mHealth adoption for the self-management of type 2 diabetes

Abstract

This research examines the adoption of mobile health (mHealth) to facilitate the selfmanagement of type 2 diabetes. mHealth encompasses the practice of supporting healthcare through the utilisation of mobile devices, such as smartphones and tablets. Previous research has shown that mHealth in various forms can facilitate selfmanagement behaviour and improve health outcomes for individuals diagnosed with type 2 diabetes. However, less is understood about why some people are more predisposed to utilising mHealth for self-management than others. Successful and sustained mHealth engagement can be very difficult for some individuals to achieve, even though they may be motivated to utilise the functionality of mobile devices for other activities in their everyday lives. Despite the recent and rapid evolution of mHealth, academic research into a theoretical understanding of the discipline has been limited, with most studies based on clinical trials and pilot studies of the technology itself. This study contributes to that research, by identifying factors that augment the adoption of mHealth by individuals diagnosed with type 2 diabetes. Because of the paucity of research in this specific, an inductive approach begins the investigation. This is augmented by a quantitative examination that triangulates and expands upon the qualitative findings. The mixed methodology examines whether individuals that have been diagnosed with type 2 diabetes, and who use mHealth to facilitate their self-management, share common characteristics in terms of behaviours or self-discipline that may predict engagement. Seventeen purposively sampled semistructured interviews initiated the investigation, and this inductive approach identified theories of self-efficacy and multidimensional health locus of control (MHLOC) that were important components of effective self-management and successful mHealth adoption. The quantitative phase of the mixed methods design comprised a convenience sample of 382 self-administered online surveys, which were employed to triangulate the qualitative findings and provide a deeper understanding of how individuals adjust to their health condition by utilising mHealth technology. Statistical analysis revealed a significant positive correlation between self-efficacy and mHealth adoption (p<.01), however, a relationship between MHLOC and mHealth utilisation was not supported by the quantitative results. Online health information seeking behaviour (OHISB) was widespread among the qualitative participants that adopted mHealth to facilitate their self-management. This finding was also confirmed by the quantitative analysis, which recorded significant correlations between OHISB and successful mHealth engagement (p<.01). While digital literacy and access to the internet are clearly essential elements of mHealth adoption, they did not prove sufficient in isolation to trigger engagement with mobile devices to enhance health outcomes. However, frequency of mobile device use was highly correlated to mHealth adoption (p<.01). This research project found three significant predictors of mHealth adoption for the self-management of type 2 diabetes. Individuals with good diabetes management selfefficacy, those who frequently use mobile devices in their everyday lives, and those who search the internet for information that is relevant to their own health status, are more likely to adopt mHealth technology to facilitate their diabetes self-management behaviours. Potential limitations to this research include the fact that all 17 of the qualitative participants were recruited from the same GP superclinic in Canberra. It also became clear during the research process that comorbidities were a major issue for some of the participants. As type 2 diabetes is a condition that is usually diagnosed later in life, comorbidities are a recognised complication of the condition. Because of this, and the fact that diabetes varies in severity for individuals diagnosed with the disease, each individual’s self-management priorities are varied, and people with type 2 diabetes should not be considered a homogenous group who collectively face identical challenges with the same solutions. This study is based on individuals’ own accounts of their illness, and no clinical or biometric data was used to establish outcomes of selfmanagement behaviours

Date of Award	2019
Original language	English
Supervisor	Sora PARK (Supervisor), John Campbell (Supervisor), James Mahoney (Supervisor) & Sally Burford (Supervisor)