Design Sprint and Usability Testing of a Patient-Facing Diabetes Dashboard Embedded in an Existing Patient Portal Mobile App

项目总结/摘要 糖尿病是肾衰竭、心脏病、中风、视力障碍和非创伤性疾病的主要原因。 下肢截肢糖尿病自我护理和预防性卫生服务可以预防或延迟许多 糖尿病相关并发症，但很少有患者持续接受所有推荐的服务或参与 建议的自我护理行为，具有挑战性的实施和维持。 数据越来越多地支持面向患者的移动的健康应用程序在改变健康行为方面的作用， 加强自我护理，并方便糖尿病患者获得医疗服务。然而，差异 在糖尿病移动的健康应用程序的设计和可用性方面， 对血糖控制的影响不一致。许多糖尿病移动的健康应用程序由于以下一种或多种原因而缺乏疗效： 以下：（a）缺乏以用户为中心的设计，（B）缺乏与医疗保健提供系统的整合， (c)缺乏最大化患者参与的关键特征，包括以患者为中心的激励策略， 和/或（d）未能考虑到老年病人和卫生知识有限的病人的特殊需要。 研究支持以用户为中心的设计方法，可用性测试，以及与个人同步 健康记录和患者门户网站，以最大限度地提高移动的健康应用程序的有效性， 现有的挑战。此外，最近公布的框架确定了促进患者 与从提供教育信息到支持行为的移动的健康应用程序互动 通过使用游戏设计和竞争元素的奖励来改变。 通过应用以用户为中心的设计方法、患者参与的关键策略和可用性， 评估，我们的目标是：（1）设计一个面向患者的糖尿病仪表板嵌入在现有的病人 Web门户移动的应用程序，可满足不同患者群体（包括老年人和 有限的健康素养）与2型糖尿病使用，和（2）评估随着时间的推移， 糖尿病移动的仪表板在目标1中开发。 这些目标与父K23应用程序设计和测试相关 糖尿病仪表板嵌入在免费的患者门户网站桌面应用程序中。开始以来 作为母公司K23奖，开发了患者门户网站移动的应用程序，现已在iOS上提供， Android移动的操作系统，提供了将桌面应用程序转换到移动的的机会 平台移动的平台通过增加可移植性为桌面应用程序提供了重要的补充， 方便性和功能性，并带来与屏幕尺寸、手势相关的新设计机会 (e.g.,滑动）、通知和导航。最后，根据R 03奖的目标， 拟议的研究将进一步扩展PI的设计和可用性评估经验， 在随后的R 01申请中提出的随机对照试验计划所必需的数据。

Project Summary/Abstract Diabetes is a leading cause of kidney failure, heart disease, stroke, visual impairment, and non-traumatic lower limb amputations. Diabetes self-care and preventative health services can prevent or delay many diabetes-related complications, yet few patients consistently receive all recommended services or engage in recommended self-care behaviors that are challenging to implement and sustain. Data increasingly support the role of patient-facing mobile health apps to modify health behavior, enhance self-care, and facilitate access to healthcare services for patients with diabetes. However, differences in the design and usability of diabetes mobile health apps have led to varying levels of patient engagement and inconsistent effects on glycemic control. Many diabetes mobile health apps lack efficacy due to one or more of the following: (a) absence of user-centered design, (b) lack of integration with the healthcare delivery system, (c) absence of key features to maximize patient engagement including patient-centered motivational strategies, and/or (d) failure to account for the unique needs of older patients and those with limited health literacy. Research supports user-centered design methods, usability testing, and synchronization with personal health records and patient web portals to maximize the effectiveness of mobile health apps and overcome existing challenges. In addition, a recently published framework identifies key strategies to promote patient engagement with mobile health apps that range from providing educational information to supporting behavior change with rewards using elements of game design and competition. By applying user-centered design methodology, key strategies for patient engagement, and usability assessments, we aim to: (1) design a patient-facing diabetes dashboard embedded within an existing patient web portal mobile app that is satisfying for a diverse group of patients (including older adults and those with limited health literacy) with type 2 diabetes to use, and (2) assess the usability over time of the patient-facing diabetes mobile dashboard developed in Aim 1. These objectives are in concert with the parent K23 application's goal of designing and testing a related diabetes dashboard embedded in a complimentary patient web portal desktop application. Since the start of the parent K23 award, a patient web portal mobile app was developed and is now available on iOS and Android mobile operating systems, providing an opportunity to translate the desktop application to the mobile platform. Mobile platforms offer an important compliment to desktop applications by increasing portability, convenience, and functionality, and bring with it new design opportunities related to screen size, hand gestures (e.g., swiping), notifications, and navigation. Finally, in accordance with the goals of the R03 award, the proposed research will further extend the design and usability assessment experience of the PI and produce data essential to the planning of a randomized controlled trial to be proposed in subsequent R01 application.