背景:对于患有1型糖尿病(T1D)的年轻人来说,围绕运动的血糖管理具有挑战性。先前的研究表明,包括决策支持辅助手段在内的干预措施可以更好地支持年轻人有效地了解血糖结果,并在运动期间和运动后采取适当的措施来优化血糖水平。移动健康(mHealth)应用程序有助于通过T1D为青少年提供健康行为干预措施,考虑到葡萄糖监测技术的使用,胰岛素剂量,和碳水化合物计数。
目标:我们的目标是开发一个新的原型mHealth应用程序,以支持T1D青少年的运动管理,详细介绍了协同设计过程和设计思维原则的应用,以指导应用程序设计和开发,并确定T1D青少年需要满足其身体活动目标的应用程序内容和功能。
方法:在18个月的设计过程(2018年3月至2019年9月)中,使用了以用户为中心的设计思维框架的协同设计方法来开发原型mHealth应用程序“acT1ve”。为了更好地了解和应对青少年糖尿病患者在身体活动时的挑战,对13-25岁的T1D青年和T1D青年父母进行了10个焦点小组。此后,我们与年轻人一起举办了参与式设计研讨会,以确定在身体活动时支持个人需求的关键应用程序功能。这些功能被整合到线框中,参与者进行了严格的审查。在iOS和android操作系统中构建了测试版的“acT1ve”,经过最终用户的严格审查,临床医生,研究人员,运动和T1D的专家,和应用程序设计师。
结果:60名T1D青年,14父母6名研究人员,10名临床医生参与了“acT1ve”的开发。\"acT1ve包括年轻人确定的关键特征,这将在身体活动时支持他们的个人需求。它提供了关于运动过程中碳水化合物和胰岛素的建议,关于低血糖治疗的信息,运动前和运动后的建议,以及有关运动管理的教育食品指南。“acT1ve”包含一个运动顾问算法,包括由糖尿病和运动研究专家开发的240条路径。根据参与者在锻炼过程中的输入,acT1ve提供个性化的胰岛素和碳水化合物建议,持续长达60分钟的运动。它还包含其他功能,包括活动日志,它显示最终用户的活动和相关的运动建议的完整记录,这些建议由应用程序的算法提供,供以后参考,和定期提醒通知最终用户检查或监测他们的血糖水平。
结论:以用户为中心的设计思维框架的协同设计方法和实际应用已成功用于开发“acT1ve”。“设计思维过程允许使用T1D的年轻人识别应用程序功能,以支持他们进行身体活动,特别是能够提供个性化的建议。此外,已经详细描述了应用程序开发,以帮助指导其他人开始类似的项目。
背景:澳大利亚新西兰临床试验注册ACTRN12619001414101;https://tinyurl.com/mu9jvn2d。
BACKGROUND: Blood glucose management around exercise is challenging for youth with type 1 diabetes (T1D). Previous research has indicated interventions including decision-support aids to better support youth to effectively contextualize blood glucose results and take appropriate action to optimize glucose levels during and after exercise. Mobile health (mHealth) apps help deliver health behavior interventions to youth with T1D, given the use of technology for glucose monitoring, insulin dosing, and carbohydrate counting.
OBJECTIVE: We aimed to develop a novel prototype mHealth app to support exercise management among youth with T1D, detail the application of a co-design process and design thinking principles to inform app design and development, and identify app content and functionality that youth with T1D need to meet their physical activity goals.
METHODS: A co-design approach with a user-centered design thinking framework was used to develop a prototype mHealth app \"acT1ve\" during the 18-month design process (March 2018 to September 2019). To better understand and respond to the challenges among youth with diabetes when physically active, 10 focus groups were conducted with youth aged 13-25 years with T1D and parents of youth with T1D. Thereafter, we conducted participatory design workshops with youth to identify key app features that would support individual needs when physically active. These features were incorporated into a wireframe, which was critically reviewed by participants. A beta version of \"acT1ve\" was built in iOS and android operating systems, which underwent critical review by end users, clinicians, researchers, experts in exercise and T1D, and app designers.
RESULTS: Sixty youth with T1D, 14 parents, 6 researchers, and 10 clinicians were engaged in the development of \"acT1ve.\" acT1ve included key features identified by youth, which would support their individual needs when physically active. It provided advice on carbohydrates and insulin during exercise, information on hypoglycemia treatment, pre- and postexercise advice, and an educational food guide regarding exercise management. \"acT1ve\" contained an exercise advisor algorithm comprising 240 pathways developed by experts in diabetes and exercise research. Based on participant input during exercise, acT1ve provided personalized insulin and carbohydrate advice for exercise lasting up to 60 minutes. It also contains other features including an activity log, which displays a complete record of the end users\' activities and associated exercise advice provided by the app\'s algorithm for later reference, and regular reminder notifications for end users to check or monitor their glucose levels.
CONCLUSIONS: The co-design approach and the practical application of the user-centered design thinking framework were successfully applied in developing \"acT1ve.\" The design thinking processes allowed youth with T1D to identify app features that would support them to be physically active, and particularly enabled the delivery of individualized advice. Furthermore, app development has been described in detail to help guide others embarking on a similar project.
BACKGROUND: Australian New Zealand Clinical Trials Registry ACTRN12619001414101; https://tinyurl.com/mu9jvn2d.