Adult Perceptions of Utilizing a Mobile Health Application for Self-Management of Type 2 Diabetes

Abstract

Background: Type two diabetes mellitus (T2DM) is a devastating, chronic disease that effects millions of people in the world (Fitzner, Heckinger, Tulas, & McKoy, 2014). Self-management is significantly important to those with this diagnosis. Proper self-management will help improve quality of life and many of the complications due to diabetes (Ahola & Groop, 2012). Objective: To determine if the use of a free mobile health app can improve the perceived self-management of T2DM. Methods: The QI project consisted of participants completing a 14-question pre-test survey and then utilizing a free mobile health application, Tactio Health, for four weeks to help with their self-management of their T2DM. The participants received a text message at week two and week three reminding them to fill out the post-test survey to gage their perceived perception of their self-management after incorporating the use of the mobile health app. At week four, participants were sent a link to the post-test survey. Four individuals agreed to participate and completed the pre-test survey. Results: Recruiting for this QI project was severely crippled when approval from the Institutional Review Board (IRB) was not granted at the community hospital that would have served as the principal recruiting site. Over four months were devoted to trying to secure approval that was never granted. This led to a change in implementation site that was not nearly as saturated with the target population meant for this project. Ultimately, recruitment took place at a community center where many individuals encountered did not meet the inclusion criteria. Another limitation, compounded by the last-minute change in implementation site, was a small sample size. Four individuals were recruited at the community center. Such a small sample size does not allow for any clinical significance to be determined. An additional limitation was the 100% attrition rate. None of the participants completed the post-test survey, which would have demonstrated whether the perception of self-management stayed the same, declined or improved. However, there were similarities and differences noted based on the pre-test survey. For example, 75% of participants strongly agreed managing their diabetes at home is extremely important. 75% check their blood sugar as often as their provider wants them to and 75% strongly agree that poor control of their diabetes will lead to complications. Only 25% of participants currently utilized a mobile health app specifically for the management of their diabetes, but 100% strongly agreed a mobile health app would be very helpful. This infers there is a role for a mobile health app in the management of T2DM. Conclusions: Inability to receive IRB approval from the community hospital, change in recruitment site, lack of recruitment time, small sample size, and the 100% attrition rate were all significant barriers to the success of this QI project. However, valuable information was still gleaned from the pre-test survey. Future projects, which a much larger sample size, need to be completed to further assess the role of mobile health apps in the perceived self-management of T2DM.