Perspectives From Underserved African Americans and Their Health Care Providers on the Development of a Diabetes Self-Management Smartphone App: Qualitative Exploratory Study

Tai Barber-Gumbs; Ylva Trolle Lagerros; Laura M Sena; Joel Gittelsohn; Larry W Chang; Wayne W Zachary; Pamela J Surkan

doi:10.2196/18224

Perspectives From Underserved African Americans and Their Health Care Providers on the Development of a Diabetes Self-Management Smartphone App: Qualitative Exploratory Study

JMIR Form Res. 2021 Feb 26;5(2):e18224. doi: 10.2196/18224.

Authors

Tai Barber-Gumbs¹, Ylva Trolle Lagerros^{2

3}, Laura M Sena⁴, Joel Gittelsohn⁴, Larry W Chang⁵, Wayne W Zachary^#⁶, Pamela J Surkan^#⁷

Affiliations

¹ Program in Public Health, Johns Hopkins University, Baltimore, MD, United States.
² Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
³ Center for Obesity, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden.
⁴ Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
⁵ Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
⁶ Starship Health Technologies, LLC, Fort Washington, PA, United States.
⁷ Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.

^# Contributed equally.

PMID: 33635279
PMCID: PMC7954654
DOI: 10.2196/18224

Abstract

Background: Type 2 diabetes mellitus (T2DM) affects approximately 10% of the US population, disproportionately afflicting African Americans. Smartphone apps have emerged as promising tools to improve diabetes self-management, yet little is known about the use of this approach in low-income minority communities.

Objective: The goal of the study was to explore which features of an app were prioritized for people with T2DM in a low-income African American community.

Methods: Between February 2016 and May 2018, we conducted formative qualitative research with 78 participants to explore how a smartphone app could be used to improve diabetes self-management. Information was gathered on desired features, and app mock-ups were presented to receive comments and suggestions of improvements from smartphone users with prediabetes and T2DM, their friends and family members, and health care providers; data were collected from six interactive forums, one focus group, and 15 in-depth interviews. We carried out thematic data analysis using an inductive approach.

Results: All three types of participants reported that difficulty with accessing health care was a main problem and suggested that an app could help address this. Participants also indicated that an app could provide information for diabetes education and self-management. Other suggestions included that the app should allow people with T2DM to log and track diabetes care-related behaviors and receive feedback on their progress in a way that would increase engagement in self-management among persons with T2DM.

Conclusions: We identified educational and tracking smartphone features that can guide development of diabetes self-management apps for a low-income African American population. Considering those features in combination gives rise to opportunities for more advanced support, such as determining self-management recommendations based on data in users' logs.

Keywords: diabetes; diabetes self-management; mHealth; mobile app; mobile phone; type 2 diabetes mellitus.

©Tai Barber-Gumbs, Ylva Trolle Lagerros, Laura M Sena, Joel Gittelsohn, Larry W Chang, Wayne W Zachary, Pamela J Surkan. Originally published in JMIR Formative Research (http://formative.jmir.org), 26.02.2021.

Abstract

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