Instrument for assessing mobile technology acceptability in diabetes self-management: a validation and reliability study

Figures & data

Figure 1 Summary of the study design.

Abbreviation: HbA1c, hemoglobin A1c.

Figure 2 Mobile technology acceptance model for DM self-management.

Abbreviation: DM, diabetes mellitus.

Table 1 Patients’ anthropometric, demographic, and socioeconomic characteristics

Patients’ characteristics	Values
Number of patients	103
DMa
Type 1	63 (61.16)
Type 2	40 (38.83)
Age (years)b	37 (26–59)
Gender (female)a	52 (50.5)
Weight (kg)b	73 (63.5–89.5)
Height (cm)b	167.5 (163–173.5)
Abdominal circumference (cm)b	80 (69.5–101)
DM durationa
<1 year	10 (9.7)
1–5 years	15 (14.6)
6–10 years	24 (23.3)
>10 years	54 (52.4)
Latest HbA1c <7.5a	37 (35.9)
Major cardiovascular events (yes)	9 (8.7)
Education levela
Without studies	10 (9.8)
Elementary level	2 (4.9)
Secondary level	9 (8.7)
Professional school	13 (12.6)
High school	33 (32)
Bachelor	33 (32)
Master/PhD	3 (2.9)
Employment statusa
Unemployed	13 (12.6)
Retired	36 (35)
Working full time	29 (28.2)
Working part time	1 (0.97)
Independent	13 (12.6)
Total incomea
Low level	31 (30.1)
Middle level	44 (38.9)
High level	8 (7.8)
I do not want to answer/I do not know	24 (23.3)

Notes:

a Categorical variables are presented by absolute frequency and percentage in the sample.

b Continuous variables (with non-Gaussian distribution) are indicated by their median (interquartile range).

Abbreviations: DM, diabetes mellitus; HbA1c, hemoglobin A1c.

Table 2 Results of factor analysis – rotated component matrix

Instrument’s statements	Component
	1	2	3	4	5
Electronic monitoring is more precise	0.278	0.842	0.054	0.061	0.041
Electronic monitoring is more convenient	0.153	0.863	0.047	−0.125	−0.062
Raises confidence in decisions for DM monitoring	0.104	0.759	0.294	0.157	0.056
Helps monitor the hyper- or hypoglycemic events	−0.001	0.818	0.188	0.01	−0.294
New technology is helpful	0.216	−0.039	−0.114	−0.598	0.413
I am actively interested in testing cutting-edge products	0.199	0.095	0.754	−0.202	−0.148
I want to learn myself how to use cutting-edge products	0.276	0.227	0.815	0.255	0.045
I am passionate about exploring the potential of cutting-edge products	0.271	0.258	0.803	0.308	0.073
Technology is part of my life	0.479	0.339	0.386	0.574	0.076
Utility of a smartphone application	0.708	−0.119	0.186	−0.025	0.169
Utility of notifications	0.799	−0.065	0.131	0.063	0.001
Tracking glycemic values	0.837	−0.022	0.353	−0.127	−0.063
Tracking ingested carbohydrates	0.841	0.146	0.288	−0.024	−0.028
Tracking daily physical activity	0.861	0.154	0.110	0.200	0.027
Tracking administered medication	0.766	0.245	0.365	−0.168	0.149
Monitoring by the physician and medication adjustment	0.732	−0.22	0.168	−0.295	−0.243
Security and confidentiality of the personal data	0.784	0.281	0.163	−0.200	−0.192
Multiple user profiles	0.792	0.297	0.119	−0.036	−0.158
Option to input data on a website	0.836	0.423	0.042	−0.088	−0.102
Backup system for information already included	0.865	0.298	−0.092	0.221	−0.144
Sending data; export and print the inputted information	0.890	0.304	−0.068	0.185	−0.097
Notification without Internet connection	0.845	0.290	−0.007	0.270	−0.115
Available on many operating systems	0.847	0.397	0.119	−0.065	−0.127
Available on many languages	0.826	0.217	0.335	−0.087	−0.064
Notifications about medication administration	0.807	0.163	0.258	−0.202	0.078
Notifications about eating behavior	0.855	0.196	0.274	−0.123	0.047
Notifications about physical effort optimization	0.921	0.130	0.071	0.145	−0.014
Alerts a potential risk	0.839	0.082	0.152	0.241	0.057
Interaction with the physician	−0.168	−0.077	0.002	−0.097	0.844

Note: The bold values show the statements which loaded in each of the five components.

Abbreviation: DM, diabetes mellitus.

Table 3 Attitude toward mobile technology for DM self-management

Components	Internal consistency	Reliability	Criterion validity
	αa	ICC	Group	Median (IQR)b	P-valuec
(I) Perceived ease of use of mobile technology for DM self-management	0.898	0.746	Group 1	11.5 (9–14)	<0.001
			Group 2	5 (1–10)
(II) Confidence about technology and latest generation products	0.909	0.714	Group 1	15 (12.5–18.5)	<0.001
			Group 2	5 (2.5–20)
(III) Usefulness of notifications about the risk of DM-related complications	0.9	0.818	Group 1	19 (15–20)	<0.01
			Group 2	10 (4–20)

Notes:

a Cronbach’s alpha.

b Attitude rated where the lower limit indicates poor attitude and the upper limit indicates good attitude (I) 1–25, (II) 1–20, and (III) 1–20.

c Mann–Whitney U test, null hypothesis: the distribution of scores is the same across the categories of using or not Internet.

Abbreviations: DM, diabetes mellitus; ICC, interclass correlation coefficient; IQR, interquartile range; Group 1, group of patients using Internet; Group 2, group of patients not using Internet.

Table 4 Perceived usefulness about the inclusion of various attributes into a mobile device application for DM self-management

Attributes of mobile device applications for DM self-management	Internal consistency	Reliability	Criterion validity
	αa	ICC	Group	Median (IQR)b	P-valuec
(I) Tracking functions for glycemic values, ingested carbohydrates, and administered medication	0.949	0.823	Group 1	40 (36–40)	<0.001
			Group 2	28 (9–36)
(II) Security and confidentiality of personal data, backup system, data portability, and off-line notifications	0.978	0.815	Group 1	99 (85.5–100)	<0.001
			Group 2	57 (20–85)
(III) Notifications about medication administration, eating behaviors, and physical effort optimization	0.97	0.889	Group 1	40 (34–40)	<0.001
			Group 2	25.5 (8–37.5)

Notes:

a Cronbach’s alpha.

b Attitude rated where the lower limit indicates poor attitude and the upper limit indicates good attitude (I) 1–40; (II) 1–100; (III) 1–40.

c Mann–Whitney U test, null hypothesis: the distribution of scores is the same across the categories of using or not using smartphone.

Abbreviations: DM, diabetes mellitus; ICC, interclass correlation coefficient; IQR, interquartile range; Group 1, group of patients using smartphone; Group 2, group of patients not using smartphone.

Figure 3 The correlated factors of the mobile technology acceptance model for DM self-management.

Notes: *Correlation is significant at the 0.05 level (two tailed t-test); **Correlation is significant at the 0.01 level (two tailed t-test).
Abbreviations: DM, diabetes mellitus; IPP, interaction patient-physician; ED, electronic devices; PEOU, perceived ease of use; PU, perceived usefulness; IU, intention to use.