eHealth technologies to support nutrition and physical activity behaviors in diabetes self-management

Figures & data

Table 1 Advantages and disadvantages of eHealth technologies

Technology	Advantages	Disadvantages
Mobile phones and smartphones
Text messages	Broad reach due to ubiquitous use of cell/mobile phones and smartphones and ability to be sent across multiple operating systems Messages can be personalized to the individual Useful as an adjunct (booster) with other technology types Relatively less expensive to set up and deliver compared to other technologies	Character count (n=160) per message limits detailed messages (although multiple messages can be sent) Although other content can be sent (eg, audio or video), individuals may have restrictions on the type of content that can be received (ie, text only) Interaction may not be offered (ie, one way) or may be limited (ie, single word replies) due to limited automation
Applications (apps)	Portability of smartphones and associated mobile devices allows immediate access to apps Ability to push notifications and reminders based on data entered or collected passively Ability to link data with other apps and/or devices (eg, through the use of API) Offline functionality is common, however, it is dependent on the features of the app	If using a third-party app, no control over the timing or type of content and/or feature changes If developing an app, ongoing costs associated with maintenance and updates to software (eg, update of operating system) Some apps are only available on selected operating systems (eg, Apple’s iOS) which may limit accessibility
Web-based programs	Flexibility in the content and features including capability for multimedia content and peer and health professional support Can be used across multiple devices with Internet access (eg, computer through to smartphone); however, user experience may differ across the different devices	Requires Internet connection with most having limited or no offline capacity
Video games	Most commonly used for promoting exercise Increased accessibility in the home setting removes some barriers to participation, eg, transport, cost of gym membership, and stigma associated with exercising at a gym	Requires specific technology (eg, video game console) Largely generic and unsupervised; may not account for variations in an individual’s ability to exercise
Virtual reality	Simulation of real-world scenarios can be used to deliver information and train patients in self-management behaviors providing an immersive, yet controlled environment to rehearse behaviors	Requires specific technology (eg, headset) Generic simulation of real-world scenarios may not exactly translate to individuals’ lived experience with diabetes
Augmented reality	Provides information to support decision making in the context of real-life situations Able to be used on common devices (eg, smartphones)	Virtual content tends to be built for specific situations; therefore, the use may be limited to selected environments
Wearable technologies	Conveniently located and immediate feedback on behaviors (eg, step/day) Ability to program alerts and reminders (eg, sedentary time)	Battery life can vary between devices Limited information available on device itself, requires pairing with computer/smartphone

Abbreviations: API, application programming interface; eHealth, electronic health.