The design and development of MyT1DHero: A mobile app for adolescents with type 1 diabetes and their parents

Introduction Type 1 diabetes impacts approximately 1.25 m Americans, many of them young children. As a child grows, there is a transition towards independence and they must learn to manage their diabetes independently. The objective of this study was to design, develop and conduct a prototype test to assess the satisfaction and feasibility of a mobile app for adolescents with type 1 diabetes and their parents to aid in this transition. Methods Ten parent/adolescent groups used MyT1DHero for four weeks. They were given a pre-test/post-test survey regarding family conflict with three tasks of diabetes management and the general tone of family communication. At post-test they were asked questions regarding their satisfaction and perception of ease of use of the app. They also participated in short interviews regarding the app. Additionally, we used server data to examine actual app usage. Results The parents’ perceptions of conflict around the results of the blood sugar tests increased (t(9) = 2.71, p = .02) as did perceptions of conflict around logging the blood sugar results (t(9) = 3.67, p = .005). The adolescents perceived increased conflict surrounding the results around logging the blood sugars results (t(9) = 3.09, p = .01).There was no change in the tone of general family communication. During the prototype testing, we discovered that the app crashed repeatedly and several of the functions were not working properly. In the interview data, three main themes emerged, app-crashing issues, problems with notifications and positive feedback. Discussion Through this process, all of the reported issues were corrected and new features were planned for subsequent versions. A smartphone application has the potential to be a novel intervention for engaging adolescents and their parents in positive communication to support type 1 diabetes management.

[1]  D. Veríssimo,et al.  IDF21-0463 Type 1 Diabetes with insulin resistance following SARS-CoV-2 infection , 2022, Diabetes Research and Clinical Practice.

[2]  K. Aroian,et al.  Health Care Transition for Young Adults With Type 1 Diabetes: Stakeholder Engagement for Defining Optimal Outcomes , 2017, Journal of pediatric psychology.

[3]  Amanda J. Holmstrom,et al.  Developing a Patient-Centered mHealth App: A Tool for Adolescents With Type 1 Diabetes and Their Parents , 2017, JMIR mHealth and uHealth.

[4]  Anne L. Ersig,et al.  Stressors in Teens with Type 1 Diabetes and Their Parents: Immediate and Long-Term Implications for Transition to Self-Management. , 2016, Journal of pediatric nursing.

[5]  11. Children and Adolescents , 2015, Diabetes Care.

[6]  Emily Gerth-Guyette,et al.  Impact of mHealth Chronic Disease Management on Treatment Adherence and Patient Outcomes: A Systematic Review , 2015, Journal of medical Internet research.

[7]  L. K. Bartholomew,et al.  Preparing Adolescents With Chronic Disease for Transition to Adult Care: A Technology Program , 2014, Pediatrics.

[8]  M. Weaver,et al.  Emerging Adults With Type 1 Diabetes During the First Year Post-High School , 2014, Emerging adulthood.

[9]  J. Fortenberry,et al.  Impulse control, diabetes-specific self-efficacy, and diabetes management among emerging adults with type 1 diabetes. , 2013, Journal of pediatric psychology.

[10]  J. Walsh,et al.  Adolescent and parent diabetes distress in type 1 diabetes: the role of self-efficacy, perceived consequences, family responsibility and adolescent-parent discrepancies. , 2013, Journal of psychosomatic research.

[11]  Lucy Yardley,et al.  Opportunities and Challenges for Smartphone Applications in Supporting Health Behavior Change: Qualitative Study , 2013, Journal of medical Internet research.

[12]  R. Plotnikoff,et al.  Preventing Obesity Among Adolescent Girls: One-Year Outcomes of the Nutrition and Enjoyable Activity for Teen Girls (NEAT Girls) Cluster Randomized Controlled Trial. , 2012, Archives of pediatrics & adolescent medicine.

[13]  J. Cafazzo,et al.  Design of an mHealth App for the Self-management of Adolescent Type 1 Diabetes: A Pilot Study , 2012, Journal of medical Internet research.

[14]  B. Holtz,et al.  Diabetes management via mobile phones: a systematic review. , 2012, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[15]  Kimberlydawn Wisdom,et al.  Using Social Cognitive Theory to Predict Physical Activity and Fitness in Underserved Middle School Children , 2011, Research quarterly for exercise and sport.

[16]  Shakir Hussain,et al.  Comparison of the role of self-efficacy and illness representations in relation to dietary self-care and diabetes distress in adolescents with type 1 diabetes , 2009, Psychology & health.

[17]  J. Ioannidis Why Most Discovered True Associations Are Inflated , 2008, Epidemiology.

[18]  R. Iannotti,et al.  Self-Efficacy, Outcome Expectations, and Diabetes Self-Management in Adolescents with Type 1 Diabetes , 2006, Journal of developmental and behavioral pediatrics : JDBP.

[19]  G. Ingersoll,et al.  Online Forum Messages Posted by Adolescents With Type 1 Diabetes , 2004, The Diabetes educator.

[20]  D. Christie,et al.  Motivational/solution‐focused intervention improves HbA1c in adolescents with Type 1 diabetes: a pilot study , 2003, Diabetic medicine : a journal of the British Diabetic Association.

[21]  B. Anderson,et al.  Impact of ambulatory, family-focused teamwork intervention on glycemic control in youth with type 1 diabetes. , 2003, The Journal of pediatrics.

[22]  Diana Guthrie,et al.  Adolescents' Behavioral Autonomy Related to Diabetes Management and Adolescent Activities/Rules , 2003, The Diabetes educator.

[23]  A. Connell,et al.  Family conflict, adherence, and glycaemic control in youth with short duration Type 1 diabetes , 2002, Diabetic medicine : a journal of the British Diabetic Association.

[24]  Jennifer Shroff Pendley,et al.  Peer and family support in children and adolescents with type 1 diabetes. , 2002, Journal of pediatric psychology.

[25]  P Greco,et al.  A peer group intervention for adolescents with type 1 diabetes and their best friends. , 2001, Journal of pediatric psychology.

[26]  T. Skinner,et al.  Social support and personal models of diabetes as predictors of self-care and well-being: a longitudinal study of adolescents with diabetes. , 2000, Journal of pediatric psychology.

[27]  B. Anderson,et al.  An office-based intervention to maintain parent-adolescent teamwork in diabetes management. Impact on parent involvement, family conflict, and subsequent glycemic control. , 1999, Diabetes care.

[28]  T. Skinner,et al.  Social support and personal models of diabetes in relation to self-care and well-being in adolescents with type I diabetes mellitus ☆ , 1998 .

[29]  E B Fisher,et al.  I get by with a little help from my family and friends: adolescents' support for diabetes care. , 1995, Journal of pediatric psychology.

[30]  James R. Lewis,et al.  IBM computer usability satisfaction questionnaires: Psychometric evaluation and instructions for use , 1995, Int. J. Hum. Comput. Interact..

[31]  M. Fitzpatrick,et al.  Communication Schemata Within the Family , 1994 .

[32]  Jakob Nielsen,et al.  A mathematical model of the finding of usability problems , 1993, INTERCHI.

[33]  E. Deci,et al.  The general causality orientations scale: Self-determination in personality , 1985 .

[34]  Michael E. Fagan Design and Code Inspections to Reduce Errors in Program Development , 1976, IBM Syst. J..

[35]  Monica Anderson,et al.  Parents, Teens and Digital Monitoring , 2016 .

[36]  A. Lenhart Teens, Social Media & Technology Overview 2015 , 2015 .

[37]  B. Anderson,et al.  Updated and Revised Diabetes Family Conflict Scale RUNNING TITLE: Revised Diabetes Family Conflict Scale Received for publication 17 November 2006 and accepted in revised form 14 March 2007. , 2007 .

[38]  Daniel J. Canary,et al.  Communication, conflict, and the quality of family relationships. , 2004 .

[39]  B. Anderson Family Conflict and Diabetes Management in Youth: Clinical Lessons From Child Development and Diabetes Research , 2004 .

[40]  V. Braun,et al.  Please Scroll down for Article Qualitative Research in Psychology Using Thematic Analysis in Psychology , 2022 .

[41]  Cde,et al.  The Diabetes Empowerment Scale A measure of psychosocial self-efficacy , 2022 .