i-PREVENTDIABETES: A FRAMEWORK FOR PREDIABETES SELF-CARE APPLICATION USING BEHAVIOURAL CHANGE THEORIES AND TECHNIQUES

Abstract

Type 2 diabetes is a chronic condition in which the body fails to properly use and store glucose that can lead to potentially serious issues, like neuropathy, or nerve damage; vision problems; an increased risk of heart disease; and other diabetes complications. As such, it needs immediate attention and should be prevented. Diabetes can be prevented or delayed at the prediabetes stage itself. Prediabetes is a stage when the blood glucose level is at the borderline and has not yet reached the stage to be called diabetes. It is a reversible condition, in which with the proper lifestyle and diet modification, it can be prevented or delayed in its occurrence. With the evolution of technology, applications which promote self-care are increasing. However, existing self-care applications focus more on managing diabetes instead of preventing it. They are also not developed based on user requirements. In this thesis, a proposed i-PreventDiabetes framework and application prototype are presented and evaluated. The framework consists of health behaviour change theories, such as the Transtheoretical Model. It also illustrates the contributing factors that are needed to change behaviour. The behaviour change techniques are added in the form of self-care application features. The Stages of Change of the Transtheoretical Model of individuals are also demonstrated to identify the individual’s behaviour change stage. Based on this proposed framework, i-PreventDiabetes application prototype is developed, with the intention of enabling prediabetics to take care of their own health. In modifying lifestyle and diet, the behaviour needs to be changed. However, changing behaviour is not an easy task; it is a challenging process that requires awareness, education, trigger, attitude, motivation and commitment. Commonly used behaviour change theories and techniques, and its effectiveness is identified by reviewing the literature. User requirements of i-PreventDiabetes are elicited via Focus Group Discussions conducted with prediabetics and diabetics, and Semi-structured Interviews are conducted with healthcare professionals. Based on these findings, the i-PreventDiabetes framework is developed. This framework is validated through expert review method, after which an application prototype is developed and evaluated. A formative evaluation of the i-PreventDiabetes application is carried out, confirming that the prediabetics are satisfied with the overall concept and usability. Subsequently, summative evaluation is conducted with a larger sample size of prediabetics and is presented, demonstrating the overall feasibility and acceptability of the application. The results demonstrate that the i-PreventDiabetes framework and application is feasible to promote behaviour change among the prediabetics. Through this application, the prediabetics realised that their health control comes from within themselves, and not from others nor happen by chance. The application is also found to be useful and easy to use. Users are motivated to use the application and experienced it positively. Overall, the results suggest that i-PreventDiabetes has the potential in instilling the right behaviour among the prediabetics to modify their lifestyle and diet. This helps the prediabetics to proactively take care of their health and in preventing the disease.