Hermanns Norbert, Cerletti Paco, Laurent Julie, Scibilia Renza, Skovlund Sören
Research Institute of the Diabetes Academy Mergentheim (FIDAM), Johann Hammer Str. 24, 97980, Bad Mergentheim, Germany.
Department for Clinical Psychology and Psychotherapy of the University of Bamberg, Markusplatz 3, Bamberg, D-96047, Germany.
Acta Diabetol. 2025 Aug 8. doi: 10.1007/s00592-025-02564-6.
This study examines the use, perceptions, and inequalities in access to Digital Health Solutions (DHS) among people with diabetes (PwD). It aims to identify factors influencing adoption and explore perceived benefits and barriers to using DHS, focusing on person-important outcomes such as physical health, mental burden, and access to care.
The primary objective of this feasibility study was to assess the intervention acceptability, feasibility, and app usability. The secondary aim is to explore preliminary intervention effects.
A cross-sectional online survey was conducted in France from April to July 2022. A total of 301 PwD (149 with type 1 diabetes [T1D], 152 with type 2 diabetes [T2D]) completed the study. The survey assessed the use of three DHS categories: information/education (DHS1), self-management support (DHS2), and data-sharing/collaborative care (DHS3). We used univariate and multivariate logistic regression to identify predictors of DHS use, including demographic, socioeconomic, psychological, and medical variables.
DHS1 was the most commonly used category, followed by DHS2 and DHS3. PwD with T1D were more likely to use multiple DHS. Type of diabetes and perceived health status were the strongest predictors of DHS use. Surprisingly, people in poorer health were less likely to use DHS despite potentially benefiting most from them. DHS-naïve individuals expected more benefits but reported greater concerns, especially about information overload and data security. These concerns were stronger than the perceived benefits. For example, concerns about data security reduced the likelihood of using DHS2 and DHS3 by up to 89%.
The study highlights disparities in DHS adoption and the critical role of perceived barriers. Addressing these concerns-particularly among PwD in poorer health-and aligning DHS with outcomes that matter to patients may improve equitable adoption and diabetes care.
本研究调查了糖尿病患者对数字健康解决方案（DHS）的使用情况、看法以及获取方面的不平等。其目的是确定影响采用的因素，并探索使用DHS的感知益处和障碍，重点关注身体健康、心理负担和获得护理等对个人重要的结果。
本可行性研究的主要目标是评估干预措施的可接受性、可行性和应用程序可用性。次要目标是探索初步干预效果。
2022年4月至7月在法国进行了一项横断面在线调查。共有301名糖尿病患者（149名1型糖尿病患者[T1D]，152名2型糖尿病患者[T2D]）完成了该研究。该调查评估了三类DHS的使用情况：信息/教育（DHS1）、自我管理支持（DHS2）和数据共享/协作护理（DHS3）。我们使用单变量和多变量逻辑回归来确定DHS使用的预测因素，包括人口统计学、社会经济、心理和医学变量。
DHS1是最常用的类别，其次是DHS2和DHS3。T1D患者更有可能使用多种DHS。糖尿病类型和感知健康状况是DHS使用的最强预测因素。令人惊讶的是，健康状况较差的人使用DHS的可能性较小，尽管他们可能从DHS中获益最多。初次接触DHS的人期望更多益处，但报告的担忧更多，尤其是关于信息过载和数据安全。这些担忧比感知到的益处更强烈。例如，对数据安全的担忧使使用DHS2和DHS3的可能性降低了多达89%。
该研究突出了DHS采用方面的差异以及感知障碍的关键作用。解决这些担忧——尤其是在健康状况较差的糖尿病患者中——并使DHS与对患者重要的结果保持一致，可能会改善公平采用和糖尿病护理。
