, needs, and blood glucose readings (12.90). Twenty-One engagement strategies were generated. Overall, the experts showed a moderate degree of consensus in their strategy rankings (Kendall’s W=0.454, χ2 15=99.924; P <0.001). The top five engagement strategies included a user-friendly design (educational and age-appropriate design) (2.82), a free app (3.73), allowing the user to communicate or send information/data to a healthcare providers (HCP) (5.36), HCPs prescribing the mobile app in the clinic and asking about patients’ compliance for using the app during the clinical visit (6.91), flexibility and customization (7.91).
Conclusions:
This is the first study in the region consisting of a local panel of experts from the diabetes field gathering together by using an iterative process to combine the experts’ opinion into group consensus. The result of this study could thus be useful for health authorities and HCPs for future decision-making on the topic.
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