Diabetes BeDur, A Type 2 Diabetes Mobile Application for Iranian Nationals in the U.S.
Date
2021
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Abstract
Diabetes is a growing public health challenge worldwide. Among all developed countries, the U.S. has the highest rate of diabetes prevalence. Minority populations including immigrants are at high risk from this disease. Iran is rated as having the third largest number of adults with diabetes in the MENA (Middle East and North Africa) region. Type 2 diabetes mellitus (T2DM) is now the most common form of the disease. DiabetesBeDur, a type 2 diabetes health mobile application for Iranian nationals in the U.S. was developed to primarily raise awareness about this global health issue among the U.S. minority populations in general, and the Iranians living in the U.S. specifically. The current research is designed as a sequential exploratory multi-method communication intervention study. A content analysis of 18 English and Farsi mobile health applications concerning type 2 diabetes was conducted to guide the development of the mobile application. Following that, 17 subjects were recruited to evaluate the DiabetesBeDur mobile application by participating in an online usability testing questionnaire by providing their feedback, experiences, and recommendations about the mobile app. As a result of the usability testing, the application was edited and improved in terms of ease of use, interface, and usefulness. Finally, a pretest-posttest outcome evaluation experiment with 77 subjects assessed the effectiveness of the mobile application. This research employed the health belief model and the theory of reasoned action to evaluate the effectiveness of the application. The results of the study showed that the application was successful in influencing individuals’ knowledge, attitude, behavioral intention, perceived susceptibility, perceived barriers, and perceived benefits about type 2 diabetes. Although participants’ attitudes, perceived susceptibility, perceived barriers, and benefits changed over time and after being exposed to the DiabetesBeDur app, none of these variables were found to affect the subjects’ intention to undertake T2D preventive actions. However, knowledge about T2D was found as a predictor of one’s intention about type 2 diabetes preventive behaviors. Thus, the DiabetesBeDur application can encourage its users to participate in preventive actions for T2D by educating them about the disease. The present study is the first attempt to create a culturally-grounded and evidence-based health mobile application for Iranian nationals living in the U.S. to promote T2D prevention. The present study contributed to the literature by filling a gap concerning developing culturally-tailored programs targeting vulnerable populations. Limitations, future studies, and practical implications are discussed. Keywords: Type 2 Diabetes, Health Communication, E-health, Health Belief Model (HBM), Theory of Reasoned Action (TRA), Vulnerable populations.