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Despite a growing number of clinical-intervention studies of mobile applications for diabetes self-management, details of participants' engagement with the intervention tools and of usability and feasibility issues are seldom reported. The Few Touch application is a mobile-phone-based self-management system for people with Type 2 diabetes mellitus (T2DM) developed by involving patient-users in design processes from an early phase to a long-term trial. An improved version was tested in a five-month trial by 11 individuals either with T2DM or at high risk of T2DM. Results showed clearer correlations between usage and perceived usefulness among these individuals compared with those involved in the design process. However, feedback on usability issues was mostly consistent between the two trials. This study therefore confirmed: 1) the value of including patient-users not only in design-concept development but also in a long-term trial to identify as many factors critical to usability and usage as possible, and 2) the importance of reflecting their feedback in design iterations to minimize the number of critical factors.
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