Researchers at the Center for Health Information and Decisions Systems (CHIDS) at the University of Maryland’s Robert H. Smith School of Business in the US have published the results of a study that set out to determine how personality impacts the effectiveness of mHealth apps.

As part of the 13 week pilot clinical trial, the team of researchers in partnership with the Fraunhofer Center for Experimental Software Engineering designed and then tested an app, called DiaSocial, for self-managing diabetes.

The app was uploaded to tablet devices and then given to test subjects made up of a group of older military veterans. The researchers focused on this demographic because they were found to have a heavy diabetes burden and are underrepresented in mHealth intervention studies.

To qualify for the study, participants had to be over 60 years old and had to have been diagnosed with type 2 diabetes at least three years prior. Of the 70 patients who expressed initial interest in the study, a final sample of 27 research participants aged 61–86, including three women, took part in the study.

At the beginning of the study the participants completed an initial questionnaire including demographic information and a personality inventory during their regular diabetes clinic visit. At study outset, participants completed a two-hour group training session where they were given a Samsung Galaxy Tab 3 preloaded with the DiaSocial app, configured to match their experimental group and a Fitbit One.

Over the 13 week study period, the participants were instructed to use the app daily, and were encouraged to earn points by recording their progress in achieving better diabetes self-care goals through managing glucose level, exercise, diet, and medication adherence. Participants who were assigned to teams met their teammates in person during the training session and were able to continue to interact online through the app.

In addition to testing the overall efficacy of the DiaSocial app, the trial focused on the roles of psychological traits called locomotion (“just do it”) and assessment (“do it right”). “Locomotors, more than assessors, benefited from the app, as the relationship between locomotion and performance over time was a bit stronger,” said one of the researchers, Social Psychologist and CHIDS Post-doctoral Researcher, Michelle Dugas.

The findings of the study, which were published in PLOS ONE, showed DiaSocial users high in locomotion performed more self-management behaviours related to physical activity, diet, medication adherence and glucose measures, and earned more points in the app than their counterparts low in locomotion. The participants who earned more points in the app subsequently experienced greater declines in average blood glucose, which is a key clinical outcome for diabetes.

However, the locomotors’ expectedly high performance trended downward after the middle of the trial, suggesting they got bored more easily.

“This decreasing usage pattern might be mitigated by tailoring an app to periodically integrate new goals and challenges consistent with engagement levels and a user’s individual characteristics,” said CHIDS Deputy Director, iSchool Doctoral Candidate and DiaSocial Lead Designer, Kenyon Crowley.

According to Dugas, incorporating mHealth in diabetes self-management – and accounting for personality traits – “is increasingly critical, given time constraints experienced by healthcare providers and growing prevalence of US diabetes cases.”

Dugas added that her team’s findings also give insight into developing interventions that would benefit low locomotors and assessors. “We plan to build on these initial findings and continue to research to better understand who benefits from different types of mHealth treatments and why.”

“We anticipate the results will give additional insight into how to craft tailored mHealth tools that will be more effective for more people,” concluded Dugas.

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