Adu, Mary D., Malabu, Usman H., Malau-Aduli, Aduli E.O, Drovandi, Aaron, and Malau-Aduli, Bunmi S. (2020) User retention and engagement with a mobile app intervention to support self-management in Australians with type 1 or type 2 diabetes (My Care Hub): mixed methods study. JMIR Mhealth Uhealth, 8 (6). e17802.

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Abstract

Background: Mobile health apps are commonly used to support diabetes self-management. However, there is limited research assessing if such apps are able to meet the basic requirements to retain and engage users.

Objective: In this study, we aimed to evaluate participants' retention and engagement with My Care Hub (MCH), a mobile app for diabetes self-management.

Methods: This study employed an explanatory mixed-method design. Participants were people with type 1 or type 2 diabetes who used the health app intervention for 2 weeks. Retention was measured by completion of the post-intervention survey. Engagement was measured using system log indices and interviews. Retention and system log indices were presented using descriptive statistics. Transcripts were analyzed using content analysis to develop themes interpreted according to the Behavioural Intervention Technology theory.

Results: Of the 50 individuals enrolled, 42 (84%) adhered to the study protocol. System usage data showed multiple and frequent interaction with the app by most of the enrolled participants (84%, 42/50). Participants used the app on an average of 11 out of the 14 intervention days (range 2-14 days); where two-thirds of participants who inputted data returned to use the app after week 1 (85%, 36/42) and week 2 (71.4%, 30/42) of installation. Most daily used features were tracking of blood glucose (BG) (67.5%, 28/42) and accessing educational information (12.57%, 6/42). The interview results revealed the app's potential as a behavioural change intervention tool, particularly because it eased participants' self-care effort and improved their engagement with diabetes self-management activities such as BG monitoring, physical exercise and healthy eating. Participants suggested extra functionalities such as extended access to historical analytic data, automated data transmission from BG meter as well as periodic update of meals and corresponding nutrients to further enhance engagement with the app.

Conclusions: The findings of this short-term intervention study suggested acceptable levels of participant retention and engagement with MCH, indicating that is a promising tool for extending diabetes self-management support and education beyond the confines of a physical clinic.

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