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Accepted for/Published in: JMIR Human Factors

Date Submitted: Jun 11, 2025
Open Peer Review Period: Jun 23, 2025 - Aug 18, 2025
Date Accepted: Feb 19, 2026
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Aspects Supporting and Hindering Type 2 Diabetes Self-Management in Web-Based Educational Portals: Usability Testing Study With Updated Framework in Razavi-Khorasan, Iran

Jafari J, Karlgren K, Karimi Moonaghi H, Mazaheri Habibi MR, Eslami S, Masiello I, Bonacina S

Aspects Supporting and Hindering Type 2 Diabetes Self-Management in Web-Based Educational Portals: Usability Testing Study With Updated Framework in Razavi-Khorasan, Iran

JMIR Hum Factors 2026;13:e78903

DOI: 10.2196/78903

PMID: 41921110

Warning: This is an author submission that is not peer-reviewed or edited.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.

Aspects supporting and hindering type 2 diabetes self-management in web-based educational portals: A usability study in Razavi-Khorasan, Iran

  • Javad Jafari; 
  • Klas Karlgren; 
  • Hossein Karimi Moonaghi; 
  • Mohammad Reza Mazaheri Habibi; 
  • Saeid Eslami; 
  • Italo Masiello; 
  • Stefano Bonacina

ABSTRACT

Background:

The rising prevalence of diabetes necessitates continuous monitoring and treatment, especially for type 2 diabetes. Patient education plays a crucial role in enabling self-management, and web-based educational portals can support patients effectively. While literature highlights various issues impacting self-management system design, few studies explore the usability aspects that either facilitate or hinder such systems for this patient group.

Objective:

This study investigated usability issues related to a web-based educational portal for diabetes patients, in Razavi-Khorasan province, Iran. Additionally, it sought to develop a framework of design principles to address critical usability concerns for diabetes self-management.

Methods:

The literature on diabetes self-management was analyzed. The analysis focused on design and usability issues affecting self-management. A think-aloud study was carried out with ten patients using a web-based educational portal designed for diabetes patients. The portal comprises nine sections, with patients performing tasks related to each one. Participants’ task completion times were measured, and problem severity ratings were calculated.

Results:

Five design principles were proposed that cover: (1) understanding and learning about one’s condition, (2) motivation and fostering sustained practices, (3) autonomy and confidence, (4) interaction and collaboration, and (5) privacy and security. The study identified 111 usability problems related to the portal’s nine sections. Feedback from participants was considered to refine the principles, and participants’ considerations were recorded for any issues that worked against the principles. A total of 16 suggestions for improvement were extrapolated from the data.

Conclusions:

This study highlights critical usability and design aspects to consider when developing web-based educational portals to support self-management in type 2 diabetes.


 Citation

Please cite as:

Jafari J, Karlgren K, Karimi Moonaghi H, Mazaheri Habibi MR, Eslami S, Masiello I, Bonacina S

Aspects Supporting and Hindering Type 2 Diabetes Self-Management in Web-Based Educational Portals: Usability Testing Study With Updated Framework in Razavi-Khorasan, Iran

JMIR Hum Factors 2026;13:e78903

DOI: 10.2196/78903

PMID: 41921110

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