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other·endocrinology, public health, epidemiology, family medicine, research methods·PMC10015356

Influences on Patient Uptake of and Engagement With the National Health Service Digital Diabetes Prevention Programme: Qualitative Interview Study

Journal of Medical Internet Research · 4 authors, 3 centres

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TL;DR

This qualitative interview study explored factors influencing decisions to take up and engage with the NHS digital diabetes prevention programme among 32 adults with nondiabetic hyperglycemia. Participants found the programme convenient and accessible, with health coaches and tracking tools important for motivation and engagement, though barriers related to referral processes and health care professionals' engagement were also identified.

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This qualitative study used semistructured interviews with 32 adults diagnosed with nondiabetic hyperglycemia who had been offered the NHS-digital-DPP in England. Recruitment was conducted via four programme providers and three primary care practices. Interviews were guided by a theoretically informed topic guide and analyzed using inductive thematic analysis. Seven overarching themes were identified as important to uptake and engagement: knowledge and understanding, referral process, self-efficacy, self-identity, motivation and support, advantages of digital service, and reflexive monitoring. The study included participants who accepted, declined, or chose a different delivery mode, but lacked diversity in socioeconomic status and digital access, limiting representation of those on the other side of the digital divide. The primary focus was on uptake and initial engagement rather than long-term use.

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other

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endocrinology

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ORIGINAL PAPER

PMC10015356

Influences on Patient Uptake of and Engagement With the National Health Service Digital Diabetes Prevention Programme: Qualitative Interview Study

Journal of Medical Internet Research

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ABSTRACT

Background Digital diabetes prevention programs (digital-DPPs) are being implemented as population-based approaches to type 2 diabetes mellitus prevention in several countries to address problems with the uptake of traditional face-to-face diabetes prevention programs. However, assessments of digital-DPPs have largely focused on clinical outcomes and usability among those who have taken them up, whereas crucial information on decision-making about uptake (eg, whether a user downloads and registers on an app) and engagement (eg, the extent of use of an app or its components over time) is limited. Greater understanding of factors that influence uptake and engagement decisions may support large-scale deployments of digital-DPPs in real-world settings. Objective This study aimed to explore the key influences on uptake and engagement decisions of individuals who were offered the National Health Service Healthier You : Digital Diabetes Prevention Programme (NHS-digital-DPP). Methods A qualitative interview study was conducted using semistructured interviews. Participants were adults, aged ≥18 years, diagnosed with nondiabetic hyperglycemia, and those who had been offered the NHS-digital-DPP. Recruitment was conducted via 4 providers of the NHS-digital-DPP and 3 primary care practices in England. Interviews were conducted remotely and were guided by a theoretically informed topic guide. Analysis of interviews was conducted using an inductive thematic analysis approach. Results Interviews were conducted with 32 participants who had either accepted or declined the NHS-digital-DPP. In total, 7 overarching themes were identified as important factors in both decisions to take up and to engage with the NHS-digital-DPP. These were knowledge and understanding, referral process, self-efficacy, self-identity, motivation and support, advantages of digital service, and reflexive monitoring. Perceptions of accessibility and convenience of the NHS-digital-DPP were particularly important for uptake, and barriers in terms of the referral process and health care professionals’ engagement were reported. Specific digital features including health coaches and monitoring tools were important for engagement. Conclusions This study adds to the literature on factors that influence the uptake of and engagement with digital-DPPs and suggests that digital-DPPs can overcome many barriers to the uptake of face-to-face diabetes prevention programs in supporting lifestyle changes aimed at diabetes prevention.

CITATION EXPORT

Jamie Ross, Sarah Cotterill, Peter Bower et al.. Influences on Patient Uptake of and Engagement With the National Health Service Digital Diabetes Prevention Programme: Qualitative Interview Study. Journal of Medical Internet Research. (2023). https://doi.org/10.2196/40961

AUTHORS

4 · 3 CENTRES

Jamie Ross, Sarah Cotterill, Peter Bower, Elizabeth Murray

1 Centre for Primary Care Wolfson Institute of Population Health Science, Barts and The London School of Medicine and Dentistry Queen Mary University of London London United Kingdom
2 Division of Population Health Health Services Research & Primary Care University of Manchester Manchester United Kingdom
3 E-health Unit Department of Primary Care and Population Health University College London London United Kingdom

EDITOR / REVIEWER

Gunther Eysenbach, Jacqueline Mair, Milton Eder