JMIR Publications

ABSTRACT

Background:

Effective self-management of type 1 diabetes mellitus (T1DM) in children and adolescents remains challenging despite advances in insulin delivery and glucose monitoring technologies. Mobile health (mHealth) interventions have emerged as promising tools to support pediatric diabetes care. However, their clinical impact and the behavioral mechanisms through which they operate—particularly those grounded in Social Cognitive Theory (SCT)—are not well established.

Objective:

This scoping review assesses mHealth applications focused on management of T1DM in the pediatric population and looks into the underlying behavioral frameworks in accordance with the Social Cognitive Theory (SCT)

Methods:

We conducted a scoping review of five databases (PubMed, Cochrane Library, EMBASE, CINAHL, Scopus) for English-language studies published between January 2000 and July 2024. Eligible studies evaluated mHealth applications for pediatric patients with T1DM (≤18 years) and reported outcomes including glycemic control, self-efficacy, adherence, self-management, or quality of life. Data were extracted and synthesized according to clinical outcomes and the presence of SCT constructs—namely self-efficacy, behavioral capability, expectations, reinforcements, and reciprocal determinism.

Results:

Of 5607 studies screened, 12 met inclusion criteria. These comprised 4 randomized controlled trials, 4 pilot studies, 2 pre-post intervention studies, 1 retrospective cohort study, and 1 double crossover trial. App features included glucose logging, insulin tracking, bolus calculators, reminders, gamification, and structured educational content. Nine studies reported HbA1c outcomes; four demonstrated statistically significant improvements, while others reported stability or no change. Several studies also reported improvements in treatment adherence and perceived self-efficacy. Eleven of twelve studies incorporated at least one SCT construct, with most integrating behavioral capability and self-efficacy as core components. Interventions employing multiple SCT constructs showed greater promise in supporting sustained behavior change.

Conclusions:

mHealth applications for pediatric T1DM are complex behavioral interventions that often leverage key principles of Social Cognitive Theory to promote effective self-management. While the evidence supports modest benefits in glycemic control and behavioral outcomes, heterogeneity in study design and outcome measurement limits broader generalizability. Future research should prioritize the development and evaluation of SCT-informed digital interventions with standardized outcome frameworks to improve pediatric diabetes care.