JMIR Publications

ABSTRACT

Background:

Technology-assisted self-management programmes are increasingly recommended to patients for delivery or support of lifestyle interventions in part to reduce the burden on healthcare providers in the face of increasing non-communicable diseases, such as diabetes. However, there are a number of personal and external factors affecting the ability to engage with and effectively utilise such programmes. A randomised controlled trial of a multi-modal on-line programme for diabetes self-management (BetaMe/Melon) was conducted in the primary care setting, and a process evaluation completed at the end of the study period.

Objective:

This process evaluation aimed to examine utilisation patterns of BetaMe/Melon, identify which components participants found the most (and least) useful, and identify future improvements.

Methods:

Process evaluation data were collected for intervention arm participants from three sources: the mobile/web platform, to identify key usage patterns over the 16 week core programme; through an on-line questionnaire completed during the final study assessment, and; from interviews conducted with a subset of participants following the study period. Participants were classified as ‘actively engaged’ if any usage data was recorded for the participant (in any week) and patterns reported by age, gender, ethnicity and diabetes/pre-diabetes status. The on-line questionnaire asked participants about the usefulness of the programme and whether they would recommend BetaMe/Melon to others according to a five point Likert Scale. Eighteen of 23 invited participants participated in a digitally-recorded semi-structured telephone interview. Interview data were thematically analysed.

Results:

Of the 215 participants, 160 (74%) were actively engaged with the programme at some point during the 16 week core programme. Engagement varied by demographic grouping, with female, younger and ethnic majority populations appearing to - or having - higher engagement. Usage steadily declined from 50% utilisation at week 0 to 23% at week 15. Participants ranked component usefulness as: education resources (63.7%), health coaches (59.2%), goal tracking (48.8%) and online peer support (42.1%). While only 53% agreed that the programme was easy to use, 64% would recommend the programme to others. Interview participants found BetaMe/Melon useful overall, with most identifying beneficial outcomes (increased knowledge, behaviour changes and weight loss). Barriers to engagement related to programme functionality, internet connectivity, incomplete delivery of all programme components and participant motivation. A range of improvements to the BetaMe/Melon programme were suggested.

Conclusions:

The programme was generally well received by participants and active engagement was initially high, although declined steadily. Maintaining engagement of participants over time, individualising programmes and addressing technical barriers are important to maximise potential health benefits from on-line diabetes self-management programmes. Clinical Trial: Trial Registration number ACTRN12617000549325; Universal Trial Number (UTN) U1111–1189-9094.