Abstract:
Background: Adolescents living with type 1 diabetes (T1D) or type 2 diabetes (T2D) have an increased risk of psychological disorders due to the demands of managing a chronic illness and dealing with the challenges of adolescence. Psychological disorders during adolescence increase the risk of suboptimal glycaemic control, potentially leading to serious diabetes-related complications. Digital health interventions may be a way to improve access to psychological support, and research shows these interventions show efficacy for improving physical and mental health outcomes in patients. However, there are currently no apps for adolescents with diabetes that have a focus on improving psychological well-being.
Aim: This study aimed to explore the acceptability and usability of a recently developed well-being app for youth called ‘Whitu: 7 Ways in 7 Days’. We interviewed adolescents with T1D and T2D, parents, and healthcare professionals. This study also explored the cultural acceptability of the app for Māori and Pacific adolescents.
Method: Thirty-four participants, including 13 adolescents (11 with T1D and 2 with T2D), 10 parents, and 11 healthcare professionals were recruited from Starship Diabetes Outpatients Clinics or Facebook diabetes groups. Each participant attended one 1-hour focus group on zoom, in person, or via phone sessions and were recorded with permission. Researchers asked for feedback on what makes an effective and engaging app for adolescents with diabetes and specific feedback about Whitu. Audiotaped recordings were transcribed, and content analysis was used to analyse the qualitative data.
Results: Overall, adolescents, parents, and healthcare professionals found Whitu acceptable and usable however, healthcare professionals were more critical. Three main themes were identified from adolescents and healthcare professionals and four from parents. Adolescents and parents wanted to include more diabetes-related content and healthcare professionals and parents expressed a desire for more external support in the app. Parents and adolescents were open to using mHealth apps however, clinicians expressed less awareness about mHealth apps.
Conclusions: This study found that adolescents with diabetes, parents, and healthcare professionals found Whitu to be acceptable and usable, however there was a preference for more diabetes-specific content. The qualitative research from this study will guide future development of Whitu for adolescents with diabetes to improve psychological well-being.