PMID- 38446526 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240323 IS - 2371-4379 (Electronic) IS - 2371-4379 (Linking) VI - 9 DP - 2024 Mar 6 TI - Acceptability of Mobile App-Based Motivational Interviewing and Preferences for App Features to Support Self-Management in Patients With Type 2 Diabetes: Qualitative Study. PG - e48310 LID - 10.2196/48310 [doi] LID - e48310 AB - BACKGROUND: Patients with type 2 diabetes mellitus (T2DM) experience multiple barriers to improving self-management. Evidence suggests that motivational interviewing (MI), a patient-centered communication method, can address patient barriers and promote healthy behavior. Despite the value of MI, existing MI studies predominantly used face-to-face or phone-based interventions. With the growing adoption of smartphones, automated MI techniques powered by artificial intelligence on mobile devices may offer effective motivational support to patients with T2DM. OBJECTIVE: This study aimed to explore the perspectives of patients with T2DM on the acceptability of app-based MI in routine health care and collect their feedback on specific MI module features to inform our future intervention. METHODS: We conducted semistructured interviews with patients with T2DM, recruited from public primary care clinics. All interviews were audio recorded and transcribed verbatim. Thematic analysis was conducted using NVivo. RESULTS: In total, 33 patients with T2DM participated in the study. Participants saw MI as a mental reminder to increase motivation and a complementary care model conducive to self-reflection and behavior change. Yet, there was a sense of reluctance, mainly stemming from potential compromise of autonomy in self-care by the introduction of MI. Some participants felt confident in their ability to manage conditions independently, while others reported already making changes and preferred self-management at their own pace. Compared with in-person MI, app-based MI was viewed as offering a more relaxed atmosphere for open sharing without being judged by health care providers. However, participants questioned the lack of human touch, which could potentially undermine a patient-provider therapeutic relationship. To sustain motivation, participants suggested more features of an ongoing supportive nature such as the visualization of milestones, gamified challenges and incremental rewards according to achievements, tailored multimedia resources based on goals, and conversational tools that are interactive and empathic. CONCLUSIONS: Our findings suggest the need for a hybrid model of intervention involving both app-based automated MI and human coaching. Patient feedback on specific app features will be incorporated into the module development and tested in a randomized controlled trial. CI - (c)Sungwon Yoon, Haoming Tang, Chao Min Tan, Jie Kie Phang, Yu Heng Kwan, Lian Leng Low. Originally published in JMIR Diabetes (https://diabetes.jmir.org), 06.03.2024. FAU - Yoon, Sungwon AU - Yoon S AUID- ORCID: 0000-0001-9458-6097 AD - Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore. AD - Centre for Population Health Research and Implementation, SingHealth Regional Health System, Singapore, Singapore. FAU - Tang, Haoming AU - Tang H AUID- ORCID: 0009-0005-7510-1599 AD - Duke-NUS Medical School, Singapore, Singapore. FAU - Tan, Chao Min AU - Tan CM AUID- ORCID: 0000-0002-3723-9344 AD - Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore. AD - Centre for Population Health Research and Implementation, SingHealth Regional Health System, Singapore, Singapore. FAU - Phang, Jie Kie AU - Phang JK AUID- ORCID: 0000-0003-1357-8568 AD - Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore. AD - Centre for Population Health Research and Implementation, SingHealth Regional Health System, Singapore, Singapore. FAU - Kwan, Yu Heng AU - Kwan YH AUID- ORCID: 0000-0001-7802-9696 AD - Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore. AD - Centre for Population Health Research and Implementation, SingHealth Regional Health System, Singapore, Singapore. AD - Internal Medicine Residency, SingHealth Residency, Singapore, Singapore. FAU - Low, Lian Leng AU - Low LL AUID- ORCID: 0000-0003-4228-2862 AD - Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore. AD - Centre for Population Health Research and Implementation, SingHealth Regional Health System, Singapore, Singapore. AD - Post-Acute and Continuing Care, Outram Community Hospital, Singapore, Singapore. AD - SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore. LA - eng PT - Journal Article DEP - 20240306 PL - Canada TA - JMIR Diabetes JT - JMIR diabetes JID - 101719410 PMC - PMC10955395 OTO - NOTNLM OT - acceptability OT - application OT - communication OT - diabetes OT - feedback OT - health coaching OT - healthy behavior OT - hybrid model OT - management OT - mobile health OT - motivational interviewing OT - patient barrier OT - self-management OT - type 2 diabetes OT - visualization COIS- Conflicts of Interest: None declared. EDAT- 2024/03/06 12:42 MHDA- 2024/03/06 12:43 PMCR- 2024/03/06 CRDT- 2024/03/06 11:53 PHST- 2023/04/18 00:00 [received] PHST- 2024/01/28 00:00 [accepted] PHST- 2023/11/05 00:00 [revised] PHST- 2024/03/06 12:43 [medline] PHST- 2024/03/06 12:42 [pubmed] PHST- 2024/03/06 11:53 [entrez] PHST- 2024/03/06 00:00 [pmc-release] AID - v9i1e48310 [pii] AID - 10.2196/48310 [doi] PST - epublish SO - JMIR Diabetes. 2024 Mar 6;9:e48310. doi: 10.2196/48310.