title: The Systematic Design of a Behavioural Mobile Health Application for the Self-Management of Type 2 Diabetes.
abstract: Patients with diabetes often face serious complications due to limited self-management skills, the inability to adhere to care regimens, and psychosocial factors. Although regular self-monitoring of blood glucose is known to benefit patients receiving insulin therapy, its role in patients not treated with insulin has been unclear. However, recent studies have demonstrated that structured self-monitoring of blood glucose can significantly benefit patients who are not taking insulin, facilitating improved self-awareness and clinical decision making. We hypothesize that effective self-management by patients with type 2 diabetes who do not need insulin requires a behavioural intervention that enables the association between lifestyle behaviours, such as dietary intake and physical activity, and overall glycemic control. Mobile health applications (apps), coupled with wireless medical peripheral devices, can facilitate self-monitoring; deliver tailored, actionable knowledge; elicit positive behaviour changes and promote effective self-management of diabetes. Although existing apps incorporate tracking and feedback from healthcare providers, few attempt to elicit positive behaviour changes for the purposes of developing patients' self-care skills. The purpose of this article is to present a systematic approach to the design and development a diabetes self-management mobile app, which included 1) a scoping review of literature; 2) the development of an overarching theoretical approach and 3) validation of the app features through user-centred design methods. The resulting app, bant II, facilitates 1) self-monitoring of blood glucose, physical activity, diet and weight; 2) identification of glycemic patterns in relation to lifestyle; 3) remedial decision making and 4) positive behaviour change through incentives.
authors.affiliation: Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, Ontario, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada. Electronic address: shivani.goyal@uhn.ca.
authors.forename: Shivani
authors.initials: S
authors.lastname: Goyal
authors.affiliation: Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, Ontario, Canada.
authors.forename: Plinio
authors.initials: P
authors.lastname: Morita
authors.affiliation: Departments of Medicine and Physiology, Division of Endocrinology and the Banting and Best Diabetes Centre, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Gary F
authors.initials: GF
authors.lastname: Lewis
authors.affiliation: Division of Endocrinology & Metabolism and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Faculty of Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Catherine
authors.initials: C
authors.lastname: Yu
authors.affiliation: Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Emily
authors.initials: E
authors.lastname: Seto
authors.affiliation: Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, Ontario, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Cafazzo
mesh_terms: D006801:Humans; D001521:Behavior Therapy / Q000639:trends; D035843:Biomedical Research; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000628:therapy; D003927:Diet, Diabetic; D004038:Diet, Reducing; D006943:Hyperglycemia / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008019:Life Style; D063731:Mobile Applications; D008960:Models, Psychological; D009042:Motivation; D009043:Motor Activity; D050177:Overweight / Q000150:complications / Q000178:diet therapy / Q000628:therapy; D010349:Patient Compliance; D057285:Precision Medicine / Q000639:trends; D012107:Research Design; D012648:Self Care / Q000639:trends; D061108:Social Media; D017216:Telemedicine / Q000639:trends; D015431:Weight Loss
chemical_list: D007004:Hypoglycemic Agents
keywords: A1c; activité physique; blood glucose; conception de logiciels; diabetes mellitus; diabète sucré; glycémie; lifestyle; mesures incitatives; mobile health; mode de vie; poids corporel; prise en charge autonome; régime alimentaire; santé mobile; self-management