Effect of an mHealth intervention for persons with type 2 diabetes and their acceptability of the device: Results from the Norwegian randomised controlled study in RENEWING HeALTH

Abstract

Having type 2 diabetes constitutes a burden for the persons affected, and digital solutions can be useful supplements to clinical care enabling individualized approach and strengthening of self-management. The aims of the thesis were to investigate the effects and acceptability of use of a diabetes diary as a mobile app with or without health counselling compared to usual care by performing a three-armed randomized controlled trial assessing clinical health data, self-reported questionnaires and in-depth interviews. The use of the mobile app for one year did not show any statistically significant effect on long-term blood glucose (HbA1c), health related quality of life, self-management, depression or lifestyle measures, even with four months of health counselling from a diabetes specialist nurse. The acceptability of the app was measured with the Service User Technology Acceptability Questionnaire (SUTAQ). The questionnaire assesses apps used in health care, and was translated into Norwegian. Factor analysis only confirmed two of five predefined domains, perceived benefit and care personnel concerns. Self-management measured at baseline was not associated to acceptability of the app after one year. Qualitative findings indicated different patterns of use, such as routine storage of measures, and use of the measures to gain new insight in relations between blood glucose, physical activity and diet. Barriers, such as negative experiences with the technology, could lead to stress and in turn increased blood glucose. Contact with health care personnel was of importance to provide new insight, or to confirm self-management decisions made. In summary, there is a need for further studies with interdisciplinary collaboration focusing on the utility of mobile apps in daily life and integration of use of apps in health care.