PMID- 35084357
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220329
IS  - 2371-4379 (Electronic)
IS  - 2371-4379 (Linking)
VI  - 7
IP  - 1
DP  - 2022 Jan 27
TI  - Barriers and Drivers Regarding the Use of Mobile Health Apps Among Patients With 
      Type 2 Diabetes Mellitus in the Netherlands: Explanatory Sequential Design Study.
PG  - e31451
LID - 10.2196/31451 [doi]
LID - e31451
AB  - BACKGROUND: Self-monitoring of blood glucose levels, food intake, and physical 
      activity supports self-management of patients with type 2 diabetes mellitus 
      (T2DM). There has been an increase in the development and availability of mobile 
      health apps for T2DM. OBJECTIVE: The aim of this study is to explore the actual 
      use of mobile health apps for diabetes among patients with T2DM and the main 
      barriers and drivers among app users and nonusers. METHODS: An explanatory 
      sequential design was applied, starting with a web-based questionnaire followed 
      by semistructured in-depth interviews. Data were collected between July and 
      December 2020. Questionnaire data from 103 respondents were analyzed using IBM 
      SPSS Statistics (version 25.0). Descriptive statistics were performed for the 
      actual use of apps and items of the Unified Theory of Acceptance and Use of 
      Technology (UTAUT). The UTAUT includes 4 key constructs: performance expectancy 
      (the belief that an app will help improve health performance), effort expectancy 
      (level of ease associated with using an app), social influence (social support), 
      and facilitating conditions (infrastructural support). Differences between users 
      and nonusers were analyzed using chi-square tests for individual items. 
      Independent 2-tailed t tests were performed to test for differences in mean 
      scores per the UTAUT construct. In total, 16 respondents participated in the 
      interviews (10 users and 6 nonusers of apps for T2DM). We performed content 
      analysis using a deductive approach on all transcripts, guided by the UTAUT. 
      RESULTS: Regarding actual use, 55.3% (57/103) were nonusers and 44.7% (46/103) 
      were users of apps for T2DM. The main driver for the use of apps was the belief 
      that using apps for managing diabetes would result in better personal health and 
      well-being. The time and energy required to keep track of the data and understand 
      the app were mentioned as barriers. Mean scores were significantly higher among 
      users compared with nonusers of apps for T2DM for the constructs performance 
      expectancy (4.06, SD 0.64 vs 3.29, SD 0.89; P<.001), effort expectancy (4.04, SD 
      0.62 vs 3.50, SD 0.82; P<.001), social influence (3.59, SD 0.55 vs 3.29, SD 0.54; 
      P=.007), and facilitating conditions (4.22, SD 0.48 vs 3.65, SD 0.70; P<.001). On 
      the basis of 16 in-depth interviews, it was recognized that health care 
      professionals play an important role in supporting patients with T2DM in using 
      apps. However, respondents noticed that their health care professionals were 
      often not supportive of the use of apps for managing diabetes, did not show 
      interest, or did not talk about apps. Reimbursement by insurance companies was 
      mentioned as a missing facilitator. CONCLUSIONS: Empowering health care 
      professionals' engagement is of utmost importance in supporting patients with 
      T2DM in the use of apps. Insurance companies can play a role in facilitating the 
      use of diabetes apps by ensuring reimbursement.
CI  - (c)Marloes Bults, Catharina Margaretha van Leersum, Theodorus Johannes Josef 
      Olthuis, Robin Enya Marije Bekhuis, Marjolein Elisabeth Maria den Ouden. 
      Originally published in JMIR Diabetes (https://diabetes.jmir.org), 27.01.2022.
FAU - Bults, Marloes
AU  - Bults M
AUID- ORCID: 0000-0002-6142-4574
AD  - Technology, Health & Care Research Group, Saxion University of Applied Sciences, 
      Enschede, Netherlands.
FAU - van Leersum, Catharina Margaretha
AU  - van Leersum CM
AUID- ORCID: 0000-0002-1003-0794
AD  - Science, Technology, and Policy Studies, Faculty of Behavioural, Management and 
      Social Sciences, University of Twente, Enschede, Netherlands.
FAU - Olthuis, Theodorus Johannes Josef
AU  - Olthuis TJJ
AUID- ORCID: 0000-0001-7470-0956
AD  - Care & Technology Research Group, Regional Community College of Twente, Hengelo, 
      Netherlands.
FAU - Bekhuis, Robin Enya Marije
AU  - Bekhuis REM
AUID- ORCID: 0000-0003-4109-0404
AD  - Department of Smartup Innovation, Ziekenhuisgroep Twente, Almelo, Netherlands.
FAU - den Ouden, Marjolein Elisabeth Maria
AU  - den Ouden MEM
AUID- ORCID: 0000-0001-7821-1578
AD  - Technology, Health & Care Research Group, Saxion University of Applied Sciences, 
      Enschede, Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20220127
PL  - Canada
TA  - JMIR Diabetes
JT  - JMIR diabetes
JID - 101719410
PMC - PMC8832276
OTO - NOTNLM
OT  - acceptance
OT  - mixed methods research
OT  - mobile health, mobile apps
OT  - mobile phone
OT  - prevention
OT  - self-management
OT  - type 2 diabetes
COIS- Conflicts of Interest: None declared.
EDAT- 2022/01/28 06:00
MHDA- 2022/01/28 06:01
PMCR- 2022/01/27
CRDT- 2022/01/27 12:14
PHST- 2021/06/22 00:00 [received]
PHST- 2021/11/24 00:00 [accepted]
PHST- 2021/10/01 00:00 [revised]
PHST- 2022/01/27 12:14 [entrez]
PHST- 2022/01/28 06:00 [pubmed]
PHST- 2022/01/28 06:01 [medline]
PHST- 2022/01/27 00:00 [pmc-release]
AID - v7i1e31451 [pii]
AID - 10.2196/31451 [doi]
PST - epublish
SO  - JMIR Diabetes. 2022 Jan 27;7(1):e31451. doi: 10.2196/31451.