JMIR Publications

ABSTRACT

Background:

Research

Objective:

Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder that, if left unmanaged, can lead to serious health complications, significantly impairing health-related quality of life (HRQoL) and imposing a substantial socioeconomic burden on healthcare systems. This study examined the lived experiences of patients with type 2 diabetes mellitus (T2DM) in the Deep South, aiming to understand patients' perceptions of potential digital health interventions for managing T2DM.

Objective:

Study Design: This study was part of a larger NIH clinical trial (5R01DK129378-03) designed to explore the feasibility of a digital coaching intervention for managing T2DM. The study employed a qualitative, phenomenological approach to examine and assess the needs of patients with T2DM surrounding digital coaching. Twelve patients were recruited from the University of Alabama at Birmingham (UAB). Data collection involved in-depth, semi-structured interviews conducted via telephone calls or secure Zoom sessions. All interviews were audio-recorded, professionally transcribed, and verified for accuracy. Two independent coders analyzed the data using NVivo Software version 14 Plus.

Methods:

Population Studied: The study population consisted of UAB patients diagnosed with T2DM who received routine clinical care at the Department of Family and Community Medicine at UAB between August and December 2022.

Results:

Principal Findings: A total of 12 adults with type 2 diabetes mellitus (T2DM) were enrolled in the study, with a mean age of 54.58±12.39 years, 83.33% female, 83.33% African American, and 91.67% non-Hispanic/Latino. Thematic analysis revealed two primary themes: (1) experiences associated with managing T2DM and (2) expectations surrounding potential digital health coaching for T2DM management. In the first theme, participants reported implementing various self-management strategies, including dietary modifications, adherence to prescribed medication regimens, regular physical activity, and consistent blood sugar monitoring. Primary care provider interactions were beneficial for medication adjustments and dietary guidance. As part of the second theme, participants articulated their expectations for a future digital health coaching intervention that would benefit their diabetes management. They expressed interest in gaining nuanced information on the effects of diet, exercise, and medication. They perceived health coaches to provide tailored nutritional guidance and comprehensive support that extends beyond traditional primary care. Digital reminders, such as daily or weekly calls or text messages, were perceived as potentially effective for enhancing medication adherence and promoting regular physical activity.

Conclusions:

Conclusion: The day-to-day management strategies for T2DM included lifestyle modifications, with the majority of challenges related to diet, physical activity, and medication insurance coverage. Expectations associated with a potential digital health coaching intervention for managing T2DM included incorporation of specific information related to diet, exercise and medication effects as intervention components; additionally, participants perceived that digital communication with a health coach (via weekly phone call/text) will assist them as a meal guide and reminder to medication and physical activity. Clinical Implications: Insights gained from this study will inform the development of need-based and user-friendly digital health coaching interventions for the effective management of type 2 diabetes mellitus. Clinical Trial: N/A