JMIR Publications

ABSTRACT

Background:

Mobile health (mHealth) tools are used to collect data on patient-reported outcomes (PRO) and facilitate assessment of patients’ self-management behaviors outside the clinic environment. Despite high availability of mHealth diabetes tools, there lacks understanding of the underlying reasons why these mHealth PRO tools succeed or fail to change patients’ self-management behaviors.

Objective:

The objectives of this study were to: (1) identify the factors that drive engagement with a mHealth PRO tool and facilitate patients’ adoption of self-management behaviors; and (2) elicit suggestions for improvement in the context of a randomized controlled trial.

Methods:

A qualitative analysis of 67 semi-structured interviews was conducted with participants randomized to a mHealth PRO intervention. Interviews were conducted at the 3-, 6-, 9- and 12-month study visits. Data were analyzed using conventional qualitative content analysis.

Results:

We identified four overarching themes: (1) reasons for engagement with the mHealth PRO tool are multifactorial, driven by both internal and external factors; (2) use of the mHealth tool changed patients’ attitudes toward their disease and health behaviors; (3) patients feel more committed to their health as a result of using the tool; and (4) limitations in the tool’s design detracted from patients’ experience.

Conclusions:

This study isolated internal and external factors that prompted patients to change their views about their diabetes, become more engaged with the intervention and their health, and adopt healthy behaviors. These behavioral mechanisms provide important insights to drive future development of mHealth interventions that could lead to sustained behavior change.