Engaging Black Men in Digital Health to Improve Self-Management of Type 2 Diabetes: An Iterative Participatory Design Approach

ABSTRACT
Helping patients self-manage a complex chronic illness such as Type 2 Diabetes (T2DM) remains a challenge
particularly for racial minorities especially for Black men, who experience higher rates of incidence and poorer
health outcomes. Diabetes requires stringent self-management and monitoring of blood glucose levels, weight,
medication adherence and lifestyle behaviors such as diet and exercise. Yet, Black men face more barriers to
diabetes self-management than non-Hispanic whites for a variety of reasons, including disparities in access
and delivery of care, communication and health literacy barriers, gender roles and, mistrust and cultural beliefs
regarding the medical system. Due to the ubiquity of smartphones and healthcare dashboards, digital
technologies can be leveraged across diverse populations to collect and monitor diabetes-related data from
patients in their daily environments (i.e., blood glucose, weight, medication adherence, and lifestyle behaviors).
These data can be analyzed and in near real-time to provide guidance to patients to self-manage and give
clinicians a more complete picture of health in-between clinic visits. However, research on digital health that
facilitates self-management among Black men with T2DM is scarce, particularly as it relates to how to
appropriately engage Black men with T2DM in use of digital health technologies to improve self-management.
While digital health holds great promise, we do not yet know how to develop technologies that are relevant and
tailored for Black men who need to self-manage their diabetes.
Congruent with the strategic plan of the National Institute of Nursing Research, which seeks to promote
innovations using technology to improve health and improve quality of life for individuals with chronic illness
through self-management, this study aims to fill a knowledge gap concerning Black men and how to effectively
tailor digital health technologies to facilitate T2DM management. The purpose of this study is to investigate the
barriers, facilitators, and preferences of using digital health technologies for T2DM self-management among
Black men. This qualitative study will employ focus groups to explore the perspectives of 40 Black men living
with T2DM in North Carolina. Further, we will employ an iterative participatory design approach to develop and
refine a healthcare dashboard that addresses specific racial/ethnic and gender-based needs and preferences.
This knowledge is essential for meeting the self-management needs of the growing population of Black men
with diabetes. The long-term goal of this study is to inform future research that will develop and test digital
health technologies to improve self-management that align with the racial/ethnic needs and gender-based
preferences of Black men living with T2DM.