Background Diabetes is a major cause of morbidity and mortality in the United States. In 2012, 29.1 million people were estimated to have the condition, with type 2 diabetes accounting for 95% of all cases . It is currently one of the most costly conditions in the country  and forecasts as a heavier burden for the U.S. with the prevalence expected to significantly increase . For those who live with the disease, it is possible to manage diabetes in order to prevent or delay the onset of complications . However the self-management regimen is complex and impacts nearly every important aspect of one's life .
The ubiquitous nature of mobile technologies and powerful capabilities of smartphones and tablets has led to a significant increased interest in the development and use of mobile health. Diabetes management is an application area where mobile devices could enhance the quality of life for people living with chronic illnesses –, and usability is key to the adoption of such technologies , . Past work has evaluated the usability of diabetes management apps for Android, iOS and Blackberry smartphones - despite the fact that no established method to evaluate the usability of mobile apps has emerged . To our knowledge, this study is the first to evaluate the usability of diabetes management apps on iPad.
Methods This study introduces a novel usability survey that is designed for mHealth and specific to the iOS operating system. The survey is built on previous usability findings –, Nielsen heuristics  and the Apple iOS Human Interface Guidelines . The new instrument was evaluated with three evaluators assessing ten iPad apps, selected because they were the most popular diabetes management apps on the Apple AppStore. A focus group was subsequently held to gather more insight on the usability of the apps and the survey itself. Statistical analysis using R and grounded theory were used to analyze the quantitative and qualitative results, respectively.
Results The survey identified OneTouch Reveal by LifeScan Inc. and TactioHealth by Tactic, Health Group as the most usable apps. GlucoMo by Artificial Life, Inc. and Diabetes in Check by Everyday Health, Inc. rated as the least usable apps. Setting up medication and editing blood glucose were the most problematic tasks. Some apps did not support all functions that were under review. Six main themes emerged from the focus group: the presentation of health information, aesthetic and minimalist design, flexibility and efficiency of data input, task feedback, intuitive design and app stability. These themes suggest important constructs of usability for mHealth apps.
Discussion and Conclusion Mobile health developers and researchers should focus on the tasks, heuristics and underlying issues that were identified as most problematic throughout the study. Additionally, research should further inquire on the potentially critical relation between the information available on app markets and the usability of apps. Several signs point to the potential of the usability survey that was developed but further adjustments and additional test iterations are warranted to validate its use as a reliable usability evaluation method.
|Advisor:||Johnson, Stephen, Ancker, Jessica|
|School:||Weill Medical College of Cornell University|
|School Location:||United States -- New York|
|Source:||MAI 54/02M(E), Masters Abstracts International|
|Subjects:||Information Technology, Biomedical engineering, Bioinformatics|
|Keywords:||Diabetes Management, MHealth, Mobile Apps, Usability, iPad|
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