Background Recent studies increasingly examine social support for diabetes self-management delivered via mHealth. In contrast to previous studies examining social support as an outcome of technology use, or technology as a means for... more
Background Recent studies increasingly examine social support for diabetes self-management delivered via mHealth. In contrast to previous studies examining social support as an outcome of technology use, or technology as a means for delivering social support, this paper argues that social support has an impact on the use of diabetes mHealth apps. Specifically, we postulate differences between the impact of healthcare professional versus non-professional (family/friends) support on mobile app use for diabetes self-management.Methods This research employed a triangulation of methods including exploratory semi-structured face-to-face interviews (N= 21, Study 1) and an online survey (N= 65, Study 2) with adult type 1 and type 2 diabetes patients. Thematic analysis (Study 1) was used to explore the relevance of social support (by professionals versus non-professionals) for diabetes app use. Binary logistic regression (Study 2) was applied to compare healthcare decision-making, healthcare...
Research Interests:
This paper details materials, methods, results, and analyses of the Consumer Health Search Task of the CLEF eHealth 2021 Evaluation Lab. This task investigates the effectiveness of information retrieval (IR) approaches in providing access... more
This paper details materials, methods, results, and analyses of the Consumer Health Search Task of the CLEF eHealth 2021 Evaluation Lab. This task investigates the effectiveness of information retrieval (IR) approaches in providing access to medical information to laypeople. For this a TREC-style evaluation methodology was applied: a shared collection of documents and queries is distributed, participants’ runs received, relevance assessments generated, and participants’ submissions evaluated. The task generated a new representative web corpus including web pages acquired from a 2021 CommonCrawl and social media content from Twitter and Reddit, along with a new collection of 55 manually generated layperson medical queries and their respective credibility, understandability, and topicality assessments for returned documents. This year’s task focused on three subtask: (i) ad-hoc IR, (ii) weakly supervised IR, and (iii) document credibility prediction. In total, 15 runs were submitted t...
Research Interests:
Background In the last decade, diabetes management has begun to transition to technology-based care, with young people being the focus of many technological advances. Yet, detailed insights into the experiences of young people and their... more
Background In the last decade, diabetes management has begun to transition to technology-based care, with young people being the focus of many technological advances. Yet, detailed insights into the experiences of young people and their caregivers of using technology to manage type 1 diabetes mellitus are lacking. Objective The objective of our study was to describe the breadth of experiences and perspectives on diabetes technology use among children and adolescents with type 1 diabetes mellitus and their caregivers. Methods This systematic literature review used integrated thematic analysis to guide a narrative synthesis of the included studies. We analyzed the perspectives and experiences of young people with type 1 diabetes mellitus and their caregivers reported in qualitative studies, quantitative descriptive studies, and studies with a mixed methods design. Results Seventeen articles met the inclusion criteria, and they included studies on insulin pump, glucose sensors, and rem...
ObjectiveTo explore the experiences of young people with type 1 diabetes mellitus (T1DM) and their parents in accessing integrated family-centred care in the Australian Capital Territory during the COVID-19 pandemic.Methods and... more
ObjectiveTo explore the experiences of young people with type 1 diabetes mellitus (T1DM) and their parents in accessing integrated family-centred care in the Australian Capital Territory during the COVID-19 pandemic.Methods and analysisThis is a pragmatic, qualitative descriptive study for which we conducted semistructured interviews with 11 young people with T1DM aged 12–16 years and 10 of their parents who attended an outpatient diabetes service in Canberra, Australia. Thematic analysis was conducted in accordance with the methods outlined by Braun and Clarke.ResultsThree themes were identified: feeling vulnerable, new ways of accessing care and trust in the interdisciplinary diabetes healthcare team. Participants believed having T1DM made them more vulnerable to poor outcomes if they contracted COVID-19, resulting in avoidance of face-to-face care. Telephone consultations offered a convenient and contact-free way to undertake 3-monthly reviews. The greatest difference between tel...
Research Interests:
(unstructured)An important strategy to understand young people’s needs regarding technologies for Type 1 Diabetes Mellitus (T1DM) management is to examine their day-to-day experiences with these technologies. This study aimed to describe... more
(unstructured)An important strategy to understand young people’s needs regarding technologies for Type 1 Diabetes Mellitus (T1DM) management is to examine their day-to-day experiences with these technologies. This study aimed to describe T1DM youth and their caregivers’ experiences and preferences regarding insulin pumps, sensor technologies, and related communication technologies based on a hybrid theoretical foundation, as well as to describe derived ideal device characteristics. Sixteen face-to-face interviews were conducted with young people and their parents. Data analysis included data-driven thematic analysis followed by theory-driven analysis (Unified Theory of Acceptance and Use of Technology; value sensitive design). Initial themes derived from the interviews included aspects of self-management, device use, technological characteristics, and feelings associated with device types. Interview findings were congruent with factors from the two theories. Discussions around ideal devices focused on reliability, flexibility, and automated closed loop systems that enabled an independent life for young people and alleviated parental anxiety. Reality deviated from expectations, with inaccuracy problems and technical failures reported. Technologies for diabetes self-management require continual advancement to meet the needs of young people with T1DM and their caregivers. Understanding experiences and challenges with devices enabled us to identify theory-supported device characteristics useful for the designing of improved technologies.Extended abstract (structured)BackgroundAn important strategy to understand young people’s needs and preferences regarding technologies for Type 1 Diabetes Mellitus (T1DM) management is to examine their day-to-day experiences with these technologies.ObjectiveThis study aimed to describe T1DM youth and their caregivers’ experiences and preferences regarding insulin pumps, sensor technologies, and related communication technologies based on a hybrid theoretical foundation, as well as to describe derived ideal device characteristics.Materials and MethodsSixteen face-to-face interviews were conducted with young people with T1DM and their parents about their diabetes technology use. A combination of data-driven thematic analysis in a first stage, and theory-driven analysis in a second stage was used to incorporate in-depth study analysis and existing theoretical literature. Relevant literature included technology adoption (Unified Theory of Acceptance and Use of Technology/UTAUT) and value sensitive design (VSD) models. Based on this approach ideal device characteristics for young people with T1DM were summarized.ResultsInitial themes derived from the interviews included aspects of diabetes self-management, device use, and specific device-related technological characteristics and feelings associated with the specific device types (continuous glucose monitoring, insulin pump, flash glucose monitoring). The interview data delivered information congruent with all UTAUT and VSD factors except for one (privacy). Discussions around ideal diabetes devices focused on reliability, flexibility, and automated closed loop systems that enabled an independent and normal life for adolescents, and alleviated parental anxiety. However, in line with the previous systematic review, the interview analysis showed that reality deviated from these expectations, with inaccuracy problems reported for continuous glucose monitoring devices, and technical failures occurring in both continuous glucose monitoring devices and insulin pumps.ConclusionsUTAUT and VSD approaches were found useful as a combined foundation for structuring our study findings. Technologies for diabetes self-management require continual advancement to meet the needs and expectations of young people with T1DM and their caregivers. Understanding their experiences, as well as challenges with the devices, enabled us to identify theory-supported ideal device characteristics that can be useful in the designing and developing of improved technologies.
BackgroundPortable breath ketone sensors may help people with Type 1 Diabetes Mellitus (T1DM) avoid episodes of diabetic ketoacidosis; however the design features preferred by users have not been studied. We aimed to elucidate design... more
BackgroundPortable breath ketone sensors may help people with Type 1 Diabetes Mellitus (T1DM) avoid episodes of diabetic ketoacidosis; however the design features preferred by users have not been studied. We aimed to elucidate design preferences associated with breath ketone sensors among young people with T1DM aged 12-16 years, their parents, and diabetes educators.Research Designs and MethodsTwo commercially available breath ketone sensors, designed for ketogenic diet monitoring, were assessed over one week by ten young people with T1DM following a usability evaluation approach. Participants interacted with the devices at least twice daily for five days, taking breath ketone, blood ketone and blood glucose measurements. Semi-structured interviews were conducted post-testing with participants, parents and two diabetes educators to elicit design preferences to inform the co-design of diabetes breath ketone sensor prototypes.ResultsParticipants acknowledged the non-invasiveness of br...
The number of falls among older adults is rising due to an ageing population worldwide. An integrated communication campaign utilizing mHealth (mobile health) encouraged older adults to perform strength, balance, and flexibility exercises... more
The number of falls among older adults is rising due to an ageing population worldwide. An integrated communication campaign utilizing mHealth (mobile health) encouraged older adults to perform strength, balance, and flexibility exercises to reduce their risk of falling. Campaign development was guided by a mixed-method approach which incorporated expert interviews (N=3), qualitative interviews (N=22), and a quantitative baseline pre-campaign survey (N=274) with older adults. We evaluated the campaign impact with a pre-post survey analysis (post n=141). Impact was measured by knowledge, attitudes, self-efficacy and behaviors as key Social Cognitive Theory factors to exercise adoption. Results showed that respondents with campaign exposure had a significant increase in all factor scores from pre- to post-campaign survey, which was significantly higher in the group with campaign exposure. The impact evaluation illustrated how digital mobile channels effectively provide means to reach older adults to reduce their risk of falling.
Research Interests:
Research Interests:
Community capacity building is an essential approach for health promotion, combining a participatory approach with the view to community ownership. Little research focuses on practical capacity building strategies and monitoring. Our... more
Community capacity building is an essential approach for health promotion, combining a participatory approach with the view to community ownership. Little research focuses on practical capacity building strategies and monitoring. Our paper looks into involving stakeholders in facilitated group discussions as a specific strategy for fostering capacity building processes. These processes focused on physical activity (PA) promotion in two German communities (ACTION4men). Along the dimensions of capacity building suggested in literature (e.g., problem solving, resource mobilization, leadership), we implemented two participatory stakeholder groups (1/community). These groups were motivated to develop and implement PA interventions for men >50 years. For measuring capacity building processes, a semi-standardized monitoring instrument was used to document all group meetings. Additionally, we conducted semi-standardized interviews with group participants and drop-outs to capture their pe...
Research Interests:
Background The impact of social support on diabetes management and health outcomes has been investigated comprehensively, with recent studies examining social support delivered via digital technologies. This paper argues that social... more
Background The impact of social support on diabetes management and health outcomes has been investigated comprehensively, with recent studies examining social support delivered via digital technologies. This paper argues that social support has an impact on the use of diabetes technologies. Specifically, we postulate differences between the impact of healthcare professional versus non-professional (family/friends) support on mobile app use for diabetes self-management.
Methods This research employed a triangulation of methods including exploratory semi-structured face-to-face interviews (N= 21, Study 1) and an online survey (N= 65, Study 2) with adult type 1 and type 2 diabetes patients. Thematic analysis (Study 1) was used to explore the relevance of social support (by professionals versus non-professionals) for diabetes app use. Binary logistic regression (Study 2) was applied to compare healthcare decision-making, healthcare-patient communication, and the support by the personal patient network as predictors of diabetes app use, complemented by other predictors from self-management and technology adoption theory.
Results The interviews (Study 1) demonstrated that (technology-supported) shared decision-making and supportive communication by healthcare professionals depended on the medical specialty of attending physicians. The personal patient network was perceived as either facilitating or hindering the use of mHealth for self-management. Binary logistic regression (Study 2) showed that the specialty of the physician significantly predicted the use of diabetes apps, with supervision by diabetes specialists increasing the likelihood of app use (as opposed to general practitioners). In addition, specialist care positively related to a higher chance of shared decision-making and better physician-patient communication. The support by the personal patient network predicted diabetes app use in the opposite direction, with lower family/friend support increasing the likelihood of app use.
Conclusion The results emphasize the relevance of support by healthcare professionals and by the patient network for diabetes app use and disclose differences from existing literature. In particular, we found that the use of diabetes apps may increase in the absence of social support by family or friends (e.g., compensation for lack of support), and that use of diabetes apps may decrease when support is high (e.g., no perceived need to use technology). Implications for practice are discussed.
Methods This research employed a triangulation of methods including exploratory semi-structured face-to-face interviews (N= 21, Study 1) and an online survey (N= 65, Study 2) with adult type 1 and type 2 diabetes patients. Thematic analysis (Study 1) was used to explore the relevance of social support (by professionals versus non-professionals) for diabetes app use. Binary logistic regression (Study 2) was applied to compare healthcare decision-making, healthcare-patient communication, and the support by the personal patient network as predictors of diabetes app use, complemented by other predictors from self-management and technology adoption theory.
Results The interviews (Study 1) demonstrated that (technology-supported) shared decision-making and supportive communication by healthcare professionals depended on the medical specialty of attending physicians. The personal patient network was perceived as either facilitating or hindering the use of mHealth for self-management. Binary logistic regression (Study 2) showed that the specialty of the physician significantly predicted the use of diabetes apps, with supervision by diabetes specialists increasing the likelihood of app use (as opposed to general practitioners). In addition, specialist care positively related to a higher chance of shared decision-making and better physician-patient communication. The support by the personal patient network predicted diabetes app use in the opposite direction, with lower family/friend support increasing the likelihood of app use.
Conclusion The results emphasize the relevance of support by healthcare professionals and by the patient network for diabetes app use and disclose differences from existing literature. In particular, we found that the use of diabetes apps may increase in the absence of social support by family or friends (e.g., compensation for lack of support), and that use of diabetes apps may decrease when support is high (e.g., no perceived need to use technology). Implications for practice are discussed.
Research Interests:
Chronic lifestyle related diseases like diabetes are developing into a major health burden worldwide. Prevalence numbers are increasing drastically not only in developed countries but rising in developing countries as well. With forecasts... more
Chronic lifestyle related diseases like diabetes are developing into a major health burden worldwide. Prevalence numbers are increasing drastically not only in developed countries but rising in developing countries as well. With forecasts of widespread incidence of chronic diseases due to a range of factors including improved standards of living, aging societies, and increased obesity, limited healthcare resources (manpower and facilities) are ill-equipped to face the impending crisis. With healthcare costs skyrocketing for chronic disease care, the focus has shifted away from medical system approaches toward strengthening self-management
with much stronger responsibility given to the patient . We adopt a multidimensional empowerment approach with a psychological dimension and a social influence dimension as a theoretical framework, knowledge from different research directions is brought together and connected to a theoretical concept. The result is a more robust theoretical and empirical foundation for an explanation of self-management outcomes, as well as of mHealth use as part of disease self-management as compared to previous studies focusing on single aspects of empowerment only.
with much stronger responsibility given to the patient . We adopt a multidimensional empowerment approach with a psychological dimension and a social influence dimension as a theoretical framework, knowledge from different research directions is brought together and connected to a theoretical concept. The result is a more robust theoretical and empirical foundation for an explanation of self-management outcomes, as well as of mHealth use as part of disease self-management as compared to previous studies focusing on single aspects of empowerment only.
Research Interests:
Objectives. Smart device apps for diabetes have the potential to support patients in their daily disease management. However, uncertainty exists regarding their suitability for empowering patients to improve self-management behaviors.... more
Objectives. Smart device apps for diabetes have the potential to support patients in their daily disease management. However, uncertainty exists regarding their suitability for empowering patients to improve self-management behaviors. This paper addresses a general research gap regarding theoretically based examinations of empowerment in diabetes research, by examining how diabetes app features correspond with conceptual indicators of empowerment. Methods. We examined features of 121 apps for diabetes self-management available in Singapore, with the second highest proportion of diabetes among developed nations, for psychological empowerment (feeling of empowerment) and for behavioral empowerment (social support). Results. Diabetes apps studied offered a narrow range of features, with limited feature-sets corresponding to indicators of empowerment. Customization as a strategy to improve perceived relevance of diabetes self-management as an indicator of psychological empowerment was especially limited. Moreover, there was a lack of features supporting patients' communication with healthcare professionals and within their private social networks. Conclusions. Mobile apps for diabetes self-management failed to provide relevant features for empowering patients. Specific practical recommendations target improved adoption, sustained usage, and effectiveness of diabetes self-management apps. Diabetes care programs increasingly include advanced mobile-based technological devices. These technologies entered the market aiming to supplement traditional diabetes healthcare and to support self-management by patients (1). Consequently, smart applications on mobile devices for diabetes self-management proliferated, increasing exponentially in app stores (2). Diabetes apps are designed to support self-management activities like blood glucose (BG) and complication monitoring, medication adherence, healthy eating, exercise, and problem-solving (1). With the increased availability of apps targeted at consumers, research began examining their potential for diabetes self-management. Current trends in mHealth, "the use of mobile communications for health information and services" (3, p. 1), focus on effects research (4), contrasting overly optimistic study results on diabetes app use effects (5) with a more critical view toward mHealth effectiveness (6;7). A meta-analysis showed that such interventions "that have statistically significant effects are small and of borderline clinical importance" (4, p. 25). The potential of mHealth for diabetes self-management, including diabetes apps, requires further investigation, especially in theoretical terms. We focus on the concept of empowerment as a fundamental predictor of self-management behaviors (8), particularly in relation to diabetes (9;10), to evaluate the potential of diabetes apps for empowered self-management. Specifically, this study examines how technological features of apps for diabetes self-management correspond with theoretical indicators of (RQ1) psychological and (RQ2) behavioral empowerment. The study first defines two sub-concepts of empowerment for diabetes self-management, then addresses extant gaps regarding empowerment in mHealth research, particularly in relation to diabetes apps. To address research gaps, we examined features of 121 diabetes apps corresponding to indicators of empowerment.
Research Interests:
Objectives. Smart device apps for diabetes have the potential to support patients in their daily disease management. However, uncertainty exists regarding their suitability for empowering patients to improve self-management behaviors.... more
Objectives. Smart device apps for diabetes have the potential to support patients in their daily disease management. However, uncertainty exists regarding their suitability for empowering patients to improve self-management behaviors. This paper addresses a general research gap regarding theoretically based examinations of empowerment in diabetes research, by examining how diabetes app features correspond with conceptual indicators of empowerment. Methods. We examined features of 121 apps for diabetes self-management available in Singapore, with the second highest proportion of diabetes among developed nations, for psychological empowerment (feeling of empowerment) and for behavioral empowerment (social support). Results. Diabetes apps studied offered a narrow range of features, with limited feature-sets corresponding to indicators of empowerment. Customization as a strategy to improve perceived relevance of diabetes self-management as an indicator of psychological empowerment was especially limited. Moreover, there was a lack of features supporting patients' communication with healthcare professionals and within their private social networks. Conclusions. Mobile apps for diabetes self-management failed to provide relevant features for empowering patients. Specific practical recommendations target improved adoption, sustained usage, and effectiveness of diabetes self-management apps. Diabetes care programs increasingly include advanced mobile-based technological devices. These technologies entered the market aiming to supplement traditional diabetes healthcare and to support self-management by patients (1). Consequently, smart applications on mobile devices for diabetes self-management proliferated, increasing exponentially in app stores (2). Diabetes apps are designed to support self-management activities like blood glucose (BG) and complication monitoring, medication adherence, healthy eating, exercise, and problem-solving (1). With the increased availability of apps targeted at consumers, research began examining their potential for diabetes self-management. Current trends in mHealth, "the use of mobile communications for health information and services" (3, p. 1), focus on effects research (4), contrasting overly optimistic study results on diabetes app use effects (5) with a more critical view toward mHealth effectiveness (6;7). A meta-analysis showed that such interventions "that have statistically significant effects are small and of borderline clinical importance" (4, p. 25). The potential of mHealth for diabetes self-management, including diabetes apps, requires further investigation, especially in theoretical terms. We focus on the concept of empowerment as a fundamental predictor of self-management behaviors (8), particularly in relation to diabetes (9;10), to evaluate the potential of diabetes apps for empowered self-management. Specifically, this study examines how technological features of apps for diabetes self-management correspond with theoretical indicators of (RQ1) psychological and (RQ2) behavioral empowerment. The study first defines two sub-concepts of empowerment for diabetes self-management, then addresses extant gaps regarding empowerment in mHealth research, particularly in relation to diabetes apps. To address research gaps, we examined features of 121 diabetes apps corresponding to indicators of empowerment.
Research Interests:
Background: To achieve clarity on mobile health's (mHealth's) potential in the diabetes context, it is necessary to understand potential users' needs and expectations, as well as the factors determining their mHealth use. Recently, a few... more
Background: To achieve clarity on mobile health's (mHealth's) potential in the diabetes context, it is necessary to understand potential users' needs and expectations, as well as the factors determining their mHealth use. Recently, a few studies have examined the user perspective in the mHealth context, but their explanatory value is constrained because of their limitation to adoption factors.
Research Interests:
Background: With the availability of mobile smart devices, many adolescents have developed the habit of being online and connected with other users almost all the time. Objective: The aim of this paper is to provide a definition of being... more
Background: With the availability of mobile smart devices, many adolescents have developed the habit of being online and connected with other users almost all the time. Objective: The aim of this paper is to provide a definition of being permanently online (PO) and permanently connected (PC) and to explore students' current PO/PC behaviors. Methods: An online survey was conducted with 178 university students in Germany to explore the intensity of their PO/PC behaviors in various social situations, the differences in being PO and being PC, students' feelings about a possible loss of Internet access, and their online responding behaviors. We also shed some light on the associations between being PO/PC and various aspects of well-being, as well as between PO/PC and demographics and lifestyle. Results: Smart device usage behaviors at night and behaviors in various social situations during the day indicate that PO and PC behaviors are occurring frequently. The results show that being connected to others (PC) seems to be more relevant to the participants than browsing the web (PO). Moreover, the participants expressed strong emotional responses about a temporary loss of Internet access. Coping behaviors in response to increasing number of incoming messages and permanent availability are reported. Conclusion: This exploratory study demonstrates the relevance of the concepts of being PO and PC to students, and points out further research gaps.