JMIR Publications

ABSTRACT

Background:

mHealth interventions are increasingly being used to help improve self-management among patients with diabetes. However, these interventions have not been adopted by a large number of patients and often have high dropout rates. Patients’ personality characteristics may play critical roles in app adoption and active utilization, but little research has focused on this question.

Objective:

This study aims to address a gap in understanding the relationship between personality traits and mHealth treatment for patients with diabetes. We tested the role of the Big Five personality traits (openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism/emotional stability) in mHealth adoption preference and active utilization.

Methods:

We developed an mHealth app (DiaSocial) aimed to encourage self-management. We recruited 98 patients with diabetes who freely chose standard care or the mHealth app treatment. Patients’ demographic information and their Big Five personality characteristics were assessed at baseline. App usage data was collected to measure user utilization of the app. Patient health outcomes were assessed with lab measures of HbA1c. Logistic regression models and linear regression were employed to explore factors predicting mHealth use (adoption and active utilization) and changes in health outcome.

Results:

Of 98 study participants, 46 actually downloaded and used the app. The results revealed that relatively younger patients with diabetes were 9% (P=.02; OR 0.91, 95% CI 0.85-0.98) more likely to try and use the app compared to the older patients with diabetes. Extraversion (P=.04; OR 0.71, 95% CI 0.51-0.98) was negatively associated with the adoption of the mHealth app, and openness to experience (P=.03; OR 1.73, 95% CI 1.07-2.80) was positively associated. However, gender, education, and baseline HbA1c were not associated with app adoption. Among those who adopted the app, low education level (senior vs. primary P=.003; higher vs. primary P=.03) and high level of openness to experience (P=.048; OR 2.01, 95% CI 1.01-4.00) were associated with active app utilization. Active users showed a significantly greater decrease in HbA1c than other users (change-HbA1c=-0.68, P=.05).

Conclusions:

This is one of the first studies to investigate how different personality traits influence the adoption of and active utilization of an mHealth app among patients with diabetes. The research findings suggest that personality should be considered when trying to identify patients who would benefit the most from apps for diabetes management.