JMIR Publications

ABSTRACT

Background:

Using a diabetes app can improve glycemic control, however, the use of diabetes apps is low possibly due to design issues that affect patient motivation.

Objective:

This study describes app designs desired by insulin-dependent adults to support diabetes self-management as postulated by the Self-Determination Theory (SDT) on motivation.

Methods:

This is a qualitative analysis of data collected during a crossover randomized laboratory trial (n=92) testing two diabetes apps. Data sources included: (1) observations during app testing, and (2) survey responses on desired app features. Guided by SDT, coding categories included app functions that could address psychological needs for motivation in self-management: competence, autonomy, and connection to others.

Results:

Patients described design features that addressed needs for competence, autonomy, and connectivity. To promote competence, electronic data recording and analysis should help patients track and understand blood glucose (BG) results necessary for planning behavior changes. To promote autonomy, BG trend analysis should empower patients to set safe and practical personalized behavioral goals based on time, day of the week as well as options to change diet and insulin dose. To promote connectivity, app email or messaging function could share data reports and communicate with others on self-management advice.

Conclusions:

SDT theory was useful in identifying motivational app designs that address psychological needs of competence, autonomy, and connectivity. Patients want engaging diabetes apps that go beyond data input and output. Apps should provide personalized analysis reports, provide immediate affirmation of positive behaviors, facilitate data sharing, and support patient-clinician communication.