JMIR Diabetes最新文献

{"title":"eHealth Literacy and Its Association With Demographic Factors, Disease-Specific Factors, and Well-Being Among Adults With Type 1 Diabetes: Cross-Sectional Survey Study.","authors":"Divya Anna Stephen, Anna Nordin, Unn-Britt Johansson, Jan Nilsson","doi":"10.2196/66117","DOIUrl":"https://doi.org/10.2196/66117","url":null,"abstract":"<p><strong>Background: </strong>The use of digital health technology in diabetes self-care is increasing, making eHealth literacy an important factor to consider among people with type 1 diabetes. There are very few studies investigating eHealth literacy among adults with type 1 diabetes, highlighting the need to explore this area further.</p><p><strong>Objective: </strong>The aim of this study was to explore associations between eHealth literacy and demographic factors, disease-specific factors, and well-being among adults with type 1 diabetes.</p><p><strong>Methods: </strong>The study used data from a larger cross-sectional survey conducted among adults with type 1 diabetes in Sweden (N=301). Participants were recruited using a convenience sampling method primarily through advertisements on social media. Data were collected between September and November 2022 primarily through a web-based survey, although participants could opt to answer a paper-based survey. Screening questions at the beginning of the survey determined eligibility to participate. In this study, eHealth literacy was assessed using the Swedish version of the eHealth Literacy Scale (Sw-eHEALS). The predictor variables, well-being was assessed using the World Health Organization-5 Well-Being Index and psychosocial self-efficacy using the Swedish version of the Diabetes Empowerment Scale. The survey also included research group-developed questions on demographic and disease-specific variables as well as digital health technology use. Data were analyzed using multiple linear regression presented as nested models. A sample size of 270 participants was required in order to detect an association between the dependent and predictor variables using a regression model based on an F test. The final sample size included in the nested regression model was 285.</p><p><strong>Results: </strong>The mean Sw-eHEALS score was 33.42 (SD 5.32; range 8-40). The model involving both demographic and disease-specific variables explained 31.5% of the total variation in eHealth literacy and was deemed the best-fitting model. Younger age (P=.01; B=-0.07, SE=0.03;95% CI -0.12 to -0.02), lower self-reported glycated hemoglobin levels (P=.04; B=-0.06, SE=0.03; 95% CI -0.12 to 0.00), and higher psychosocial self-efficacy (P<.001; B=3.72, SE=0.53; 95% CI 2.68-4.75) were found associated with higher Sw-eHEALS scores when adjusted for demographic and disease-specific variables in this model. Well-being was not associated with eHealth literacy in this study.</p><p><strong>Conclusions: </strong>The demographic and disease-specific factors explained the variation in eHealth literacy in this sample. Further studies in this area using newer eHealth literacy tools are important to validate our findings. The study highlights the importance of development and testing of interventions to improve eHealth literacy in this population for better glucose control. These eHealth literacy interventions should be tailored to meet ","PeriodicalId":52371,"journal":{"name":"JMIR Diabetes","volume":"10 ","pages":"e66117"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applications of AI in Predicting Drug Responses for Type 2 Diabetes.","authors":"Shilpa Garg, Robert Kitchen, Ramneek Gupta, Ewan Pearson","doi":"10.2196/66831","DOIUrl":"https://doi.org/10.2196/66831","url":null,"abstract":"<p><strong>Unlabelled: </strong>Type 2 diabetes mellitus has seen a continuous rise in prevalence in recent years, and a similar trend has been observed in the increased availability of glucose-lowering drugs. There is a need to understand the variation in treatment response to these drugs to be able to predict people who will respond well or poorly to a drug. Electronic health records, clinical trials, and observational studies provide a huge amount of data to explore predictors of drug response. The use of artificial intelligence (AI), which includes machine learning and deep learning techniques, has the capacity to improve the prediction of treatment response in patients. AI can assist in the analysis of vast datasets to identify patterns and may provide valuable information on selecting an effective drug. Predicting an individual's response to a drug can aid in treatment selection, optimizing therapy, exploring new therapeutic options, and personalized medicine. This viewpoint highlights the growing evidence supporting the potential of AI-based methods to predict drug response with accuracy. Furthermore, the methods highlight a trend toward using ensemble methods as preferred models in drug response prediction studies.</p>","PeriodicalId":52371,"journal":{"name":"JMIR Diabetes","volume":"10 ","pages":"e66831"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"School-Partnered Collaborative Care (SPACE) for Pediatric Type 1 Diabetes: Development and Usability Study of a Virtual Intervention With Multisystem Community Partners.","authors":"Christine A March, Elissa Naame, Ingrid Libman, Chelsea N Proulx, Linda Siminerio, Elizabeth Miller, Aaron R Lyon","doi":"10.2196/64096","DOIUrl":"10.2196/64096","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;School-partnered interventions may improve health outcomes for children with type 1 diabetes, though there is limited evidence to support their effectiveness and sustainability. Family, school, or health system factors may interfere with intervention usability and implementation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To identify and address potential implementation barriers during intervention development, we combined methods in user-centered design and implementation science to adapt an evidence-based psychosocial intervention, the collaborative care model, to a virtual school-partnered collaborative care (SPACE) model for type 1 diabetes between schools and diabetes medical teams.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We recruited patient, family, school, and health system partners (n=20) to cocreate SPACE through iterative, web-based design sessions using a digital whiteboard (phase 1). User-centered design methods included independent and group activities for idea generation, visual voting, and structured critique of the evolving SPACE prototype. In phase 2, the prototype was evaluated with the usability evaluation for evidence-based psychosocial interventions methods. School nurses reviewed the prototype and tasks in cognitive walkthroughs and completed the Intervention Usability Scale (IUS). Two members of the research team independently identified and prioritized (1-3 rating) discrete usability concerns. We evaluated the relationship between prioritization and the percentage of nurses reporting each usability issue with Spearman correlation. Differences in IUS scores by school nurse characteristics were assessed with ANOVA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the design phase, the partners generated over 90 unique ideas for SPACE, prioritizing elements pertaining to intervention adaptability, team-based communication, and multidimensional outcome tracking. Following three iterations of prototype development, cognitive walkthroughs were completed with 10 school nurses (n=10, 100% female; mean age 48.5, SD 9.5 years) representing different districts and years of experience. Nurses identified 16 discrete usability issues (each reported by 10%-60% of participants). Two issues receiving the highest priority (3.0): ability to access a virtual platform (n=3, 30% of participants) and data-sharing mechanisms between nurses and providers (n=6, 60% of participants). There was a moderate correlation between priority rating and the percentage of nurses reporting each issue (ρ=0.63; P=.01). Average IUS ratings (77.8, SD 11.1; 100-point scale) indicated appropriate usability. There was no difference in IUS ratings by school nurse experience (P=.54), student caseload (P=.12), number of schools covered (P=.90), or prior experience with type 1 diabetes (P=.83), suggesting that other factors may influence usability. The design team recommended strategies for SPACE implementation to overcome high-priority issues, including training users ","PeriodicalId":52371,"journal":{"name":"JMIR Diabetes","volume":"10 ","pages":"e64096"},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining How Adults With Diabetes Use Technologies to Support Diabetes Self-Management: Mixed Methods Study.","authors":"Timothy Bober, Sophia Garvin, Jodi Krall, Margaret Zupa, Carissa Low, Ann-Marie Rosland","doi":"10.2196/64505","DOIUrl":"10.2196/64505","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Technologies such as mobile apps, continuous glucose monitors (CGMs), and activity trackers are available to support adults with diabetes, but it is not clear how they are used together for diabetes self-management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to understand how adults with diabetes with differing clinical profiles and digital health literacy levels integrate data from multiple behavior tracking technologies for diabetes self-management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Adults with type 1 or 2 diabetes who used ≥1 diabetes medications responded to a web-based survey about health app and activity tracker use in 6 categories: blood glucose level, diet, exercise and activity, weight, sleep, and stress. Digital health literacy was assessed using the Digital Health Care Literacy Scale, and general health literacy was assessed using the Brief Health Literacy Screen. We analyzed descriptive statistics among respondents and compared health technology use using independent 2-tailed t tests for continuous variables, chi-square for categorical variables, and Fisher exact tests for digital health literacy levels. Semistructured interviews examined how these technologies were and could be used to support daily diabetes self-management. We summarized interview themes using content analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 61 survey respondents, 21 (34%) were Black, 23 (38%) were female, and 29 (48%) were aged ≥45 years; moreover, 44 (72%) had type 2 diabetes, 36 (59%) used insulin, and 34 (56%) currently or previously used a CGM. Respondents had high levels of digital and general health literacy: 87% (46/53) used at least 1 health app, 59% (36/61) had used an activity tracker, and 62% (33/53) used apps to track ≥1 health behaviors. CGM users and nonusers used non-CGM health apps at similar rates (16/28, 57% vs 12/20, 60%; P=.84). Activity tracker use was also similar between CGM users and nonusers (20/33, 61% vs 14/22, 64%; P=.82). Respondents reported sharing self-monitor data with health care providers at similar rates across age groups (17/32, 53% for those aged 18-44 y vs 16/29, 55% for those aged 45-70 y; P=.87). Combined activity tracker and health app use was higher among those with higher Digital Health Care Literacy Scale scores, but this difference was not statistically significant (P=.09). Interviewees (18/61, 30%) described using blood glucose level tracking apps to personalize dietary choices but less frequently used data from apps or activity trackers to meet other self-management goals. Interviewees desired data that were passively collected, easily integrated across data sources, visually presented, and tailorable to self-management priorities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Adults with diabetes commonly used apps and activity trackers, often alongside CGMs, to track multiple behaviors that impact diabetes self-management but found it challenging to link tracked behaviors to glycem","PeriodicalId":52371,"journal":{"name":"JMIR Diabetes","volume":"10 ","pages":"e64505"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Enhancing Health Equity and Patient Engagement in Diabetes Care: Technology-Aided Continuous Glucose Monitoring Pilot Implementation Project.","authors":"Madhur Thakur, Eric W Maurer, Kim Ngan Tran, Anthony Tholkes, Sripriya Rajamani, Roli Dwivedi","doi":"10.2196/72689","DOIUrl":"https://doi.org/10.2196/72689","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2196/68324.].</p>","PeriodicalId":52371,"journal":{"name":"JMIR Diabetes","volume":"10 ","pages":"e72689"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient and Clinician Perspectives on the Effectiveness of Current Telemedicine Approaches in Endocrinology Care for Type 2 Diabetes: Qualitative Study.","authors":"Margaret Zupa, Megan Hamm, Lane Alexander, Ann-Marie Rosland","doi":"10.2196/60765","DOIUrl":"10.2196/60765","url":null,"abstract":"<p><strong>Background: </strong>Since the rapid widespread uptake in 2020, the use of telemedicine to deliver diabetes specialty care has persisted. However, evidence evaluating patient and clinician perspectives on benefits, shortcomings, and approaches to improve telemedicine care for type 2 diabetes is limited.</p><p><strong>Objective: </strong>This study aims to assess clinician and patient perspectives on specific benefits and limitations of current telemedicine care delivery for type 2 diabetes and views on approaches to enhance telemedicine effectiveness for patients who rely on it.</p><p><strong>Methods: </strong>We conducted semistructured qualitative interviews with diabetes specialty clinicians and adults with type 2 diabetes. We used a qualitative description approach to characterize participant perspectives on care delivery for type 2 diabetes via telemedicine.</p><p><strong>Results: </strong>Both clinicians (n=15) and patients (n=13) identify significant benefits of telemedicine in overcoming both physical (geographic and transportation) and scheduling (work commitments and wait times) barriers to specialty care for type 2 diabetes. In addition, telemedicine may enhance communication around diabetes care by improving information sharing between patients and clinicians. However, clinicians identify limited availability of home blood glucose data and vital signs as factors, which impair the optimal management of type 2 diabetes and related comorbid conditions via telemedicine. Previsit preparation, involvement of multidisciplinary providers, and frequent brief check-ins were identified by patients and clinicians as potential strategies to improve the quality of telemedicine care for adults with type 2 diabetes.</p><p><strong>Conclusions: </strong>Patients and clinicians identify key strengths of telemedicine in enhancing access to diabetes specialty care for adults with type 2 diabetes and describe approaches to ensure that telemedicine delivers high-quality diabetes care to patients who rely on it.</p>","PeriodicalId":52371,"journal":{"name":"JMIR Diabetes","volume":"10 ","pages":"e60765"},"PeriodicalIF":0.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Glycemic Control, Renal Progression, and Use of Telemedicine Phone Consultations Among Japanese Patients With Type 2 Diabetes Mellitus During the COVID-19 Pandemic: Retrospective Cohort Study.","authors":"Akiko Sankoda, Yugo Nagae, Kayo Waki, Wei Thing Sze, Koji Oba, Makiko Mieno, Masaomi Nangaku, Toshimasa Yamauchi, Kazuhiko Ohe","doi":"10.2196/72076","DOIUrl":"10.2196/72076","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2196/42607.].</p>","PeriodicalId":52371,"journal":{"name":"JMIR Diabetes","volume":"10 ","pages":"e72076"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143576058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes Medical Group Visits and Type 2 Diabetes Outcomes: Mediation Analysis of Diabetes Distress.","authors":"Matthew Reichert, Barbara A De La Cruz, Paula Gardiner, Suzanne Mitchell","doi":"10.2196/57526","DOIUrl":"10.2196/57526","url":null,"abstract":"<p><strong>Background: </strong>Group-based diabetes care, both technology-enabled and in-person, can improve diabetes outcomes in low-income minority women, but the mechanism remains unclear.</p><p><strong>Objective: </strong>We tested whether diabetes group medical visits (GMVs) reduced hemoglobin A1c (HbA1c) by mitigating diabetes distress (DD), an emotional response affecting nearly half of adults with type 2 diabetes in community settings.</p><p><strong>Methods: </strong>We conducted a mediation and moderation analysis of data from the Women in Control 2.0 comparative effectiveness study, which showed that both technology-enabled and in-person diabetes GMVs improve HbA1c. We tested whether DD mediated the relationship between diabetes GMV engagement and reductions in HbA1c. We also tested whether this relationship was moderated by depressive symptoms and social support. Participants were 309 low-income and minority women. Diabetes GMV engagement was measured using the Group Climate Questionnaire. The mediator, DD, was measured using the Diabetes Distress Screening Scale. The outcome was the 6-month change in HbA1c. Social support was measured using the Medical Outcomes Study Social Support Survey.</p><p><strong>Results: </strong>DD mediated the relationship between engagement and 6-month HbA1c. Specifically, group engagement affected HbA1c by reducing distress associated with the regimen of diabetes self-management (P=.04), and possibly the emotional burden of diabetes (P=.09). The relationship between engagement and 6-month HbA1c was moderated by depressive symptoms (P=.02), and possibly social support (P=.08).</p><p><strong>Conclusions: </strong>Engagement in diabetes GMVs improved HbA1c because it helped reduce diabetes-related distress, especially related to the regimen of diabetes management and possibly related to its emotional burden, and especially for women without depressive symptoms and possibly for women who lacked social support.</p>","PeriodicalId":52371,"journal":{"name":"JMIR Diabetes","volume":"10 ","pages":"e57526"},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Health Equity and Patient Engagement in Diabetes Care: Technology-Aided Continuous Glucose Monitoring Pilot Implementation Project.","authors":"Madhur Thakur, Eric W Maurer, Kim Ngan Tran, Anthony Tholkes, Sripriya Rajamani, Roli Dwivedi","doi":"10.2196/68324","DOIUrl":"10.2196/68324","url":null,"abstract":"<p><p>Federally Qualified Health Centers (FQHCs) provide service to medically underserved areas and communities, providing care to over 32 million patients annually. The burden of diabetes is increasing, but often, the vulnerable communities served by FQHCs lag in the management of the disease due to limited resources and related social determinants of health. With the increasing adoption of technologies in health care delivery, digital tools for continuous glucose monitoring (CGM) are being used to improve disease management and increase patient engagement. In this viewpoint, we share insights on the implementation of a CGM program at an FQHC, the Community-University Health Care Center (CUHCC) in Minneapolis, Minnesota. Our intent is to improve diabetes management through better monitoring of glucose and to ensure that the CGM program enables our organization's overarching digital strategy. Given the resource limitations of our population, we provided Libre Pro devices to uninsured patients through grants to improve health care equity. We used an interdisciplinary approach involving pharmacists, nurses, and clinicians and used hemoglobin A1c (HbA1c) levels as a measure of diabetes management. We assessed the CGM program and noted key aspects to guide future implementation and scalability. We recruited 148 participants with a mean age of 54 years; 39.8% (59/148) self-identified their race as non-White, 9.5% (14/148) self-identified their ethnicity as Hispanic or Latino, and one-third (53/148, 35.8%) were uninsured. Participants had diverse language preferences, with Spanish (54/148, 36.5%), English (52/148, 35.1%), Somali (21/148, 14.2%), and other languages (21/148, 14.2%). Their clinical characteristics included an average BMI of 29.91 kg/m2 and a mean baseline HbA1c level of 9.73%. Results indicate that the CGM program reduced HbA1c levels significantly from baseline to first follow-up (P<.001) and second follow-up (P<.001), but no significant difference between the first and second follow-up (P=.94). We share key lessons learned on cultural and language barriers, the digital divide, technical issues, and interoperability needs. These key lessons are generalizable for improving implementation at FQHCs and refining digital strategies for future scalability.</p>","PeriodicalId":52371,"journal":{"name":"JMIR Diabetes","volume":"10 ","pages":"e68324"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Needs and Preferences of Users and Parents to Design a Mobile App to Deliver Mental Health Peer Support to Adolescents With Type 1 Diabetes: Qualitative Study.","authors":"Titilola I Yakubu, Poonamdeep Jhajj, Samantha Pawer, Nicholas C West, Shazhan Amed, Tricia S Tang, Matthias Görges","doi":"10.2196/64267","DOIUrl":"10.2196/64267","url":null,"abstract":"<p><strong>Background: </strong>Beyond physical health, managing type 1 diabetes (T1D) also encompasses a psychological component, including diabetes distress, that is, the worries, fears, and frustrations associated with meeting self-care demands over the lifetime. While digital health solutions have been increasingly used to address emotional health in diabetes, these technologies may not uniformly meet the unique concerns and technological savvy across all age groups.</p><p><strong>Objective: </strong>This study aimed to explore the mental health needs of adolescents with T1D, determine their preferred modalities for app-based mental health support, and identify desirable design features for peer-delivered mental health support modeled on an app designed for adults with T1D.</p><p><strong>Methods: </strong>A semistructured qualitative focus group study was conducted with adolescents with T1D and parents of adolescents with T1D. Data were collected through pre-focus group surveys, including sociodemographic background, diabetes status, health care experiences, and focus group sessions, including their opinions on peer support and technology. A thematic analysis following an inductive and iterative process was performed to develop themes and subthemes from the collected information.</p><p><strong>Results: </strong>Focus group participants included 10 adolescents (mean 16, SD 1 years; 8/10, 80% female; who had been living with diabetes for an average of 9, SD 5 years) and 10 parents (mean age 51, SD 7 years; 9/10, 90% female). Four core themes emerged: (1) experience: navigating adolescence with T1D, (2) empowerment: support systems that enabled better management of their T1D, (3) obstacles: societal barriers that affect adolescents' T1D management, and (4) innovation: adolescent-driven preferences for digital peer support platforms.</p><p><strong>Conclusions: </strong>App-based peer support offers a promising avenue for addressing the mental health needs of adolescents with T1D. Understanding the unique support needs of these adolescents and using this information to suggest design considerations for a mental health peer support app is an important step toward addressing their complex emotional and social challenges.</p>","PeriodicalId":52371,"journal":{"name":"JMIR Diabetes","volume":"10 ","pages":"e64267"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11791445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}