JMIR Publications

ABSTRACT

Background:

MyDiaMate is a web-based intervention specifically designed for adults with type 1 diabetes (T1D), that aims to help them improve and maintain their mental health. Prior pilot testing of MyDiaMate verified its acceptability, feasibility, and usability.

Objective:

The present study aimed to investigate the real-world uptake and usage of MyDiaMate in the Netherlands.

Methods:

Between March 2021 and December 2022, MyDiaMate was made freely available to Dutch adults with T1D. Usage (participation and completion rates of the modules) was tracked using log-data. Users could volunteer to participate in the user profile study, which required filling out a set of baseline questionnaires. Usage of study participants was examined separately for participants scoring above and below the cut-offs of PAID-11 (diabetes distress), WHO-5 (emotional well-being), and CIS (fatigue). Two months after creating an account, study participants received an evaluation questionnaire to provide us with feedback.

Results:

In total, N = 1008 adults created a MyDiaMate account, of which n = 344 (34.1%) participated in the user profile study. Mean age was 43 years (18 - 76 years). Most participants were female (n = 217, 63.1%) and higher educated (n = 198, 57.6%). The majority had been living with T1D for over 5 years. Of the 344 participants, 59.1% (n = 199) persons reported low emotional well-being (WHO-5 ≤50), 70.9% (n = 239) reported elevated diabetes distress (PAID-11 ≥18) and 52.4% (n = 178) reported severe fatigue (CIS ≥35). Participation rates varied between 9.5% for Social Environment to 100% for Diabetes in Balance, which opened by default. Completion rates ranged from 4.3% for Energy, an extensive CBT (cognitive behavioural therapy) module, to 68.6% for the shorter module on Hypos. There were no differences in terms of participation and completion rates of the modules between study participants with a more severe profile i.e. lower emotional well-being, greater diabetes distress, or more fatigue symptoms, and those with a less severe profile. Further, not one technical problem was reported and different suggestions were made by study participants to improve the application, suggesting a need for more personalisation

Conclusions:

Data from this naturalistic study demonstrated the potential of MyDiaMate as a self-help tool for adults with T1D, supplementary to ongoing diabetes care, to improve healthy coping with diabetes and mental health. Future research is needed to explore engagement strategies and test the efficacy of MyDiaMate in a randomized controlled trial.