Exploring the use of activity trackers to support physical activity and reduce sedentary behaviour in adults diagnosed with type 2 diabetes: A qualitative interview study using the RE-AIM Framework (Preprint)

BACKGROUND The prevalence of type 2 diabetes in adults worldwide is increasing. Low levels of physical activity and sedentary behaviour are major risk factors of developing the disease. Physical activity interventions incorporating activity trackers can reduce blood glucose levels in adults diagnosed with type 2 diabetes. The My Diabetes My Way website is a support and educational platform for people diagnosed with diabetes and health care professionals. Users of the My Diabetes My Way website can upload their Fitbit activity data onto the system but this is not presently being analysed and used routinely within clinical care. Developers of the My Diabetes My Way system are planning to allow different makes of activity trackers to be integrated with the platform. OBJECTIVE The objective of this qualitative study was to explore (through the RE-AIM framework) views from adults diagnosed with type 2 diabetes and health care professionals on the integration of activity trackers into type 2 diabetes care. METHODS Adults (n=12) diagnosed with type 2 diabetes and health care professionals (GP n=4, Consultant n=1, Diabetes Nurse n=2, Practice Nurse n=1, Physical Activity Advisor n=1) were recruited through social media and professional contacts. Semi-structured one to one interviews were conducted. Abductive thematic analysis was undertaken and main themes and sub-themes identified. The RE-AIM framework was used to evaluate the themes in respect of the wider use of activity trackers and the My Diabetes My Way platform within type 2 diabetes clinical care. RESULTS Six main themes (awareness, access, cost, promotion, support, technology and data) and 20 sub-themes were identified. Evaluation using the 5 RE-AIM dimensions found that reach could be improved by raising awareness of the My Diabetes My Way platform and the ability to upload activity tracker data onto the system. Effectiveness could be improved by implementing appropriate personalised measures of health benefits and providing appropriate support for patients and health care staff. Adoption could be improved by better promotion of the intervention among stakeholders and development of joint procedures. Implementation could be improved through the development of an agreed protocol, staff training and introducing measurements of costs. Maintenance could be improved by supporting all patients for long term engagement and measuring improvements to patients health. CONCLUSIONS Using the RE-AIM framework allowed for the examine of improving the reach, effectiveness, adoption, implementation and maintenance of using activity trackers to increase physical activity and reduce sedentary behaviour in adults diagnosed with type 2 diabetes.