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Design, development, and usability evaluation of a smartphone-based application for nutrition management in patients with type II diabetes

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Abstract

Purpose

Information technology (IT)-based interventions, especially mobile health (mHealth), possess a great potential for promoting self-management in patients with chronic diseases, including diabetes type II. The present study was aimed to design and develop a smartphone-based application (app) for nutrition management in patients with type II diabetes and evaluation of its usability.

Methods

In this study, a three-phase research approach was followed; (1) To determine the information content and functionalities of the app, a five-point Likert scale checklist including six parts was developed based on reviews of clinical practice guidelines and specialized databases. The checklist was then given to ten experts in endocrinology and metabolism, internal medicine, and nutrition, and those items with a mean score higher than 3.75 were approved. (2) In Android Studio, the app was designed and developed using Java language. (3) The Questionnaire for User Interaction Satisfaction (QUIS) was used to assess the app’s usability by 21 patients with type II diabetes, ten IT experts, and seven endocrinologists, internal medicine practitioners, and nutritionists over one month. Mean scores were divided into three levels: weak (0–3), average (3–6), and good (6–9).

Results

According to experts’ view, 17 out of 22 educational content and 17 out of 27 functionalities were approved. The app’s most important educational content was the timing of meals for insulin patients and the definition of diabetes and its complications. The designed app had the following functionalities: providing educational information, recording information, performing calculations, representing data graphically, setting reminders, and communicating with physicians. The most important features of the app were the insulin dose calculation, reminders for doctors’ appointments, setting times for tests and blood glucose measurements, and also tracking weight, blood glucose levels, and blood pressure. In terms of usability evaluation, the app was rated “good” level by diabetic patients (7.83 ± 0.74), IT experts (8.1 ± 0.66), and physicians (8.03 ± 0.95).

Conclusion

Given the desirable evaluation of the app by patients, physicians, and IT experts, it can be concluded that the developed app has the required functionalities for nutrition management of patients with type II diabetes. Smartphone-based apps appear to be able to improve self-management, the quality of care and health in patients with diabetes, and reduce many of their unnecessary visits to healthcare centers, and costs.

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Data Availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The present article is part of an MSc thesis in health information technology. The authors wish to thank the Research and Technology Deputy of Kashan University of Medical Sciences for their support.

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Authors and Affiliations

  1. Health Information Management Research Center, Department of Health Information Management and Technology, School of Allied Health Professions, Kashan University of Medical Sciences, Pezeshk Blvd, 5th of Qotbe Ravandi Blvd – Pardis Daneshgah, Kashan, IR, Iran

    Ehsan Nabovati, Fatemeh Rangraz Jeddi, Rahele Hamidi & Reihane Sharif

  2. Department of Internal Medicine, School of Medicine, Kashan University of Medical Sciences, Kashan, IR, Iran

    Seyed Mashallah Tabatabaeizadeh

Authors
  1. Ehsan Nabovati
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  2. Fatemeh Rangraz Jeddi
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  3. Seyed Mashallah Tabatabaeizadeh
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  4. Rahele Hamidi
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  5. Reihane Sharif
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Contributions

Conception and design of study (EN, FR), Development of materials (EN, RH), Data collection (ST, RH), Data analysis and interpretation (RH, RSh), Drafting the article (EN, RSh, RH), Revising article critically for important intellectual content (EN, RSh), Final approval of the version to be published (EN, FR, ST, RH, RSh).

Corresponding author

Correspondence to Rahele Hamidi.

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Funding.

This study was supported by a grant from Kashan University of Medical Sciences Research Council (Number: 96104) and did not receive any grants from non-profit organizations and funding agencies in the public and commercial sectors.

Competing interests

The authors declare that they have no competing interests.

Ethics approval and consent to participate

The present study was approved by the Ethics Committee of Kashan University of Medical Sciences (Code: IR.KAUMS.NUHEPM.REC.1396.21). The researcher obtained the necessary permission to conduct the study from the university officials. The study objectives were explained to the participants and their informed consent was obtained. The participants’ independence was maintained by assuring them about their voluntary participation, non-participation, and withdrawal. Data were confidentially kept by the researcher and were only used for the study purposes. Regarding the use of scientific references and translation, copyrights were entirely observed.

List of abbreviations

Type II diabetes mellitus (T2DM), World Health Organization (WHO), electronic Health (eHealth), mobile Health (mHealth), Applications (apps), Information Technology (IT), electronic Health (eHealth), Content Validity Index (CVI), Content Validity Ratio (CVR), Statistical Package for Social Sciences (SPSS), Graphical User Interface (GUI), Questionnaire for User Interaction Satisfaction (QUIS).

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Nabovati, E., Rangraz Jeddi, F., Tabatabaeizadeh, S.M. et al. Design, development, and usability evaluation of a smartphone-based application for nutrition management in patients with type II diabetes. J Diabetes Metab Disord 22, 315–323 (2023). https://doi.org/10.1007/s40200-022-01140-x

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