Analysis of Healthy Coping Feedback Messages from Diabetes Mobile Apps

To analyze Healthy Coping-related feedback messages from diabetes mobile apps against the theoretical framework based on behavioral change theories. We searched apps using the search terms: “diabetes,” “blood sugar,” “glucose,” and “mood” from iTunes and Google Play stores. We entered a range of values on three Healthy Coping domains: 1) diabetes-related measures, 2) physical exercise/activity, and 3) mood to generate feedback messages. We developed behavioral change theory-based framework and analyzed the feedback messages against three dimensions of timing, intention, and content (feedback purpose and feedback response). The feedback purposes were categorized into seven purposes; warning, suggestion, self-monitoring, acknowledging, reinforcement, goal setting, and behavior contract. We identified 1,749 apps and eligible 156 diabetes mobile apps generated a total of 473 feedback messages. The majority of feedback messages generated were about blood sugar under the diabetes-related measures domain. Only feedback messages on blood sugar under diabetes-related measures and mood domains encompassed all seven feedback purposes under the content dimension. Many feedback messages neither supported Healthy Coping domains nor followed the behavioral theory-based framework. It is important that feedback messages be structured around the dimensions of the behavioral theory-based framework to enhance diabetes self-management education and support (DSME/S) effectiveness and promote behavior change.

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