Abstract: The Impact of Diabetes Self-Management Mobile Technology Application Usage on Self-Care Behaviors Among Older Adults (Society for Social Work and Research 22nd Annual Conference - Achieving Equal Opportunity, Equity, and Justice)

Schedule:

Friday, January 12, 2018: 3:52 PM

Marquis BR Salon 12 (ML 2) (Marriott Marquis Washington DC)

* noted as presenting author

Kexin Yu, BA, Doctoral Student, University of Southern California, Los Angeles, CA

Shinyi Wu, PhD, Associate Professor, University of Southern California, Los Angeles, CA

Iris Chi, DSW, Professor, University of Southern California, Los Angeles, CA

Hsinyi Hsiao, PhD, Research Associate Professor, University of Southern California, Los Angeles, CA

Peyjiuan Lee, MA, Data Analyst, University of Southern California, Los Angeles, CA

Background: Self-management is critical in controlling diabetes but many older adults expressed frustration and difficulty. The advancement of mobile technology applications offers promising tools to better access health information and facilitating self-care behaviors (Agboola et al., 2016; Hou, Carter, Hewitt, Francisa, & Mayor, 2016). This study examines the effect of mobile technology application (app) usage on self-care behaviors among older type-2 diabetes patients.

Methods: The research team of the Intergenerational Mobile Technology Opportunities Program (IMTOP) developed a graphic-interface aging-friendly touchscreen diabetes self-management app to activate self-monitoring and health-related behavior change. The IMTOP app allows the older adults to record their biomarkers and health behaviors for self-management of type 2 diabetes. The app also includes information aid (e.g., desirable range or blood sugar control) and reminders, as well as rewarding feedbacks (e.g., confetti and cheering sound). The data, presented in the forms of daily, weekly and long-term charts, facilitates patient self-service visual analytics and their communication with healthcare providers.

Data from first post-intervention follow-up survey was used to examine the influence of usage of IMTOP app on diabetes patient’s self-care behavior. Data was collected on three aspects of IMTOP app usage (i.e., perceived ease of usage, affective responses towards IMTOP app and actual usage frequency). One single items measured their perceived ease of using IMTOP app on a four-point scale, ranging from very difficult to very easy. Affective responses towards IMTOP App was measured on a four-point scale, ranging strongly dislike to strongly like. Self-reported frequency of use was measured using an item with five-point scale, ranging from never to three times a day and above. Participants’ diabetes self-care behaviors were measured using the Summary of Diabetes Self-Care Activities (SDSCA) overall score and specific domain scores including general diet, specific diet, exercise, blood-sugar testing and foot care.

The effects of IMTOP app usage on diabetes self-care behaviors were evaluated with linear regression models. The regression models adjusted for age, gender, education, and clinic site.

Results: Higher self-reported frequency of use was significantly associated with more overall diabetes self-care behavior (F (4, 309) = 7.17, p<.0001). Perceived ease of use and affective responses towards IMTOP App were not related with diabetes self-care behavior. Analyses using specific self-care domain scores found that self-reported frequency of IMTOP App use positively related with general diet (F (4, 309) = 5.09, p<.001), and blood-sugar testing (F (4, 309) = 6.15, p<.0001).

Conclusion and Implications: The findings supported the effectiveness of using IMTOP app to activate a number of self-care behaviors among older patients with type-2 diabetes. The results are compatible with former research (Torbjørnsen et al., 2014; Wayne, Perez, Kaplan, & Ritvo, 2015). The findings confirmed mobile technology possessed the competence to facilitate chronic disease population to develop healthier life style, to improve their quality of life and to reduce health disparities.