Exploring the Usability and Acceptability of a Well-Being App for Adolescents Living with Type 1 Diabetes: A Qualitative Study (Preprint)

Background: Adolescents living with either type 1 diabetes (T1D) or type 2 diabetes (T2D) have an increased risk of psychological disorders due to the demands of managing a chronic illness and the challenges of adolescence. Psychological disorders during adolescence increase the risk of suboptimal glycaemic outcomes and may lead to serious diabetes-related complications. Research shows digital health interventions may increase both access to psychological support for adolescents as well as improving physical and mental health outcomes for youth with diabetes. To our knowledge there are no evidence-based, publicly available mental health apps with a focus on improving psychological well-being in adolescents with diabetes. Objective: To explore the acceptability and usability of our evidence-based well-being app for New Zealand adolescents ‘Whitu: 7 Ways in 7 Days’ (Whitu), to allow us to further tailor it for youth with diabetes. We interviewed adolescents with T1D and T2D, their parents, and healthcare professionals to explore their views on the Whitu app and suggestions for tailoring the app for adolescent with diabetes. We also explored the cultural acceptability of the Whitu app for M?ori and Pacific adolescents. Methods: Thirty-four participants, comprising 13 adolescents aged 12-16 years (11 with T1D and 2 with T2D), 10 parents, and 11 healthcare professionals were recruited from a specialist diabetes outpatient clinic and Facebook diabetes groups. Each participant attended one 1-hour focus group on Zoom, in person, or via phone. Researchers gathered general feedback on what makes