Which behaviour change techniques work best for diabetes self-management mobile apps? Results from a systematic review and meta-analysis of randomised controlled trials
Open accessAbstract
BACKGROUND: Self-management is pivotal in addressing noncommunicable diseases, such as diabetes. The increased availability of digital behaviour change interventions (DBCIs) delivered through mobile health apps offers unprecedented opportunities to enhance self-management and improve health outcomes. However, little is known about the characteristics of DBCIs for diabetes that significantly impact glycaemic control. Therefore, our systematic review with meta-analysis aimed to summarize characteristics and behaviour change components in DBCIs for diabetes self-management and explore potential associations with metabolic outcomes. METHODS: A systematic search was conducted in PubMed, Embase, the Cochrane Central Register of Controlled Trials, and Scopus to identify randomized controlled trials published until November 2023. The main outcome variable was the change in the mean difference of HbA1c levels between baseline and follow-up across intervention and control groups. Random-effects meta-regression was used to explore variation in glycaemic control as a function of prespecified characteristics of study designs and app interventions. FINDINGS: A total of 57 studies was included in the analysis, showing a statistically significant percentage point reduction in HbA1c for the intervention group compared to the control arm (-0.36, 95% CI = -0.46 to -0.26, p < 0.001). The inclusion of "self-monitoring of behaviour" as a behaviour change technique (β = -0.22, p = 0.04) and "taking medication" as a target behaviour (β = -0.20, p = 0.05) was associated with improved metabolic outcomes. INTERPRETATION: Our analyses endorse the use of diabetes self-management apps, highlighting characteristics statistically associated with intervention effectiveness and guiding the design of more effective DBCIs. FUNDING: This project received funding from the European Union's Horizon 2020 programme.
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The effect size for HbA1c was similar to those reported in other systematic reviews (SMD range −0.31 to −0.44, MD range −0.40% to −0.49%).
“This effect size was similar to those reported in other systematic reviews (SMD range −0.31 to −0.44, MD range −0.40% to −0.49%).10,15,16,18”
From Effective behavioral change techniques in m-health app supported interventions for glycemic control among patients with type 2 diabetes: A meta-analysis and meta-regression analysis of randomized controlled trials (2025) · cites this paper as [18]
The Discussion (page unavailable) says the paper’s pooled HbA1c effect of −0.36 was similar to, but slightly less favourable than, estimates from previous meta-analyses. The Results, ‘Effects of apps on glycaemic control’ (page unavailable), confirms the −0.36 mean difference. Our copy does not give the claimed SMD range of −0.31 to −0.44 or MD range of −0.40% to −0.49% for those other reviews. (LLM, conf=0.87)
Experimental — accuracy not yet measuredThe average number of BCTs used (5.77) was similar to those reported in similar existing reviews (average number of BCTs: 4.5 to 9.07).
“This number was similar to those reported in similar existing reviews (average number of BCTs: 4.5 to 9.07).17,18,24,65”
Our results are consistent with other studies indicating that BCT number was not associated with better health outcomes.
“However, our results are consistent with other studies18,65 indicating that BCT number was not associated with better health outcomes.”
A decrease in HbA1c by 0.3% was associated with a lower risk of diabetic complications.
“It was also considered clinically meaningful because a decrease in HbA1c by 0.3% was associated with a lower risk of diabetic complications.18,64”
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Cites
Bias in meta-analysis detected by a simple, graphical test
Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997) · BMJ · doi:10.1136/bmj.315.7109.629 · Cited by 56,722 · see citing works
RoB 2: a revised tool for assessing risk of bias in randomised trials
Sterne, J. A. C., Savović, J., Page, M. J., Elbers, R. G., Blencowe, N. S., Boutron, I., Cates, C. J., Cheng, H.-Y., Corbett, M. S., Eldridge, S. M., et al. (2019) · BMJ · doi:10.1136/bmj.l4898 · Cited by 33,583 · see citing works
Cochrane Handbook for Systematic Reviews of Interventions
(2019) · doi:10.1002/9781119536604 · Cited by 14,828 · see citing works
The PRISMA 2020 statement: an updated guideline for reporting systematic reviews
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., et al. (2021) · Systematic Reviews · doi:10.1186/s13643-021-01626-4 · Cited by 13,874 · see citing works
Wan, X., Wang, W., Liu, J., & Tong, T. (2014) · BMC Medical Research Methodology · doi:10.1186/1471-2288-14-135 · Cited by 11,735 · see citing works
The Transtheoretical Model of Health Behavior Change.
Prochaska, J. O., & Velicer, W. F. (1997) · American Journal of Health Promotion · doi:10.4278/0890-1171-12.1.38 · Cited by 7,782 · see citing works
Michie, S., Richardson, M., Johnston, M., Abraham, C., Francis, J., Hardeman, W., Eccles, M. P., Cane, J., & Wood, C. E. (2013) · Annals of Behavioral Medicine · doi:10.1007/s12160-013-9486-6 · Cited by 7,629 · see citing works
McGuinness, L. A., & Higgins, J. P. T. (2021) · Research Synthesis Methods · doi:10.1002/jrsm.1411 · Cited by 5,579 · cited 1× · see citing works
“54”
Self-management education: History, definition, outcomes, and mechanisms
Lorig, K. R., & Holman, H. R. (2003) · Annals of Behavioral Medicine · doi:10.1207/s15324796abm2601_01 · Cited by 4,094 · see citing works
How should meta‐regression analyses be undertaken and interpreted?
Thompson, S. G., & Higgins, J. P. T. (2002) · Statistics in Medicine · doi:10.1002/sim.1187 · Cited by 3,026 · see citing works
Self-management approaches for people with chronic conditions: a review
Barlow, J., Wright, C., Sheasby, J., Turner, A., & Hainsworth, J. (2002) · Patient Education and Counseling · doi:10.1016/s0738-3991(02)00032-0 · Cited by 2,800 · see citing works
A taxonomy of behavior change techniques used in interventions
Abraham, C., & Michie, S. (2008) · Health Psychology · doi:10.1037/0278-6133.27.3.379 · Cited by 2,525 · see citing works
Webb, T. L., Joseph, J., Yardley, L., & Michie, S. (2010) · Journal of Medical Internet Research · doi:10.2196/jmir.1376 · Cited by 2,517 · see citing works
Effective techniques in healthy eating and physical activity interventions: A meta-regression.
Michie, S., Abraham, C., Whittington, C., McAteer, J., & Gupta, S. (2009) · Health Psychology · doi:10.1037/a0016136 · Cited by 2,229 · see citing works
Davis, R., Campbell, R., Hildon, Z., Hobbs, L., & Michie, S. (2015) · Health Psychology Review · doi:10.1080/17437199.2014.941722 · Cited by 1,411 · see citing works
Analysis of self-efficacy theory of behavioral change
Bandura, A., & Adams, N. E. (1977) · Cognitive Therapy and Research · doi:10.1007/bf01663995 · Cited by 1,338 · see citing works
Global Economic Burden of Diabetes in Adults: Projections From 2015 to 2030
Bommer, C., Sagalova, V., Heesemann, E., Manne‐Goehler, J., Atun, R. A., Bärnighausen, T., Davies, J. I., & Vollmer, S. (2018) · Diabetes Care · doi:10.2337/dc17-1962 · Cited by 1,137 · see citing works
Health behavior models in the age of mobile interventions: are our theories up to the task?
Riley, W. T., Rivera, D. E., Atienza, A. A., Nilsen, W., Allison, S. M., & Mermelstein, R. (2011) · Translational Behavioral Medicine · doi:10.1007/s13142-011-0021-7 · Cited by 978 · see citing works
Management and Prevention Strategies for Non-communicable Diseases (NCDs) and Their Risk Factors
Budrevičiūtė, A., Damiati, S., Sabir, D. K., Önder, K., Schuller‐Götzburg, P., Plakys, G., Katileviciute, A., Khoja, S. M., & Kodzius, R. (2020) · Frontiers in Public Health · doi:10.3389/fpubh.2020.574111 · Cited by 955 · see citing works
Unending Work and Care: Managing Chronic Illness at Home
Kinney, J. M., Kahana, E., Corbin, J. M., & Strauss, A. (1989) · Contemporary Sociology · doi:10.2307/2074227 · Cited by 946 · see citing works
Chrvala, C. A., Sherr, D., & Lipman, R. D. (2016) · Patient Education and Counseling · doi:10.1016/j.pec.2015.11.003 · Cited by 914 · see citing works
The digitally engaged patient: self-monitoring and self-care in the digital health era
Lupton, D. (2013) · Social Theory & Health · doi:10.1057/sth.2013.10 · Cited by 728 · see citing works
Carey, R., Bohlen, L. C., Johnston, M., Rothman, A. J., de Bruin, M., Kelly, M. P., & Michie, S. (2018) · Annals of Behavioral Medicine · doi:10.1093/abm/kay078 · Cited by 692 · see citing works
Quinn, C. C., Shardell, M. D., Terrin, M. L., Barr, E. A., Ballew, S. H., & Gruber-Baldini, A. L. (2011) · Diabetes Care · doi:10.2337/dc11-0366 · Cited by 650 · see citing works
Meyerowitz-Katz, G., Ravi, S., Arnolda, L., Feng, X., Maberly, G., & Astell-Burt, T. (2020) · Journal of Medical Internet Research · doi:10.2196/20283 · Cited by 561 · see citing works
Influence of trial sample size on treatment effect estimates: meta-epidemiological study
Dechartres, A., Trinquart, L., Boutron, I., & Ravaud, P. (2013) · BMJ · doi:10.1136/bmj.f2304 · Cited by 544 · see citing works
Greenwood, D. A., Gee, P. M., Fatkin, K. J., & Peeples, M. (2017) · Journal of Diabetes Science and Technology · doi:10.1177/1932296817713506 · Cited by 526 · see citing works
Dombrowski, S. U., Sniehotta, F. F., Avenell, A., Johnston, M., MacLennan, G., & Araújo-Soares, V. (2012) · Health Psychology Review · doi:10.1080/17437199.2010.513298 · Cited by 504 · see citing works
Powers, M. A., Bardsley, J. K., Cypress, M., Funnell, M. M., Harms, D., Hess-Fischl, A., Hooks, B., Isaacs, D., Mandel, E. D., Maryniuk, M. D., et al. (2020) · Diabetes Care · doi:10.2337/dci20-0023 · Cited by 500 · see citing works
Adherence to diabetes medication: a systematic review
Krass, I., Schieback, P., & Dhippayom, T. (2014) · Diabetic Medicine · doi:10.1111/dme.12651 · Cited by 468 · see citing works
Enablers and barriers to effective diabetes self-management: A multi-national investigation
Adu, M. D., Malabu, U. H., Malau‐Aduli, A. E. O., & Malau‐Aduli, B. S. (2019) · PLoS ONE · doi:10.1371/journal.pone.0217771 · Cited by 420 · see citing works
Hou, C., Carter, B., Hewitt, J., Francisa, T., & Mayor, S. (2016) · Diabetes Care · doi:10.2337/dc16-0346 · Cited by 411 · see citing works
Milne-Ives, M., Lam, C., De Cock, C., Van Velthoven, M. H., & Meinert, E. (2020) · JMIR mhealth and uhealth · doi:10.2196/17046 · Cited by 393 · see citing works
ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Hilliard, M. E., Isaacs, D., Johnson, E. L., et al. (2023) · Diabetes Care · doi:10.2337/dc23-s005 · Cited by 362 · see citing works
Kirwan, M., Vandelanotte, C., Fenning, A., & Duncan, M. J. (2013) · Journal of Medical Internet Research · doi:10.2196/jmir.2588 · Cited by 343 · see citing works
Cradock, K. A., ÓLaighin, G., Finucane, F. M., Gainforth, H. L., Quinlan, L. R., & Ginis, K. A. M. (2017) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-016-0436-0 · Cited by 343 · see citing works
Challenges in Participant Engagement and Retention Using Mobile Health Apps: Literature Review
Amagai, S., Pila, S., Kaat, A. J., Nowinski, C. J., & Gershon, R. C. (2022) · Journal of Medical Internet Research · doi:10.2196/35120 · Cited by 343 · cited 1× · see citing works
“25 With the continuous reinforcement of strategies to tackle traditional challenges like participant engagement and retention, 26 apps thereby provide unprecedented opportunities for self-management by delivering complex interventions based on behaviour change techniques (BCTs), “ observable,…”
BackgroundChanging Physical Activity Behavior in Type 2 Diabetes
Avery, L., Flynn, D., van Wersch, A., Sniehotta, F. F., & Trenell, M. I. (2012) · Diabetes Care · doi:10.2337/dc11-2452 · Cited by 340 · cited 2× · see citing works
“Despite previous meta-regressions in different domains alternatively demonstrated a lack 45,46,57 or presence 112,113 of a positive association between the number of BCTs and study effectiveness, all studies have underscored the necessity for further investigation on this matter.”
BackgroundResultInfluentialShan, R., Sarkar, S., & Martin, S. S. (2019) · Diabetologia · doi:10.1007/s00125-019-4864-7 · Cited by 339 · see citing works
Guo, C., Ashrafian, H., Ghafur, S., Fontana, G., Gardner, C., & Prime, M. S. (2020) · npj Digital Medicine · doi:10.1038/s41746-020-00314-2 · Cited by 322 · see citing works
Fleming, G. A., Petrie, J. R., Bergenstal, R. M., Holl, R. W., Peters, A. L., & Heinemann, L. (2020) · Diabetes Care · doi:10.2337/dci19-0062 · Cited by 306 · see citing works
Holmen, H., Torbjørnsen, A., Wahl, A. K., Jenum, A. K., Småstuen, M. C., Årsand, E., & Ribu, L. (2014) · JMIR mHealth and uHealth · doi:10.2196/mhealth.3882 · Cited by 294 · see citing works
Bonoto, B. C., de Araújo, V. E., Godói, I. P., de Lemos, L. L. P., Godman, B., Bennie, M., Diniz, L. M., & Junior, A. A. G. (2017) · JMIR mhealth and uhealth · doi:10.2196/mhealth.6309 · Cited by 294 · see citing works
Charpentier, G., Benhamou, P.-Y., Dardari, D., Clergeot, A., Franc, S., Schaepelynck-Belicar, P., Catargi, B., Melki, V., Chaillous, L., Farret, A., et al. (2011) · Diabetes Care · doi:10.2337/dc10-1259 · Cited by 292 · see citing works
Medication Adherence With Diabetes Medication
Capoccia, K. L., Odegard, P. S., & Letassy, N. A. (2015) · The Science of Diabetes Self-Management and Care · doi:10.1177/0145721715619038 · Cited by 292 · see citing works
Identification of behaviour change techniques to reduce excessive alcohol consumption
Michie, S., Whittington, C., Hamoudi, Z., Zarnani, F., Tober, G., & West, R. (2012) · Addiction · doi:10.1111/j.1360-0443.2012.03845.x · Cited by 288 · see citing works
Wu, Y., Yao, X., Vespasiani, G., Nicolucci, A., Dong, Y., Kwong, J., Li, L., Sun, X., Tian, H., & Li, S. (2017) · JMIR mHealth and uHealth · doi:10.2196/mhealth.6522 · Cited by 283 · see citing works
Peters, G.-J., de Bruin, M., & Crutzen, R. (2013) · Health Psychology Review · doi:10.1080/17437199.2013.848409 · Cited by 276 · see citing works
T2DM Self-Management via Smartphone Applications: A Systematic Review and Meta-Analysis
Cui, M., Wu, X., Mao, J., Wang, X., & Nie, M. (2016) · PLOS ONE · doi:10.1371/journal.pone.0166718 · Cited by 269 · see citing works
DEBATE: Do interventions based on behavioral theory work in the real world?
Hagger, M. S., & Weed, M. (2019) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-019-0795-4 · Cited by 266 · see citing works
An Effective Model of Diabetes Care and Education: The ADCES7 Self-Care Behaviors™
Kolb, L. E. (2021) · The Science of Diabetes Self-Management and Care · doi:10.1177/0145721720978154 · Cited by 266 · see citing works
Horigan, G., Davies, M., Findlay‐White, F., Chaney, D., & COATES, V. E. (2016) · Diabetic Medicine · doi:10.1111/dme.13120 · Cited by 262 · see citing works
Wu, X., Guo, X., & Zhang, Z. (2019) · JMIR mHealth and uHealth · doi:10.2196/12297 · Cited by 249 · see citing works
Behavioral and Psychosocial Interventions in Diabetes
Peyrot, M., & Rubin, R. R. (2007) · Diabetes Care · doi:10.2337/dc07-1222 · Cited by 247 · see citing works
Frias, J., Virdi, N., Raja, P., Kim, Y., Savage, G., & Osterberg, L. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.7833 · Cited by 211 · see citing works
Agarwal, P., Mukerji, G., Desveaux, L., Ivers, N. M., Bhattacharyya, O., Hensel, J. M., Shaw, J., Bouck, Z., Jamieson, T., Onabajo, N., et al. (2019) · JMIR mHealth and uHealth · doi:10.2196/10321 · Cited by 208 · see citing works
DialBetics: A Novel Smartphone-based Self-management Support System for Type 2 Diabetes Patients
Waki, K., Fujita, H., Uchimura, Y., Omae, K., Aramaki, E., Kato, S., Lee, H., Kobayashi, H., Kadowaki, T., & Ohe, K. (2014) · Journal of Diabetes Science and Technology · doi:10.1177/1932296814526495 · Cited by 203 · see citing works
Diabetes: a defining disease of the 21st century
Lancet, T. (2023) · The Lancet · doi:10.1016/s0140-6736(23)01296-5 · Cited by 201 · see citing works
Wayne, N., Perez, D. F., Kaplan, D. M., & Ritvo, P. (2015) · Journal of Medical Internet Research · doi:10.2196/jmir.4871 · Cited by 192 · see citing works
The history and future of digital health in the field of behavioral medicine
Arigo, D., Jake‐Schoffman, D. E., Wolin, K. Y., Beckjord, E. B., Hekler, E. B., & Pagoto, S. (2019) · Journal of Behavioral Medicine · doi:10.1007/s10865-018-9966-z · Cited by 189 · see citing works
Advancing Models and Theories for Digital Behavior Change Interventions
Hekler, E. B., Michie, S., Pavel, M., Rivera, D. E., Collins, L. M., Jimison, H. B., Garnett, C., Parral, S., & Spruijt-Metz, D. (2016) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2016.06.013 · Cited by 174 · see citing works
Fu, H., McMahon, S. K., Gross, C. R., Adam, T. J., & Wyman, J. F. (2017) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2017.06.016 · Cited by 173 · see citing works
2022 National standards for diabetes self-management education and support
Davis, J., Fischl, A. H., Beck, J., Browning, L., Carter, A., Condon, J. E., Dennison, M., Francis, T., Hughes, P. J., Jaime, S., et al. (2022) · The Science of Diabetes Self-Management and Care · doi:10.1177/26350106211072203 · Cited by 169 · see citing works
Implementation of Behavior Change Techniques in Mobile Applications for Physical Activity
Yang, C., Maher, J. P., & Conroy, D. E. (2015) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2014.10.010 · Cited by 167 · see citing works
Gong, E., Baptista, S., Russell, A., Scuffham, P., Riddell, M., Speight, J., Bird, D., Williams, E., Lotfaliany, M., & Oldenburg, B. (2020) · Journal of Medical Internet Research · doi:10.2196/20322 · Cited by 159 · see citing works
Moller, A. C., Merchant, G., Conroy, D. E., West, R., Hekler, E., Kugler, K. C., & Michie, S. (2017) · Journal of Behavioral Medicine · doi:10.1007/s10865-016-9818-7 · Cited by 151 · see citing works
Moschonis, G., Siopis, G., Jung, J., Eweka, E., Willems, R., Kwasnicka, D., Asare, B. Y.-A., Kodithuwakku, V., Verhaeghe, N., Vedanthan, R., et al. (2023) · The Lancet Digital Health · doi:10.1016/s2589-7500(22)00233-3 · Cited by 149 · see citing works
Advancing digital health applications: priorities for innovation in real-world evidence generation
Stern, A. D., Brönneke, J. B., Debatin, J. F., Hagen, J., Matthies, H., Patel, S., Clay, I., Eskofier, B. M., Herr, A., Hoeller, K., et al. (2022) · The Lancet Digital Health · doi:10.1016/s2589-7500(21)00292-2 · Cited by 148 · see citing works
Goyal, S., Nunn, C. A., Rotondi, M., Couperthwaite, A. B., Reiser, S., Simone, A., Katzman, D. K., Cafazzo, J. A., & Palmert, M. R. (2017) · JMIR mHealth and uHealth · doi:10.2196/mhealth.7336 · Cited by 146 · see citing works
Technology and diabetes self-management: an integrative review
Hunt, C. W. (2015) · World Journal of Diabetes · doi:10.4239/wjd.v6.i2.225 · Cited by 133 · see citing works
Karhula, T., Vuorinen, A.-L., Rääpysjärvi, K., Pakanen, M., Itkonen, P., Tepponen, M., Junno, U.-M., Jokinen, T., van Gils, M., Lähteenmäki, J., et al. (2015) · Journal of Medical Internet Research · doi:10.2196/jmir.4059 · Cited by 131 · see citing works
Kebede, M. M., Zeeb, H., Peters, M., Heise, T. L., & Pischke, C. R. (2018) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2018.0216 · Cited by 131 · see citing works
Sun, C., Sun, L., Xi, S., Zhang, H., Wang, H., Feng, Y., Deng, Y., Wang, H., Xiao, X., Wang, G., et al. (2019) · JMIR mHealth and uHealth · doi:10.2196/10664 · Cited by 124 · see citing works
Effective strategies for encouraging behavior change in people with diabetes
Hood, K. K., Hilliard, M., Piatt, G., & Ievers-Landis, C. E. (2015) · Diabetes Management · doi:10.2217/dmt.15.43 · Cited by 122 · see citing works
Kleinman, N. J., Shah, A., Shah, S., Phatak, S., & Viswanathan, V. (2017) · Telemedicine and e-Health · doi:10.1089/tmj.2016.0265 · Cited by 116 · see citing works
The evolution of the Italian National Health Service
Ricciardi, W., & Tarricone, R. (2021) · The Lancet · doi:10.1016/s0140-6736(21)01733-5 · Cited by 114 · see citing works
Self-citationCurrent Issues and Future Directions for Research Into Digital Behavior Change Interventions
Yardley, L., Choudhury, T., Patrick, K., & Michie, S. (2016) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2016.07.019 · Cited by 112 · see citing works
Zhou, W., Chen, M., Yuan, J., & Sun, Y. (2016) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2016.03.018 · Cited by 107 · see citing works
Rossi, M. C., Nicolucci, A., Lucisano, G., Pellegrini, F., Bartolo, P. D., Miselli, V., Anichini, R., & Vespasiani, O. B. O. T. D. S. G. (2013) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2013.0021 · Cited by 105 · see citing works
Diabetes self-management programmes in older adults: A systematic review and meta-analysis
Sherifali, D., Bai, J. ‐., Kenny, M., Warren, R., & Ali, M. U. (2015) · Diabetic Medicine · doi:10.1111/dme.12780 · Cited by 102 · see citing works
Huang, Z., Tan, E. J. H., Lum, E., Sloot, P. M. A., Boehm, B. O., & Car, J. (2019) · JMIR mhealth and uhealth · doi:10.2196/14914 · Cited by 100 · see citing works
Cornet, V. P., Toscos, T., Bolchini, D. P., Ghahari, R. R., Ahmed, R., Daley, C. N., Mirro, M. J., & Holden, R. J. (2020) · JMIR mhealth and uhealth · doi:10.2196/17703 · Cited by 98 · see citing works
Patients’ perspective on self-management: type 2 diabetes in daily life
van Smoorenburg, A. N., Hertroijs, D. F. L., Dekkers, T., Elissen, A., & Melles, M. (2019) · BMC Health Services Research · doi:10.1186/s12913-019-4384-7 · Cited by 90 · see citing works
Devlin, A. M., Lennon, M., O’Donnell, C. A., Bouamrane, M.-M., Agbakoba, R., O’Connor, S., Grieve, E., Finch, T. L., Wyke, S., Watson, N., et al. (2015) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocv097 · Cited by 89 · see citing works
He, Q., Zhao, X., Wang, Y., Xie, Q., & Cheng, L. (2021) · Journal of Advanced Nursing · doi:10.1111/jan.14993 · Cited by 89 · see citing works
Lim, S. L., Ong, K. W., Johal, J., Han, C. Y., Yap, Q. V., Chan, Y. H., Chooi, Y. C., Zhang, Z. P., Chandra, C. C., Thiagarajah, A. G., et al. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.12417 · Cited by 87 · see citing works
Alfonsi, J., Choi, E., Arshad, T., Sammott, S.-A. S., Pais, V., Nguyen, C., Maguire, B. R., Stinson, J., & Palmert, M. R. (2020) · JMIR mhealth and uhealth · doi:10.2196/22074 · Cited by 84 · see citing works
Lee, E. Y., Cha, S.-A., Yun, J.-S., Lim, S.-Y., Lee, J.-H., Ahn, Y.-B., Yoon, K.-H., Hyun, M. K., & Ko, S.-H. (2022) · Journal of Medical Internet Research · doi:10.2196/37430 · Cited by 83 · see citing works
Bekele, B. B., Negash, S., Bogale, B., Tesfaye, M., Getachew, D., Weldekidan, F., & Balcha, B. (2021) · Diabetes & Metabolic Syndrome: Clinical Research & Reviews · doi:10.1016/j.dsx.2020.12.030 · Cited by 82 · see citing works
Leong, C. M., Lee, T.-I., Chien, Y.-M., Kuo, L.-N., Kuo, Y.-F., & Chen, H.-Y. (2022) · Journal of Medical Internet Research · doi:10.2196/31449 · Cited by 79 · see citing works
Böhm, A.-K., Jensen, M. L., Sørensen, M. R., & Stargardt, T. (2020) · JMIR mhealth and uhealth · doi:10.2196/22212 · Cited by 75 · see citing works
Klonoff, D. C. (2019) · Journal of Diabetes Science and Technology · doi:10.1177/1932296818820303 · Cited by 73 · see citing works
Cucciniello, M., Petracca, F., Ciani, O., & Tarricone, R. (2021) · npj Digital Medicine · doi:10.1038/s41746-021-00517-1 · Cited by 73 · see citing works
Self-citationWang, J., Cai, C. C., Padhye, N. S., Orlander, P. R., & Zare, M. (2018) · JMIR mhealth and uhealth · doi:10.2196/mhealth.4478 · Cited by 72 · see citing works
Zhang, L., He, X., Shen, Y., Yu, H., Pan, J., Zhu, W., Zhou, J., & Bao, Y. (2019) · Journal of Medical Internet Research · doi:10.2196/15401 · Cited by 68 · see citing works
Novel Smartphone Game Improves Physical Activity Behavior in Type 2 Diabetes
Höchsmann, C., Müller, O., Ambühl, M., Klenk, C., Königstein, K., Infanger, D., Walz, S. P., & Schmidt-Trucksäss, A. (2019) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2019.02.017 · Cited by 67 · see citing works
Yu, Y., Yan, Q., Li, H., Li, H., Wang, L., Wang, H., Zhang, Y., Xu, L., Tang, Z., Yan, X., et al. (2019) · Journal of Diabetes Investigation · doi:10.1111/jdi.13031 · Cited by 65 · see citing works
Castensøe-Seidenfaden, P., Husted, G. R., Jensen, A. K., Hommel, E., Olsen, B., Pedersen-Bjergaard, U., Kensing, F., & Teilmann, G. (2018) · JMIR mHealth and uHealth · doi:10.2196/mhealth.9487 · Cited by 63 · see citing works
Distinguishing features in the assessment of mHealth apps
Tarricone, R., Petracca, F., Ciani, O., & Cucciniello, M. (2021) · Expert Review of Pharmacoeconomics & Outcomes Research · doi:10.1080/14737167.2021.1891883 · Cited by 62 · see citing works
Self-citationKim, E. K., Kwak, S. H., Jung, H. S., Koo, B. K., Moon, M. K., Lim, S., Jang, H. C., Park, K. S., & Cho, Y. M. (2019) · Diabetes Care · doi:10.2337/dc17-2197 · Cited by 61 · see citing works
Wang, Y., Li, M., Zhao, X., Pan, X., Lu, M., Lü, J., & Hu, Y. (2019) · The International Journal of Health Planning and Management · doi:10.1002/hpm.2872 · Cited by 59 · see citing works
Effectiveness of self‐management programmes in diabetes management: A systematic review
Vas, A., Devi, E. S., Vidyasagar, S., Acharya, R., Rau, N. R., George, A., Jose, T., & Nayak, B. (2017) · International Journal of Nursing Practice · doi:10.1111/ijn.12571 · Cited by 57 · see citing works
West, R., Evans, A., & Michie, S. (2011) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntr120 · Cited by 56 · see citing works
Zhang, C., Lakens, D., & IJsselsteijn, W. A. (2021) · Journal of Medical Internet Research · doi:10.2196/17127 · Cited by 56 · see citing works
Baron, J., Hirani, S. P., & Newman, S. P. (2016) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x16631628 · Cited by 55 · see citing works
The Influence of the Smart Glucose Manager Mobile Application on Diabetes Management
Gunawardena, K. C., Jackson, R., Robinett, I., Dhaniska, L., Jayamanne, S., Kalpani, S., & Muthukuda, D. (2019) · Journal of Diabetes Science and Technology · doi:10.1177/1932296818804522 · Cited by 52 · see citing works
Data-Driven Personalized Feedback to Patients with Type 1 Diabetes: A Randomized Trial
Skrøvseth, S. O., Årsand, E., Godtliebsen, F., & Joakimsen, R. M. (2015) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2014.0276 · Cited by 51 · see citing works
Boels, A. M., Rutten, G. E. H. M., Zuithoff, N. P. A., de Wit, G. A., & Vos, R. C. (2018) · BMC Endocrine Disorders · doi:10.1186/s12902-018-0304-9 · Cited by 49 · see citing works
Mäder, M., Timpel, P., Schönfelder, T., Militzer-Horstmann, C., Scheibe, S., Heinrich, R., & Häckl, D. (2023) · BMC Health Services Research · doi:10.1186/s12913-023-09287-w · Cited by 49 · see citing works
Enricho Nkhoma, D., Jenya Soko, C., Joseph Banda, K., Greenfield, D., Li, Y.-C. (., & Iqbal, U. (2021) · BMJ Health & Care Informatics · doi:10.1136/bmjhci-2020-100291 · Cited by 46 · see citing works
El-Gayar, O., Ofori, M., & Nawar, N. (2021) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2021.103839 · Cited by 45 · see citing works
Li, J., Wei, D., Liu, S., Li, M., Chen, X., Chen, L., Wu, Y., Zhou, W., Ouyang, L., Tan, C., et al. (2021) · JMIR mhealth and uhealth · doi:10.2196/23338 · Cited by 44 · see citing works
Keller, R., Hartmann, S., Teepe, G. W., Lohse, K.-M., Alattas, A., Car, L. T., Müller‐Riemenschneider, F., von Wangenheim, F., Mair, J. L., & Kowatsch, T. (2021) · Journal of Medical Internet Research · doi:10.2196/33348 · Cited by 43 · see citing works
Garnett, C. V., Crane, D., Brown, J., Kaner, E., Beyer, F. R., Muirhead, C. R., Hickman, M., Redmore, J., de Vocht, F., Beard, E., et al. (2018) · Journal of Medical Internet Research · doi:10.2196/jmir.8807 · Cited by 41 · see citing works
Hsia, J., Guthrie, N. L., Lupinacci, P., Gubbi, A., Denham, D., Berman, M. A., & Bonaca, M. P. (2022) · Diabetes Care · doi:10.2337/dc22-1099 · Cited by 41 · see citing works
Jiang, Y., Ramachandran, H. J., Teo, J. Y. C., Leong, F. L., Lim, S. T., Nguyen, H. D., & Wang, W. (2022) · Journal of Advanced Nursing · doi:10.1111/jan.15178 · Cited by 40 · see citing works
Franc, S., Hanaire, H. P., Benhamou, P., Schaepelynck, P., Catargi, B., Farret, A., Fontaine, P., Guerci, B., Reznik, Y., Jeandidier, N., et al. (2020) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2020.0021 · Cited by 39 · see citing works
Forjuoh, S. N., Bolin, J. N., Huber Jr, J. C., Vuong, A. M., Adepoju, O. E., Helduser, J. W., Begaye, D. S., Robertson, A., Moudouni, D. M., Bonner, T. J., et al. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-71 · Cited by 36 · see citing works
Bee, Y. M., Batcagan-Abueg, A. P. M., Chei, C., Kyung, Y., Haaland, B. A., Goh, S., Lee, P. C., Chiam, P. P. S., Ho, E. T. L., & Matchar, D. B. (2016) · Diabetes Care · doi:10.2337/dc16-0419 · Cited by 34 · see citing works
Zhang, W., Liu, Y., Sun, B., Shen, Y., Li, M., Peng, L., Duan, H., Su, X., Lu, S., Tian, X., et al. (2021) · Scientific Reports · doi:10.1038/s41598-021-03480-9 · Cited by 32 · see citing works
Timurtas, E., Inceer, M., Mayo, N., Karabacak, N., Sertbas, Y., & Polat, M. G. (2022) · Primary care diabetes · doi:10.1016/j.pcd.2021.12.005 · Cited by 30 · see citing works
Grady, M., Katz, L. B., Cameron, H., & Levy, B. L. (2017) · JMIR Diabetes · doi:10.2196/diabetes.7454 · Cited by 29 · see citing works
Chatzakis, C., Floros, D., Papagianni, M., Tsiroukidou, K., Kosta, K., Vamvakis, A., Koletsos, N., Hatziagorou, E., Tsanakas, I. J., & Mastorakos, G. P. (2019) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2019.0170 · Cited by 29 · see citing works
Hermanns, N., Ehrmann, D., Finke-Gröne, K., Krichbaum, M., Roos, T., Haak, T., Freckmann, G., & Kulzer, B. (2023) · The Lancet Regional Health - Europe · doi:10.1016/j.lanepe.2023.100702 · Cited by 21 · see citing works
Kumar, D. S., Prakash, B. G., Chandra, B. J. S., Kadkol, P. S., Arun, V., Thomas, J. J., Kulkarni, P., Gopi, A., & Murthy, M. R. N. (2020) · Clinical Epidemiology and Global Health · doi:10.1016/j.cegh.2020.06.011 · Cited by 19 · see citing works
Xu, Y., Xu, L., Zhao, W., Li, Q., Li, M., Lu, W., Zeng, H., Yan, J., Yang, D., Wu, W., et al. (2021) · Diabetes Metabolic Syndrome and Obesity · doi:10.2147/dmso.s299070 · Cited by 17 · see citing works
Li, Y., Xu, J., Kang, C., Bai, Q., Wang, X., Du, S., Zhu, W., & Wang, J. (2021) · The American Journal of the Medical Sciences · doi:10.1016/j.amjms.2021.09.001 · Cited by 16 · see citing works
Wang, W., Cheng, M. T. M., Leong, F. L., Goh, A. W. L., Lim, S. T., & Jiang, Y. (2020) · Journal of Advanced Nursing · doi:10.1111/jan.14519 · Cited by 13 · see citing works
Dessapt-Baradez, C., Liška, J., Brulle-Wohlhueter, C., Pushkarna, D., Baxter, M., & Piette, J. D. (2022) · Diabetes Therapy · doi:10.1007/s13300-022-01244-w · Cited by 13 · see citing works
The Future of Medical Device Regulation
Cohen, G., Minssen, T., Price, W. N., Robertson, C., Shachar, C., Vokinger, K. N., Hwang, T. J., Kesselheim, A. S., Evans, B. J., Pasquale, F., et al. (2022) · Cambridge University Press eBooks · doi:10.1017/9781108975452 · Cited by 9 · see citing works
Katz, L. B., Aparicio, M., Cameron, H., & Ceppa, F. (2021) · Diabetes Spectrum · doi:10.2337/ds20-0101 · Cited by 8 · see citing works
Vokinger, K. N., Hwang, T. J., & Kesselheim, A. S. (2022) · Cambridge University Press eBooks · doi:10.1017/9781108975452.002 · Cited by 6 · see citing works
Xu, H., Yuan, Y., Li, Y. A. N. G., Takashi, E., & Kitayama, A. (2021) · Journal of Integrative Nursing · doi:10.4103/jin.jin_19_21 · Cited by 4 · see citing works
Flagged first, then by citations
2 of the 135 references couldn’t be matched to a known paper.
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Liu, K., & Xia, Y. (2025) · Digital Health · doi:10.1177/20552076251326126 · Cited by 7 · see citing works
“10,15,16,18 It was also considered clinically meaningful because a decrease in HbA1c by 0.3% was associated with a lower risk of diabetic complications.”
InfluentialKhavere, S., Hadjiconstantinou, M., Miksza, J. K., Hagan, J., Salisu-Olatunji, S. O., Naderpour, S., Hassen, S., Karimi, Z., & Gillies, C. L. (2025) · Diabetic Medicine · doi:10.1111/dme.70127 · Cited by 4 · see citing works
Comprehensive policies for scaling systemic and equitable integration of digital health technologies
Spreafico, A. M. C., Tarricone, R., & Stern, A. D. (2025) · npj Digital Medicine · doi:10.1038/s41746-025-01820-x · Cited by 4 · see citing works
Self-citationBeh, E., Lin, J., Leong, G., Loh, P. Y., Poh, E. J., & Chan, D. (2026) · JMIR mhealth and uhealth · doi:10.2196/79338 · Cited by 4 · see citing works
A digital tool for self-reporting cardiovascular risk factors: The RADICAL study
Santos, J. F., Castela, I., Madeira, S. G., Furtado, S. T., Pereira, H. V., Teixeira, D., & Dores, H. (2025) · International Journal of Cardiology Cardiovascular Risk and Prevention · doi:10.1016/j.ijcrp.2025.200368 · Cited by 3 · see citing works
Chong, C. J., Makmor‐Bakry, M., Hatah, E., Tahir, N. A. M., Mustafa, N., Capule, F. R., & Hermansyah, A. (2025) · Journal of Diabetes Science and Technology · doi:10.1177/19322968251349851 · Cited by 1 · see citing works
Ahn, J., Yang, Y., Kim, J. Y., Pahn, J., & Jang, Y. (2025) · The Science of Diabetes Self-Management and Care · doi:10.1177/26350106251361360 · Cited by 1 · see citing works
Butta, F. W., Chereka, A. A., Kanfe, S. G., Dubale, A. T., Shibabaw, A. A., Kitil, G. W., Abdu, Z., Dube, G. N., Gebeyew, A. S., Walle, A. D., et al. (2026) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-026-03357-9 · Cited by 1 · see citing works
Tengah, A., Yusoff, W. F. W., Sajali, H., Sookkumnerd, T., & Vinh, H. X. (2025) · Journal of Health Innovation and Environmental Education. · doi:10.37251/jhiee.v2i2.2597 · Cited by 1 · see citing works
Jamil, M., Kavak, A., Fotouhi, H., Rashed, M., Gezer, E., İnner, A. B., & Srivastava, G. (2026) · Nutrients · doi:10.3390/nu18193207 · Cited by 1 · see citing works
Behavioral Intervention Functions in Type 2 Diabetes Apps: Literature Review
Gabarrón, E., Randine, P., & Årsand, E. (2024) · Journal of Diabetes Science and Technology · doi:10.1177/19322968241305646 · Cited by 1 · see citing works
Asakura, E., Brain, D., Senanayake, S. J., & Barnett, A. G. (2024) · doi:10.2196/preprints.62883
Crowd Profile: Research and Review on Diabetes Mellitus Health Management
Weng, L., & Lin, Z. (2024) · Journal of medicine and health science. · doi:10.62517/jmhs.202405416
Årsand, E., Gabarrón, E., & Randine, P. (2025) · Journal of Diabetes Science and Technology · doi:10.1177/19322968251343918
Barriers to Sustained Engagement with Diabetes Self-Management Apps: A Focus Group Study
Alam, M. R., Subramaniam, S., Kang, L. C., Dhillon, J. S., & Ayyasamy, R. K. (2025) · International Conference on Innovation and Intelligence for Informatics, Computing, and Technologies (3ICT) · doi:10.1109/3ict68299.2025.11442220
Khalil, A. D., Rasool, A., & Dawood, M. (2025) · Axis Community Research Journal (ACRJ) · doi:10.67129/rb8j4j32
BROWN, K., Ushakov, M., Molodkin, E., Bagsic, S. R. S., BELL, C., & Philis‐Tsimikas, A. (2026) · Contemporary Clinical Trials · doi:10.1016/j.cct.2026.108386
Siamian, H., Ram, M., Pahlevanynejad, S., Afrazandeh, S. S., Dahouji, Z. K., & Sabahi, A. (2026) · Journal of Education and Health Promotion · doi:10.4103/jehp.jehp_1914_24
Reimagining paediatric care: technology, trust, and the global movement for child-centred innovation
Dimitri, P. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1782611
Wiktorzak, N., Stasiak, O., Gawior, B., Klimas, P., Laskus, J., Koźma, G., Rudnicki, L., Kochan-Olszewska, D., Prządka, J., Lipska, J., et al. (2026) · International Journal of Innovative Technologies in Social Science · doi:10.31435/ijitss.3(51).2026.6451
Lu, X., Xia, T., Wang, Z., Cheng, M., & Xu, R. S. (2026) · Brain and Behavior · doi:10.1002/brb3.71761
Hentu, A. S., Lestari, K. F., Yulianti, S., Abidin, A., Pendit, S. A., Risal, M., Bistara, D. N., & Mustamu, A. C. (2026) · Journal of Integrative Nursing · doi:10.4103/jin.jin_27_26
Le, J., Li, X.-X., & Qin, S.-L. (2026) · Digital Health · doi:10.1177/20552076261494727
ten Klooster, I., Machens, A., Kip, H., Kelders, S. M., & van Gemert‐Pijnen, J. E. W. C. (2026) · Digital Health · doi:10.1177/20552076261497265
- Authors
- Tarricone, R., Petracca, F., Svae, L., Cucciniello, M., & Ciani, O.
- Affiliations
- Bocconi University (IT)
- Corresponding author
- Petracca, Francesco
- Venue
- eBioMedicine
- Publisher
- Elsevier BV
- Published
- 2024-05
- Volume
- 103
- Pages
- 105091
- ISSN
- 2352-3964 (ISSN-L)
- PMC
- PMC11002812
- OpenAlex
- W4394004650
- Cited by
- 26
- References
- 135
- Citations by year
- 2026: 13 · 2025: 10 · 2024: 3
- FWCI
- 2.34
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- EBioMedicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Archivio istituzionale della Ricerca - Bocconi (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Horizon 2020 (779306)
- Horizon 2020 Framework Programme
- European Commission
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- diabetes self-management, mobile health apps, behaviour change techniques, glycemic control, HbA1c, medication adherence, digital behaviour change interventions, non-communicable diseases
- MeSH terms
- Self-Management, Behavior Therapy, Diabetes Mellitus, Glycated Hemoglobin, Humans, Randomized Controlled Trials as Topic, Telemedicine, Mobile Applications
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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