title: Participant experiences in a smartphone-based health coaching intervention for type 2 diabetes: A qualitative inquiry.
abstract: BACKGROUND
  We investigated the experience of individuals diagnosed with type 2 diabetes mellitus (T2DM) who participated in an intervention in which the key elements were the provision of a smartphone and self-monitoring software. The interviews focused on use of a smartphone and the effects on motivation for health behavior change.
  
  
  METHODS
  This was a qualitative evaluation of participants in a larger T2DM self-management randomized controlled trial (RCT) conducted at the Black Creek Community Health Centre (BCCHC) in Toronto, Canada (ClinicalTrials.gov Identifier: NCT02036892). The study is based on semi-structured interviews (n = 11) that were audio taped and analyzed with a thematic analytic approach. The RCT compared the effectiveness of six months of smartphone-based self-monitoring and health coaching with a control group who received health coaching without internet or smartphone-based assistance.
  
  
  RESULTS
  Qualitative data analyses resulted in derivation of four major themes that describe participant experience: (a) 'smartphone and software', describes smartphone use in relation to health behavior change; (b) 'health coach' describes how client/health coach relationships were assisted by smartphone use; (c) 'overall experience' describes perceptions of the overall intervention; and (d) 'frustrations in managing chronic conditions' describes difficulties with the complexities of T2DM management from a patient perspective.
  
  
  CONCLUSIONS
  Findings suggest that interventions with T2DM assisted by smartphone software and health coaches actively engage individuals in improved hemoglobin A1c (HbA1c) control.
authors.affiliation: School of Kinesiology and Health Science, York University, Canada.
authors.forename: Sarah
authors.initials: S
authors.lastname: Pludwinski
authors.affiliation: School of Health Policy and Management, York University, Canada North York General Hospital, Canada.
authors.forename: Farah
authors.initials: F
authors.lastname: Ahmad
authors.affiliation: School of Kinesiology and Health Science, York University, Canada.
authors.forename: Noah
authors.initials: N
authors.lastname: Wayne
authors.affiliation: School of Kinesiology and Health Science, York University, Canada Cancer Care Ontario, Research, Cancer Prevention and Control, Canada Division of Epidemiology and Biostatistics, Princess Margaret Hospital, University Health Network, Canada pritvo@yorku.ca.
authors.forename: Paul
authors.initials: P
authors.lastname: Ritvo
mesh_terms: D000328:Adult; D000368:Aged; D002170:Canada; D003376:Counseling / Q000379:methods; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D019468:Disease Management; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D000071252:Mentoring / Q000379:methods*; D008875:Middle Aged; D009042:Motivation; D036301:Qualitative Research; D012648:Self Care / Q000379:methods; D000068997:Smartphone; D012944:Social Support
chemical_list: D006442:Glycated Hemoglobin
keywords: Smartphone intervention; ehealth; health coaching; lifestyle modification; mobile health; qualitative research; type 2 diabetes