title: The diabetes app challenge: user-led development and piloting of internet applications enabling young people with diabetes to set the focus for their diabetes consultations.
abstract: BACKGROUND
  Traditionally, some teenagers and young adults with diabetes have not engaged well at diabetes appointments, giving rise to concerns about long-term health risks. We considered that apps might help this group of patients to improve preparation for, and therefore engagement at their appointments. Although there are already many apps for young people with type 1 diabetes (YPD), we thought that by supporting YPD themselves to develop apps, the resulting products would have greater "authenticity" and relevance.
  
  
  OBJECTIVE
  To test the feasibility of an online competition to (1) recruit and support YPD to develop apps (mobile or Internet based) to help prepare for clinic appointments, and (2) for these apps to be tested and rated by YPD.
  
  
  METHODS
  The "Diabetes App Challenge" was a United Kingdom (UK) national competition, run between June and October 2012 for teams including at least one YPD (aged 16-25) to pilot the design and development of apps for use by other YPD prior to clinic appointments. The competition was advertised by social media, email, AdWords and postings on the Diabetes UK website. Registrants for the competition were supported via email and discussion forum. After app development, other YPD were invited (November 2012-February 2013) to trial the apps, choose and use one prior to a clinic appointment, and review their experiences.
  
  
  RESULTS
  Of 56 people (including 28 YPD) who expressed interest in the competition, 6 teams (14 people) developed and submitted an app. Two apps aimed to facilitate agenda setting in clinic consultations, 2 enabled data logging and 2 helped insulin dose calculation. Of 135 YPD who registered to trial the apps, 83 (61.5%) took part (mean age 18.98, 37/83 male). Agenda setting apps were considered most useful for preparing for and setting the focus of clinic appointments (P=.02). Just over half (46/83, 55%) said they would use their chosen app again and 4/5 (67/83, 81%) would recommend it to a friend.
  
  
  CONCLUSIONS
  This competition to engage YPD in developing and reviewing apps proved successful. App designers and testers saw a need for a range of functions. However, this may, in part, reflect a lack of detailed knowledge of all existing apps and be limited by the technical skills of YPD. App competitions appear worth applying to other patient groups, but future competitions should include a review stage and perhaps focus on ideas for app design for subsequent professional implementation.
authors: Plymouth University, School of Nursing and Midwifery, Plymouth, United Kingdom.
authors: Emily J
authors: http://orcid.org/0000-0001-7566-9890
authors: EJ
authors: Ashurst
authors: Ray B
authors: http://orcid.org/0000-0002-2963-3421
authors: RB
authors: Jones
authors: Charles
authors: http://orcid.org/0000-0002-0901-1975
authors: C
authors: Abraham
authors: Martin
authors: http://orcid.org/0000-0001-7238-9850
authors: M
authors: Jenner
authors: Kate
authors: http://orcid.org/0000-0001-9135-5488
authors: K
authors: Boddy
authors: Rachel Ej
authors: http://orcid.org/0000-0002-0508-5838
authors: RE
authors: Besser
authors: Suzanne
authors: http://orcid.org/0000-0001-8889-3189
authors: S
authors: Hammersley
authors: Jonathan
authors: http://orcid.org/0000-0002-8927-1266
authors: J
authors: Pinkney
keywords: Type 1 diabetes; adolescents; clinic appointment; mobile technology; self-care; user-centered design; user-innovation
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