User experiences with a type 2 diabetes coaching app: a qualitative study

Background: Diabetes self-management apps have the potential to improve self-management by people with type 2 diabetes. Although efficacy trials provide evidence of health benefits, premature disengagement from apps is common. Therefore, it is important to understand factors that influence engagement in real-world settings. Objective: To explore users’ real-world experiences with the ‘My Diabetes Coach’ self-management app. Methods: We conducted telephone-based interviews with participants who had accessed the ‘My Diabetes Coach’ self-management app via their own smartphone for up to 12 months. Interviews focused on the users’ characteristics, the context within which the app was used, barriers and facilitators of app use, and on the design, content and delivery of support within the app. Results: Nineteen interviewees were aged 60 (SD=14) years. Eight (42%) were women. Eight (42%) participants had type 2 diabetes for less than five years, eight (42%) for five-ten years and three (16%) for more than ten years. Two themes were constructed from interview data: 1) the moderating effect of diabetes self-management styles on needs, preferences and expectations and 2) factors influencing users’ engagement with the app: one size does not fit all. Conclusions: User characteristics, context of use and features of the app interact and influence engagement. Promoting engagement is vital if diabetes self-management apps are to become a useful complement to clinical care in supporting optimal self-management