Adapting an evidence-based e-learning CBT program into a mobile app for people experiencing gambling-related problems: A Formative Study (Preprint)

2021 ◽  
Author(s):  
Gayl Humphrey ◽  
Joanna Chu ◽  
Rebecca Ruwhui-Collins ◽  
Stephanie Erick ◽  
Nicki Dowling ◽  
...  
Keyword(s):  
Young Adults ◽  
Focus Group ◽  
Focus Groups ◽  
End Users ◽  
Mobile App ◽  
End User ◽  
Web Based ◽  
Diverse Range ◽  
Mhealth Intervention ◽  
Gambling Harms

BACKGROUND Many people experiencing harms and problems from gambling do not seek treatment from gambling treatment services due to numerous personal and resource barriers. Mobile health (mHealth) interventions are widely used across a diverse range of health care areas and by various population groups, but there are few in the gambling harm field, despite their potential as an additional modality for the delivery of treatment. OBJECTIVE This study aims to understand the needs, preferences and priorities of people experiencing gambling harms or problems who are potential end-users of a cognitive behavioural therapy (CBT) mHealth intervention (based on the GAMBLINGLESS web-based intervention) to inform design features and functions. METHODS Drawing on a mixed-methods approach, we used the creators and domain experts to review the GAMBLINGLESS web-based online program and convert it into a prototype for a mobile phone-based intervention. Each module was reviewed against the original evidence-base to ensure that the changes maintained the fidelity and conceptual integrity intended and to ensure that there were no gaps. Early wireframes, design ideas (look, feel and function) and content examples were to be developed using multi-modalities, to help initiate discussions and ideas with end-users. Using an iterative co-creation process with a Young Adult, a Māori and a Pasifika Peoples group, all with experiences of problem or harmful gambling, we undertook six focus groups; two cycles per group. During each focus group, participants identified preferences, features, and functions for inclusion in a final design of the mHealth intervention and its content. RESULTS Over three months, the GAMBLINGLESS web-based intervention was reviewed and remapped from four modules to six. This revised program is based on the principles underpinning the Transtheoretical Model, in which it is recognised that some end-users will be more ready to change than others, change is a process than unfolds over time, a non-linear progression is common, and that different intervention options may be required by end-users across the stages of change. Two cycles of focus groups were then conducted, with a total of 30 unique participants (13 Māori, 9 Pasifika and 8 Young Adults) at the first sessions and 18 participants (7 Māori, 6 Pasifika and 5 Young Adults) at the second sessions. Using prototype examples that demonstrably reflected the focus group discussions and ideas, the features, functions and designs for the Manaaki app were finalised. Aspects such as personalisation, cultural relevance, and being positively framed were key attributes identified. Congruence of the final app attributes with the conceptual frameworks of the original program was also confirmed. CONCLUSIONS Those who experience gambling harms may not seek help from current treatment providers and as such, finding new modalities to provided treatment and support are needed. mHealth has the potential to deliver interventions direct to the end-user. Weaving underpinning theory and existing evidence of effective treatment with end-user input into the design and development of the mHealth intervention does not guarantee success. However, it does provide a foundation for framing the mechanism, context and content of the intervention and arguably provides a greater chance of demonstrating effectiveness.

scholarly journals Conducting Web-Based Focus Groups With Adolescents and Young Adults

2021 ◽  
Vol 20 ◽  
pp. 160940692199687
Author(s):  
Courtney A. Brown ◽  
Anna C. Revette ◽  
Sarah D. de Ferranti ◽  
Holly B. Fontenot ◽  
Holly C. Gooding
Keyword(s):  
Qualitative Research ◽  
Young Adults ◽  
Focus Groups ◽  
Clinical Sample ◽  
Adolescents And Young Adults ◽  
Web Based ◽  
Disease Awareness ◽  
Sex With Men ◽  
Technical Platform

This methodologic paper aims to update researchers working with adolescents and young adults on the potentials and pitfalls associated with web-based qualitative research. We present a case study of synchronous web-based focus groups with 35 adolescents and young women ages 15–24 years old recruited from a clinical sample for a mixed methods study of heart disease awareness. We contrast this with two other studies, one using asynchronous web-based focus groups with 30 transgender youth ages 13 to 24 years old and another using synchronous web-based focus groups with 48 young men who have sex with men ages 18 to 26 years old, both recruited via social media. We describe general and logistical considerations, technical platform considerations, and ethical, regulatory, and research considerations associated with web-based qualitative research. In an era of technology ubiquity and dependence, researchers should consider web-based focus groups a potential qualitative research tool, especially when working with youth.

scholarly journals Using a Web-Based App to Deliver Rehabilitation Strategies to Persons With Chronic Conditions: Development and Usability Study

10.2196/19519 ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e19519
Author(s):  
Julie Richardson ◽  
Lori Letts ◽  
Susanne Sinclair ◽  
David Chan ◽  
Jordan Miller ◽  
...  
Keyword(s):  
Focus Group ◽  
Chronic Conditions ◽  
Management Strategies ◽  
Group Analysis ◽  
End Users ◽  
Self Management ◽  
Management Support ◽  
Web Based ◽  
Usability Tests ◽  
Rehabilitation Strategies

Background The global rise in the incidence of chronic conditions and aging is associated with increased disability. Physiotherapists and occupational therapists can mitigate the resulting burden on the health care system with their expertise in optimizing function. Rehabilitation self-management strategies can assist people with chronic conditions to accept, adjust, and manage different aspects of their daily functioning. Interventions delivered using technology have the potential to increase the accessibility, availability, and affordability of rehabilitation self-management support and services. Objective This study aims to describe the development and usability evaluation of iamable, a web-based app created to provide rehabilitation self-management support for people with chronic conditions. Methods The development and evaluation of iamable were undertaken in several phases. We used user-centered design principles and an iterative process that included consultations with rehabilitation experts; developed a prototype; and conducted usability tests, heuristic evaluations, and a focus group analysis. Results The iamable app was developed to provide rehabilitation self-management strategies in the areas of exercise, fall prevention, fatigue management, pain management, physical activity, and stress management. We engaged adults aged ≥45 years with at least one chronic condition (N=11) in usability testing. They identified navigation and the understanding of instructions as the primary issues for end users. During the heuristic evaluation, clinicians (N=6) recommended that some areas of app content should be more succinct and that help should be more readily available. The focus group provided input to help guide clinical simulation testing, including strategies for selecting patients and overcoming barriers to implementation. Conclusions We engaged end users and clinicians in the development and evaluation of the iamable app in an effort to create a web-based tool that was useful to therapists and their patients. By addressing usability issues, we were able to ensure that patients had access to rehabilitation strategies that could be used to help them better manage their health. Our app also provides therapists with a platform that they can trust to empower their patients to be more active in the management of chronic conditions. This paper provides a resource that can be used by others to develop and evaluate web-based health apps.

scholarly journals Exploring patient satisfaction after operative and nonoperative treatment for midshaft clavicle fractures: a focus group analysis

2020 ◽  
Author(s):  
Eric Danjel Tutuhatunewa ◽  
Martin Stevens ◽  
Olivier C. Dams ◽  
Jeffrey van Son ◽  
Rebecca D. Louhanepessy ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Focus Group ◽  
Focus Groups ◽  
Treatment Options ◽  
Clavicle Fracture ◽  
Group Analysis ◽  
Nonoperative Treatment ◽  
Web Based ◽  
Face To Face ◽  
Clavicle Fractures

Abstract BackgroundThere is no consensus on the optimal treatment for displaced midshaft clavicle fractures. Several studies indicate superior patient satisfaction in favour of operative reconstruction. It is unknown what drives superior satisfaction in this treatment group. The aim of this study was to explore patient satisfaction and identify contributors to patient satisfaction after operative and nonoperative treatment for displaced midshaft clavicle fractures in adults using a focus group approach.MethodsFour face-to-face and two web-based focus groups were hosted. A total of 24 participants who were treated nonoperatively (n = 14) or operatively (n = 10) agreed to participate. Participants were selected using purposive sampling, ensuring variation in gender, age, treatment complications and outcomes. A question script was developed to systematically explore patient expectations, attitudes and satisfaction with different dimensions of care. All focus groups were voice-recorded and transcribed at verbatim. Thematic analysis was conducted on all face-to-face and web-based transcripts. ResultsThe main emerging themes across treatment groups were; need for more information, functional recovery, speed of recovery and patient-doctor interaction. There was no difference in themes observed between operative and nonoperative focus groups. The lack of information was the most important complaint in dissatisfied patients. Conclusion Our study shows that informing patients about their injury, treatment options and expectations for recovery is paramount for overall patient satisfaction after treatment for a displaced midshaft clavicle fracture.

scholarly journals A Mobile App–Based Intervention for Depression: End-User and Expert Usability Testing Study

2018 ◽  
Vol 5 (3) ◽  
pp. e54 ◽  
Author(s):  
Matthew Fuller-Tyszkiewicz ◽  
Ben Richardson ◽  
Britt Klein ◽  
Helen Skouteris ◽  
Helen Christensen ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Psychological Treatment ◽  
Treatment Compliance ◽  
End Users ◽  
Mobile App ◽  
End User ◽  
Self Monitoring ◽  
Participant Engagement ◽  
System Usability Scale

Background Despite the growing number of mental health apps available for smartphones, the perceived usability of these apps from the perspectives of end users or health care experts has rarely been reported. This information is vital, particularly for self-guided mHealth interventions, as perceptions of navigability and quality of content are likely to impact participant engagement and treatment compliance. Objective The aim of this study was to conduct a usability evaluation of a personalized, self-guided, app-based intervention for depression. Methods Participants were administered the System Usability Scale and open-ended questions as part of a semistructured interview. There were 15 participants equally divided into 3 groups: (1) individuals with clinical depression who were the target audience for the app, (2) mental health professionals, and (3) researchers who specialize in the area of eHealth interventions and/or depression research. Results The end-user group rated the app highly, both in quantitative and qualitative assessments. The 2 expert groups highlighted the self-monitoring features and range of established psychological treatment options (such as behavioral activation and cognitive restructuring) but had concerns that the amount and layout of content may be difficult for end users to navigate in a self-directed fashion. The end-user data did not confirm these concerns. Conclusions Encouraging participant engagement via self-monitoring and feedback, as well as personalized messaging, may be a viable way to maintain participation in self-guided interventions. Further evaluation is necessary to determine whether levels of engagement with these features enhance treatment effects.

Smoking Attitudes and Practices among Low-Income African-Americans: Qualitative Assessment of Contributing Factors

2003 ◽  
Vol 17 (4) ◽  
pp. 240-248 ◽  
Author(s):  
Bettina M. Beech ◽  
Isabel C. Scarinci
Keyword(s):  
Young Adults ◽  
African American ◽  
African Americans ◽  
Focus Group ◽  
Focus Groups ◽  
Low Income ◽  
Small Sample ◽  
Attitudes And Practices ◽  
Smoking Attitudes ◽  
American Young Adults

Purpose. Studies have shown that African-American adolescents are less likely to smoke cigarettes than white youth. National data suggest that this pattern changes in late adolescence and early adulthood. Specifically, African-American adults have a relatively high smoking prevalence rate when compared with other racial/ethnic groups. The purpose of this study was to qualitatively examine the sociocultural factors associated with smoking attitudes and practices among low-income African-American young adults. Design. Cross-sectional qualitative study. Settings. High schools, 2-year colleges, housing developments, and trade schools in New Orleans, Louisiana, and Memphis, Tennessee. Subjects. One hundred eighteen low-income African Americans between 18 and 35 years of age (65 men and 53 women). Measure/Procedure. Fourteen focus groups were conducted with the target population. Nonmonetary incentives were provided for each participant in the 1-hour sessions. The majority of focus group moderators were African-American females trained in focus group moderation. Participants were recruited through flyers and project liaisons at each field location. Results. Themes elicited from the focus groups were classified according to the PEN-3 model, and they included: lighting cigarettes for parents as a first experience with cigarettes, perceived stress relief benefits of smoking, use of cigarettes to extend the sensation of marijuana, and protective factors against smoking such as respect for parental rules. Conclusion. The results indicate that there are specific contextual and familial factors that can contribute to smoking initiation, maintenance, and cessation among low-income African-American young adults. Limitations of this study include the exploratory nature of focus groups and the relatively small sample size. Further studies are necessary to quantitatively examine the role of these factors on smoking patterns in this population.

scholarly journals Web-Based Patient Self-Reported Outcome After Radiotherapy in Adolescents and Young Adults With Cancer: Survey on Acceptance of Digital Tools (Preprint)

2020 ◽  
Author(s):  
Marco M E Vogel ◽  
Kerstin A Eitz ◽  
Stephanie E Combs
Keyword(s):  
Young Adults ◽  
Cancer Care ◽  
New Technologies ◽  
Radiation Treatment ◽  
Young Patients ◽  
Mobile App ◽  
Digital Tools ◽  
European Organization ◽  
Web Based ◽  
Willingness To Use

BACKGROUND eHealth and mobile health (mHealth) are an evolving trend in the medical field. The acceptance of digital tools is high, and the need is growing. OBJECTIVE Young adults (18-40 years) confronted with a cancer diagnosis present unique needs and require special care. They often have a strong affinity and are familiar with modern technology. On that account, we implemented a web-based symptom and quality of life (QoL) assessment to address patients’ attitudes and willingness to use mHealth tools. The study also aims to evaluate sociodemographic parameters that could influence patients’ opinions. METHODS A total of 380 young patients aged 18-40 treated with radiotherapy between 2002 and 2017 were included in the trial. We assessed QoL via the European Organization for Research and Treatment of Cancer-Core 30 (EORTC C30) questionnaire and added general questions about mHealth technology. The added questions inquired patients’ opinions regarding general aspects, including technical advances in medicine, mobile and app assistance during cancer treatment, data transfer, and app-specific features. The survey was conducted for 12 months. Participation was voluntary and pseudonymized; prior written consent was obtained. RESULTS We achieved a participation rate of 57.6% (219/380) and a completion rate of 50.2% (110/219). The median age was 33 years (range 18-40). Of all participants, 89.1% (98/110) considered new technologies in medicine as positive; 10.9% (12/110) answered with neutral. Nearly all patients (96.4%, 106/110) stated that they would send further data via a web-based platform. Of all, 96.4% (106/110) considered the provided pseudonymization of their data as safe. We further asked the patients if they would use a mobile app for symptom and QoL assessment similar to the present web-based system: 74.5% (82/110) answered with yes and 25.5% (28/110) said they would not use a mobile app in the future. We tested the willingness to use an app on several sociodemographic parameters, such as age, gender, education, health insurance status, and cancer-related parameters: tumor stage, time since radiation treatment, and treatment intention. None of these parameters correlated with app use in this group of young adults. Patients who were generally positive regarding using an app rated several possible functions of a future app. The 3 most requested features were appointment reminders (89.0%, 73/82), contact overview of all involved clinics and physicians (87%, 71/82), and making an appointment via app (78%, 64/82). CONCLUSIONS eHealth and mHealth tools should be available as an integrated part of a comprehensive cancer care approach. It provides automated, thorough documentation of health parameters during therapy and follow-up for doctors, medical staff, and tumor patients to optimize treatment. With this study, we could show that young adults are the ideal patient population to use eHealth/mHealth tools. Such tools offer further digital support and improve the patients’ need for constant QoL during cancer care.

scholarly journals Using a Web-Based App to Deliver Rehabilitation Strategies to Persons With Chronic Conditions: Development and Usability Study (Preprint)

2020 ◽  
Author(s):  
Julie Richardson ◽  
Lori Letts ◽  
Susanne Sinclair ◽  
David Chan ◽  
Jordan Miller ◽  
...  
Keyword(s):  
Focus Group ◽  
Chronic Conditions ◽  
Management Strategies ◽  
Group Analysis ◽  
End Users ◽  
Self Management ◽  
Management Support ◽  
Web Based ◽  
Usability Tests ◽  
Rehabilitation Strategies

BACKGROUND The global rise in the incidence of chronic conditions and aging is associated with increased disability. Physiotherapists and occupational therapists can mitigate the resulting burden on the health care system with their expertise in optimizing function. Rehabilitation self-management strategies can assist people with chronic conditions to accept, adjust, and manage different aspects of their daily functioning. Interventions delivered using technology have the potential to increase the accessibility, availability, and affordability of rehabilitation self-management support and services. OBJECTIVE This study aims to describe the development and usability evaluation of iamable, a web-based app created to provide rehabilitation self-management support for people with chronic conditions. METHODS The development and evaluation of iamable were undertaken in several phases. We used user-centered design principles and an iterative process that included consultations with rehabilitation experts; developed a prototype; and conducted usability tests, heuristic evaluations, and a focus group analysis. RESULTS The iamable app was developed to provide rehabilitation self-management strategies in the areas of exercise, fall prevention, fatigue management, pain management, physical activity, and stress management. We engaged adults aged ≥45 years with at least one chronic condition (N=11) in usability testing. They identified navigation and the understanding of instructions as the primary issues for end users. During the heuristic evaluation, clinicians (N=6) recommended that some areas of app content should be more succinct and that help should be more readily available. The focus group provided input to help guide clinical simulation testing, including strategies for selecting patients and overcoming barriers to implementation. CONCLUSIONS We engaged end users and clinicians in the development and evaluation of the iamable app in an effort to create a web-based tool that was useful to therapists and their patients. By addressing usability issues, we were able to ensure that patients had access to rehabilitation strategies that could be used to help them better manage their health. Our app also provides therapists with a platform that they can trust to empower their patients to be more active in the management of chronic conditions. This paper provides a resource that can be used by others to develop and evaluate web-based health apps.

scholarly journals A Community-Engaged Approach to Creating a Mobile HIV Prevention App for Black Women: Focus Group Study to Determine Preferences via Prototype Demos (Preprint)

2020 ◽  
Author(s):  
Rasheeta Chandler ◽  
Natalie Hernandez ◽  
Dominique Guillaume ◽  
Shanaika Grandoit ◽  
Desiré Branch-Ellis ◽  
...  
Keyword(s):  
Black Women ◽  
Hiv Prevention ◽  
Focus Group ◽  
Focus Groups ◽  
The United States ◽  
Mobile App ◽  
Message Delivery ◽  
Focus Group Study ◽  
Hiv Prevention Intervention ◽  
Hiv Epidemic

BACKGROUND Black women are an important but relatively overlooked at-risk group in HIV prevention efforts. Although there is an aggregate decline of HIV diagnoses among women in the United States, there are persistent disparate rates of new HIV infections among Black women compared to any other cisgender female subgroup. Strategies to end the HIV epidemic—as outlined in the Ending the HIV Epidemic initiative—for all communities must consider HIV prevention messaging and message delivery mediums that are created with community input. Although mobile health (mHealth) is a popular platform for delivering HIV interventions, there are currently no mobile apps that consider cisgender Black women with the goal of promoting a comprehensive women’s reproductive health and HIV prevention lifestyle. Previous research recommends inclusion of the target population from project inception and iteratively throughout development, to promote use of the intervention. OBJECTIVE The purpose of this study is to understand cisgender Black women’s preferences for functionality, format, and design of a mobile HIV prevention app and to examine their willingness to use an app for HIV prevention. METHODS We conducted a series of four focus groups with 23 Black cisgender women. Focus groups included discussion and demonstration elements to address cisgender women’s general preference for apps, HIV prevention content that would be useful in an app, and preferred app features that would promote use of an HIV-centric app. During focus group discussions, participants were shown narrated, custom wireframes of HIV prevention app prototypes to demonstrate potential app function. RESULTS Findings indicated the presence of eight subthemes within the coding structure of three overall themes: (1) health content within the mobile app, (2) mobile app functionality, format, and design, and (3) other suggested features. Specifically, participants detailed preferred educational content, content distribution, app aesthetics, privacy considerations, and marketing of the app. CONCLUSIONS Findings suggest that Black cisgender women preferred an app that integrated HIV prevention and optimal sexual health promotion. Participants provided a range of preferences for content integration and facilitators of app engagement with an HIV prevention app. Preferences centered on gender and cultural congruency of information and content, evidenced by visuals, language, and resources. Black cisgender women are viable consumers for a mobile app–based HIV prevention intervention.

scholarly journals Co-Designing a Mobile Application to Improve Mental Health and Well-being: Focus Group Study (Preprint)

2020 ◽  
Author(s):  
Felwah Alqahtani ◽  
Andrea Winn ◽  
Rita Orji
Keyword(s):  
Mental Health ◽  
Focus Group ◽  
Well Being ◽  
End Users ◽  
Mobile App ◽  
Health Issues ◽  
Health Apps ◽  
Mental Health Issues ◽  
Relaxation Exercises ◽  
Health And Well Being

BACKGROUND Recent advances in mobile technology have created opportunities to develop mobile applications (apps) to aid and assist people in achieving various health and wellness goals. Mental health apps hold significant potential to assist people suffering from various mental health issues at any time they may need it, considering the ubiquitous nature of mobile phones. However, there is a need for research exploring and understanding end-users’ perceptions, needs, and concerns with respect to such technologies. OBJECTIVE The goal of this paper is to explore the opinions, perceptions, preferences, and experiences of people who have experienced some forms of mental health issues based on self-diagnosis to inform the design of a next-generation mental health app that would be significantly more engaging and effective than currently available apps at improving mental health and well-being. METHODS We conducted six focus-group sessions with people who have experienced mental health issues based on self-diagnosis (Average age= 26.7, N = 32, 50% male, 50% female). We asked participants about their experiences with mental health issues and their viewpoints regarding two existing mental health apps (Happify app and the Self-Help Anxiety Management app). Finally, participants engaged in a design session where they each sketched a design for their ideal mental health and well-being mobile app. RESULTS Our findings revealed that participants used some strategies to deal with their mental health issues: 1) doing something to distract themselves from their current negative mood, 2) using relaxation exercises and methods to relieve symptoms, 3) interacting with others to share their issues, 4) looking for an external source to solve their problem, and 5) motivating themselves by repeating motivational sentences to support themselves or by following inspirational people. Moreover, regarding the design of mental health apps, participants identified that 1) general design characteristics, 2) personalization of the app, including 3) tracking and feedback, 4) live support, and 5) social community, and providing 6) motivational content and 7) relaxation exercises are the most important features users want in a mental health app. In contrast, including 8) games, 9) relaxation audio, 10) the Google map function, 11) personal assistance to provide suggestions, 12) goal setting, and 13) privacy preserving were surprisingly the least requested features. CONCLUSIONS Understanding end-users’ needs and concerns about mental health apps will inform the future design of mental health apps that are useful and used by many people. CLINICALTRIAL

User-centred design of a novel risk prediction behaviour change tool augmented with an Artificial Intelligence engine (MyDiabetesIQ): A sociotechnical systems approach (Preprint)

2021 ◽  
Author(s):  
Cathy Shields ◽  
Scott G Cunningham ◽  
Deborah J Wake ◽  
Evridiki Fioratou ◽  
Doogie Brodie ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
User Interface ◽  
Focus Group ◽  
Focus Groups ◽  
End Users ◽  
Unintended Consequences ◽  
Self Management ◽  
Think Aloud ◽  
User Centred Design ◽  
Digital Skills

BACKGROUND Diabetes and its complications account for 10% of annual UK healthcare spending. Digital healthcare interventions (DHIs) can provide scalable care, fostering diabetes self-management and reducing the risk of complications. Tailorability and usability are key to DHI engagement/effectiveness. User-centred design of DHIs, aligning features to end users’ needs, can generate more usable interventions, avoiding unintended consequences and improving user engagement. OBJECTIVE MyDiabetesIQ is an Artificial Intelligence engine, intended to provide users with tailored forecasts of their diabetes complications risk. It will underpin a user interface in which users will alter lifestyle parameters to see the impact this has on future risks,. MyDiabetesIQ will link to an existing DHI, My Diabetes My Way (MDMW). We describe user-centred design, informed by human factors engineering, of the user interface of MyDiabetesIQ. METHODS Current users of MDMW were invited to take part in focus groups to gather their insights about users being shown their complications risks, and any risks they perceived from using MyDiabetesIQ. Findings from focus groups informed the development of a prototype MyDiabetesIQ interface. The prototype was user tested through the ‘think aloud’ method, in which users speak aloud about their thoughts/impressions while performing prescribed tasks. Focus group and think aloud transcripts were analysed thematically (a combination of inductive and deductive analysis). For think aloud data, a sociotechnical model was used as a framework for thematic analysis. RESULTS Focus group participants (n=8) felt that some users could become anxious when shown their future complications risks. They highlighted the importance of easy navigation, avoidance of jargon, and use of positive/encouraging language. User testing of the prototype site through think aloud sessions (n=7) highlighted several usability issues. Issues included confusing visual cues and confusion over whether user-updated information fed back to healthcare teams. Some issues could be compounded for users with limited digital skills. Results of focus groups and think aloud workshops are being used in the development of a live MyDiabetesIQ platform. CONCLUSIONS Acting on the input of end users at each iterative stage of development can help to prioritise users throughout the design process, ensuring alignment of DHI features with their needs. Use of the sociotechnical framework encouraged consideration of interactions between different sociotechnical dimensions in finding solutions to issues, for example avoiding the exclusion of users with limited digital skills. Based on user feedback, the tool could scaffold good goal setting, allowing users to balance their palatable future complications risk against acceptable lifestyle changes. Good control of diabetes relies heavily on self-management. Tools such as MDMW/MyDiabetesIQ can offer personalised support for self-management alongside access to users’ electronic health records, potentially helping to delay or reduce long-term complications, thereby providing significant reductions in healthcare costs.

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