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. 2021 Jun 2;23(6):e18167.
doi: 10.2196/18167.

Mobile-Based and Cloud-Based System for Self-management of People With Type 2 Diabetes: Development and Usability Evaluation

Raheleh Salari  1 , Sharareh R Niakan Kalhori  1 , Marjan GhaziSaeedi  1 , Marjan Jeddi  2 , Mahin Nazari  3 , Farhad Fatehi  4   5
Affiliations

Mobile-Based and Cloud-Based System for Self-management of People With Type 2 Diabetes: Development and Usability Evaluation

Raheleh Salari et al. J Med Internet Res. .

Abstract

Background: As the use of smartphones and mobile apps is increasing, mobile health (mHealth) can be used as a cost-effective option to provide behavioral interventions aimed at educating and promoting self-management for chronic diseases such as diabetes. Although many mobile software apps have been developed for this purpose, they usually lack a theoretical foundation and do not follow the guidelines suggested for evidence-based practice. Therefore, this study aimed to develop a theory-based self-management app for people with type 2 diabetes and provide an app based on a needs assessment analysis.

Objective: This paper describes the development and usability evaluation of a cloud-based and mobile-based diabetes self-management app designed to help people with diabetes change their health behavior and also enable remote monitoring by health care providers.

Methods: The development of this mHealth solution comprises 3 phases. Phase I: feature extraction of the Android apps that had a user rating of 4 stars or more and review of papers related to mHealth for diabetes self-management were performed followed by seeking expert opinions about the extracted features to determine the essential features of the app. Phase II: design and implementation included selecting which behavioral change and structural theories were to be applied the app and design of the website. Phase III: evaluation of the usability and user experience of the mobile app by people with diabetes and the portal by health care providers using the User Experience Questionnaire.

Results: The developed mobile app includes modules that support several features. A person's data were entered or collected and viewed in the form of graphs and tables. The theoretical foundation of behavioral intervention is the transtheoretical model. Users were able to receive customized messages based on the behavioral change preparation stage using the Kreuter algorithm. The clinician's portal was used by health care providers to monitor the patients. The results of the usability evaluation revealed overall user satisfaction with the app.

Conclusions: Mobile- and cloud-based systems may be an effective tool for facilitating the modification of self-management of chronic care. The results of this study showed that the usability of mobile- and cloud-based systems can be satisfactory and promising. Given that the study used a behavioral model, assessment of the effectiveness of behavior change over time requires further research with long-term follow-up.

Keywords: behavior change; mHealth; mobile app, self-management; mobile health; type 2 diabetes.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Proposed architectural framework for functionalities of a system for people with diabetes.
Figure 2
Figure 2
Proposed architectural framework for functionalities of a system for health care providers.
Figure 3
Figure 3
Logbook module where participants can enter their clinical data. This screen shows that the blood glucose level was entered and saved on a specific day and time.
Figure 4
Figure 4
Overview and analysis module: participants can view the entered data in a chart format and see trends over time. Charts show physical activity range and calorie intake.
Figure 5
Figure 5
Education module: participants will learn tips on controlling diabetes, improving problem-solving skills, reducing risks, and healthy coping.
Figure 6
Figure 6
Comparison chart of average mobile app system measurements with previous studies.
Figure 7
Figure 7
Comparison chart of average web-based system measurements with previous studies.
See this image and copyright information in PMC

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