JMIR Publications

ABSTRACT

Background:

Empowering young people with type 1 diabetes (T1D) to manage their blood glucose levels during exercise is a complex challenge faced by health care professionals, due to the unpredictable nature of exercise and its effect on blood glucose levels. Mobile health applications (m-health App) would be useful as a decision-support aid to effectively contextualize a blood glucose result and take appropriate action to optimize glucose levels during and after exercise. A novel m-health app acT1ve was recently developed, based on expert consensus exercise guidelines, to provide real-time support for young people T1D during exercise.

Objective:

Our aim was to pilot acT1ve in a free living setting to assess its acceptability, functionality, and gather feedback on the user experience before testing it in a larger clinical trial.

Methods:

A prospective single arm mixed method design was used. Ten subjects with T1D (mean ± SD age 17.7 ± 4.2 years, Haemoglobin A1c 54 ± 5.5 mmol/mol (7.1 ± 0.5%)) had acT1ve installed on their phone, and were asked to use the app to guide their exercise management for 6 weeks. At the end of 6 weeks, participants completed both a semi-structured interview and the user Mobile Application Rating Scale (uMARS). All semi-structured interviews were transcribed. Thematic analysis was conducted whereby interview transcripts were independently analysed by two researchers to uncover important and relevant themes. The uMARS was scored for the four quality subscales (engagement, functionality, aesthetics, information), and a total quality score was obtained from the weighted average of the four subscales. Scores for the 4 objective subscales were determined by the mean score of each of its individual questions. The perceived impact and subjective quality of acT1ve for each participant were calculated by averaging the scores of their related questions, but were not considered in the total quality score. All scores have a maximal possible value of 5, and were presented as medians, interquartile ranges (IQRs) and ranges.

Results:

The major themes arising from the interview analysis were increased knowledge, feelings related to confidence and trust to exercise, and suitability for people who are less engaged in exercise. The uMARS scores for acT1ve were high (out of 5) for its total quality 4.3 [4.2-4.6], engagement 3.9 [3.6-4.2], functionality 4.8 [4.5-4.8], information 4.6 [4.5-4.8], aesthetics 4.3 [4.0-4.7], subjective quality 4.0 [(3.8-4.2] and perceived impact 4.3 [3.6-4.5] in the uMARS.

Conclusions:

The acT1ve App is functional and acceptable, with a high user satisfaction. The efficacy and safety of this app will be tested in a randomized control trial in the next phase of this study. Clinical Trial: Not a clinical trial