背景:移动应用程序可以通过提供患者教育来帮助管理妊娠期糖尿病(GDM),加强定期血糖监测和饮食/生活方式的改变,促进临床和社会支持。
目的:本研究旨在描述我们设计和开发文化定制应用程序的过程,Garbhakalin糖尿病athawaMadhumeha-Dhulikhel医院(GDM-DH),通过应用以用户为中心的设计方法,支持尼泊尔患者的GDM管理。
方法:多学科专家团队,以及Dhulikhel医院的医疗保健提供者和患者(Dhulikhel,尼泊尔),为GDM-DH应用程序的开发做出了贡献。完成应用程序的内容和功能后,我们创建了应用程序的线框,说明了应用程序建议的界面,导航序列,特点和功能。通过与医疗保健提供者(n=5)和焦点小组的关键线人访谈以及对GDM患者(n=12)的深入访谈,在线框上征求反馈。结合他们的投入,我们建立了一个最小可行的产品,然后对18名GDM患者进行了用户测试,并进一步完善以获得GDM-DH应用程序的最终版本。
结果:焦点小组和访谈的参与者一致同意拟议的移动应用程序对GDM患者的实用性和相关性,提供对应用程序功能和内容的基本修改和添加的额外见解(例如,包含示例膳食计划和运动视频)。可用性测试中患者的平均年龄(n=18)为28.8(SD3.3)岁,平均胎龄为27.2(SD3.0)周。10个任务的平均可用性得分为3.50(SD0.55;“非常容易”的最大得分=5);任务完成率从55.6%(n=10)到94.4%(n=17)。对可用性测试的结果进行了审查,以进一步优化GDM-DH应用程序(例如,改善数据可视化)。与社会认知理论一致,GDM-DH应用程序的最终版本通过提供健康教育并允许患者记录和自我监测血糖来支持GDM自我管理,血压,碳水化合物的摄入量,身体活动,和妊娠期体重增加。该应用程序使用创新功能,以最大限度地减少自我监控负担,以及自动反馈和数据可视化。该应用程序还包括社交网络“关注”功能,可添加朋友和家人,并允许他们查看记录的数据和进度摘要。医疗保健提供者可以使用GDM-DH应用程序的基于Web的管理门户来输入/查看葡萄糖水平和其他临床指标,跟踪患者进展,并相应地指导治疗和咨询。
结论:据我们所知,这是为低收入国家开发的第一个GDM移动健康平台,也是第一个包含社会支持功能的平台。目前正在进行一项试点临床试验,以探索GDM-DH应用程序的临床实用性。
BACKGROUND: Mobile apps can aid with the management of gestational diabetes mellitus (GDM) by providing patient education, reinforcing regular blood glucose monitoring and diet/lifestyle modification, and facilitating clinical and social support.
OBJECTIVE: This study aimed to describe our process of designing and developing a culturally tailored app, Garbhakalin Diabetes athawa Madhumeha-Dhulikhel Hospital (GDM-DH), to support GDM management among Nepalese patients by applying a user-centered design approach.
METHODS: A multidisciplinary team of experts, as well as health care providers and patients in Dhulikhel Hospital (Dhulikhel, Nepal), contributed to the development of the GDM-DH app. After finalizing the app\'s content and features, we created the app\'s wireframe, which illustrated the app\'s proposed interface, navigation sequences, and features and function. Feedback was solicited on the wireframe via key informant interviews with health care providers (n=5) and a focus group and in-depth interviews with patients with GDM (n=12). Incorporating their input, we built a minimum viable product, which was then user-tested with 18 patients with GDM and further refined to obtain the final version of the GDM-DH app.
RESULTS: Participants in the focus group and interviews unanimously concurred on the utility and relevance of the proposed mobile app for patients with GDM, offering additional insight into essential modifications and additions to the app\'s features and content (eg, inclusion of example meal plans and exercise videos).The mean age of patients in the usability testing (n=18) was 28.8 (SD 3.3) years, with a mean gestational age of 27.2 (SD 3.0) weeks. The mean usability score across the 10 tasks was 3.50 (SD 0.55; maximum score=5 for \"very easy\"); task completion rates ranged from 55.6% (n=10) to 94.4% (n=17). Findings from the usability testing were reviewed to further optimize the GDM-DH app (eg, improving data visualization). Consistent with social cognitive theory, the final version of the GDM-DH app supports GDM self-management by providing health education and allowing patients to record and self-monitor blood glucose, blood pressure, carbohydrate intake, physical activity, and gestational weight gain. The app uses innovative features to minimize the self-monitoring burden, as well as automatic feedback and data visualization. The app also includes a social network \"follow\" feature to add friends and family and give them permission to view logged data and a progress summary. Health care providers can use the web-based admin portal of the GDM-DH app to enter/review glucose levels and other clinical measures, track patient progress, and guide treatment and counseling accordingly.
CONCLUSIONS: To the best of our knowledge, this is the first mobile health platform for GDM developed for a low-income country and the first one containing a social support feature. A pilot clinical trial is currently underway to explore the clinical utility of the GDM-DH app.