TY  - JOUR
AU  - Garner, Katie
AU  - Thabrew, Hiran
AU  - Lim, David
AU  - Hofman, Paul
AU  - Jefferies, Craig
AU  - Serlachius, Anna
PY  - 2023
DA  - 2023/12/22
TI  - Exploring the Usability and Acceptability of a Well-Being App for Adolescents Living With Type 1 Diabetes: Qualitative Study
JO  - JMIR Pediatr Parent
SP  - e52364
VL  - 6
KW  - well-being
KW  - digital health interventions
KW  - type 1 diabetes
KW  - diabetes
KW  - diabetic
KW  - adolescent
KW  - youth
KW  - adolescents
KW  - young people
KW  - parents
KW  - parent
KW  - mHealth
KW  - mobile health
KW  - app
KW  - apps
KW  - application
KW  - applications
KW  - acceptability
KW  - usability
KW  - interview
KW  - interviews
KW  - opinion
KW  - opinions
KW  - perception
KW  - perceptions
KW  - perspective
KW  - perspectives
KW  - acceptance
AB  - Background: Adolescents living with either 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 the challenges of adolescence. Psychological disorders during adolescence increase the risk of suboptimal glycemic outcomes and may lead to serious diabetes-related complications. Research shows that digital health interventions may increase access to psychological support for adolescents and improve physical and mental health outcomes for youth with diabetes. To our knowledge, there are no evidence-based, publicly available mental health apps with a focus on improving the psychological well-being of adolescents with diabetes. Objective: This study aimed to explore the acceptability and usability of our evidence-based well-being app for New Zealand adolescents, Whitu: 7 Ways in 7 Days (Whitu), to allow us to further tailor it for youth with diabetes. We interviewed adolescents with T1D and T2D, their parents, and health care professionals to explore their views on the Whitu app and suggestions for tailoring the app for adolescent with diabetes. We also explored the cultural acceptability of the Whitu app for Māori and Pacific adolescents. Methods: A total of 34 participants, comprising 13 adolescents aged 12-16 years (11 with T1D and 2 with T2D), 10 parents, and 11 health care professionals, were recruited from a specialist diabetes outpatient clinic and Facebook diabetes groups. Each participant attended one 1-hour focus group on Zoom, in person, or via phone. Researchers gathered general feedback on what makes an effective and engaging app for adolescents with diabetes, as well as specific feedback about Whitu. Transcribed audio recordings of the focus groups were analyzed using directed content analysis. Results: Adolescents with T1D, their parents, and health care professionals found Whitu to be acceptable and usable. Adolescents with T1D and their parents signaled a preference for more diabetes-specific content. Health care professionals expressed less awareness and trust of digital health interventions and, as such, recommended that they be used with external support. Due to challenges in recruitment and retention, we were unable to include the views of adolescents with T2D in this qualitative study. Conclusions: There appears to be sufficient openness to the use of an app such as Whitu for supporting the well-being of adolescents with T1D, albeit with modifications to make its content more diabetes specific. Based on this qualitative study, we have recently developed a diabetes-specific version of Whitu (called LIFT: Thriving with Diabetes). We are also planning a qualitative study to explore the views of youth with T2D and their perspectives on the new LIFT app, where we are using alternative research approaches to recruit and engage adolescents with T2D and their families. 
SN  - 2561-6722
UR  - https://pediatrics.jmir.org/2023/1/e52364
UR  - https://doi.org/10.2196/52364
UR  - http://www.ncbi.nlm.nih.gov/pubmed/38153804
DO  - 10.2196/52364
ID  - info:doi/10.2196/52364
ER  -