Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 22, 2020
Date Accepted: Apr 30, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Preferences for mobile health technology and text messaging communication in patients with type 2 diabetes: A qualitative interview study
ABSTRACT
Background:
Individuals with diabetes need regular support to help them manage diabetes on their own, ideally delivered via mechanisms that they already use, such as their mobile phones. One reason for the modest effectiveness of prior technology-based interventions may be that the patient perspective has been insufficiently incorporated.
Objective:
To understand preferences for mobile health technology and how that technology could integrate into patients’ routines, especially with regard to medication use.
Methods:
We conducted semi-structured qualitative individual interviews with patients with type 2 diabetes from an urban healthcare system to elicit and explore their perspectives on: diabetes medication-taking behaviors, daily patterns of using mobile technology, use of mobile health technology for diabetes care, acceptability of text messages to support medication adherence, and preferred framing of information within text messages to support diabetes care. Interviews were digitally recorded and transcribed. Data were analyzed using codes developed by the study team to generate themes, with representative quotations selected as illustrations.
Results:
We conducted interviews with 20 participants; 60% were female, 55% were non-white, and mean glycated hemoglobin A1c control was 7.8 (SD: 1.1). Five key themes were identified: (1) Patients try to incorporate “cues” into their routines to help them with consistent medication-taking; (2) Many patients leverage some form of technology as a cue to support adherence to medication-taking and diabetes self-management behaviors; (3) Patients value simplicity and integration for technology solutions used for diabetes care, managing medications, and communicating with healthcare providers; (4) Some patients express reluctance to rely on mobile technology for these diabetes care behaviors; and (5) Patients believe they prefer positively framed communication, but communication preferences are highly individualized.
Conclusions:
Participants expressed some hesitation about using mobile technology in supporting diabetes self-management but have largely incorporated it or are open to incorporating it as a cue to make medication-taking more automatic and less burdensome. When using technology to support diabetes self-management, participants exhibited individualized preferences, but overall preferred simple and positively framed communication. Mobile health interventions may be improved by focusing on integrating them easily into daily routines and increasing customization of content. Clinical Trial: N/A
Citation
