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Cited by 676Mobile Health and mHealth ApplicationsDiabetes Management and EducationDiabetes Management and Research

The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index.

Design of an mHealth App for the Self-management of Adolescent Type 1 Diabetes: A Pilot Study

Open access
Cafazzo, Joseph A, Casselman, Mark, Hamming, Nathaniel, Katzman, Debra K, Palmert, Mark R·2012·Journal of Medical Internet Research
DOI 10.2196/jmir.2058PMC PMC3799540
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Abstract

BACKGROUND: The use of mHealth apps has shown improved health outcomes in adult populations with type 2 diabetes mellitus. However, this has not been shown in the adolescent type 1 population, despite their predisposition to the use of technology. We hypothesized that a more tailored approach and a strong adherence mechanism is needed for this group. OBJECTIVE: To design, develop, and pilot an mHealth intervention for the management of type 1 diabetes in adolescents. METHODS: We interviewed adolescents with type 1 diabetes and their family caregivers. Design principles were derived from a thematic analysis of the interviews. User-centered design was then used to develop the mobile app bant. In the 12-week evaluation phase, a pilot group of 20 adolescents aged 12-16 years, with a glycated hemoglobin (HbA(1c)) of between 8% and 10% was sampled. Each participant was supplied with the bant app running on an iPhone or iPod Touch and a LifeScan glucometer with a Bluetooth adapter for automated transfers to the app. The outcome measure was the average daily frequency of blood glucose measurement during the pilot compared with the preceding 12 weeks. RESULTS: Thematic analysis findings were the role of data collecting rather than decision making; the need for fast, discrete transactions; overcoming decision inertia; and the need for ad hoc information sharing. Design aspects of the resultant app emerged through the user-centered design process, including simple, automated transfer of glucometer readings; the use of a social community; and the concept of gamification, whereby routine behaviors and actions are rewarded in the form of iTunes music and apps. Blood glucose trend analysis was provided with immediate prompting of the participant to suggest both the cause and remedy of the adverse trend. The pilot evaluation showed that the daily average frequency of blood glucose measurement increased 50% (from 2.4 to 3.6 per day, P = .006, n = 12). A total of 161 rewards (average of 8 rewards each) were distributed to participants. Satisfaction was high, with 88% (14/16 participants) stating that they would continue to use the system. Demonstrating improvements in HbA(1c) will require a properly powered study of sufficient duration. CONCLUSIONS: This mHealth diabetes app with the use of gamification incentives showed an improvement in the frequency of blood glucose monitoring in adolescents with type 1 diabetes. Extending this to improved health outcomes will require the incentives to be tied not only to frequency of blood glucose monitoring but also to patient actions and decision making based on those readings such that glycemic control can be improved.

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  1. Wagner, EH, 1998, Eff Clin Pract, 1, 2
  2. Cafazzo, JA, 2010, Biomed Instrum Technol, Suppl Home Healthcare, 47

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Metadata

Authors
Cafazzo, J. A., Casselman, M., Hamming, N., Katzman, D. K., & Palmert, M. R.
Affiliations
  • University Health Network (CA)
  • University of Toronto (CA)
Corresponding author
Cafazzo, Joseph A
ORCID
Venue
Journal of Medical Internet Research
Publisher
JMIR Publications Inc.
Published
2012-05-08
Volume
14
Issue
3
Pages
e70
ISSN
1438-8871 (ISSN-L)
DOI
10.2196/jmir.2058
PMC
PMC3799540
OpenAlex
W2142564124
Cited by
676
References
30
Citations by year
2026: 21 · 2025: 22 · 2024: 37 · 2023: 29 · 2022: 54 · 2021: 55 · 2020: 49 · 2019: 66 · 2018: 79 · 2017: 74 · 2016: 69 · 2015: 57 · 2014: 32 · 2013: 24 · 2012: 7
FWCI
68.18
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Medical Internet Research (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • University Health Network
  • Hospital for Sick Children
Topics
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
type 1 diabetes, adolescents, mobile health apps, self-management, blood glucose monitoring, gamification, user-centered design, HbA1c, social community, family caregivers, user interviews, user satisfaction, health behavior change, decision inertia, health data sharing, rewards and incentives
MeSH terms
Adolescent, Diabetes Mellitus, Type 1, Glycated Hemoglobin, Humans, Pilot Projects, Self Care, Software, Cell Phone

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