Brands, Dorthe

Droppers, Eline

Hietbrink, Eclaire Antoinette Gonnelien

Hijink, Manou

Koster, Arie

Logtenberg, Anouk

Meulman, Marlin

Middelweerd, Anouk

Schemkes, Lara

Welmers, Petra

English

Background: Health literacy forms the basis of the healthy lifestyle that is required in the management of type 2 diabetes (T2D). Many people with T2D have low health literacy (LHL), which means that they have difficulty obtaining, understanding, and applying health-related information. Therefore, this group has more difficulty maintaining a healthy lifestyle. Many existing (digital) lifestyle interventions are not accessible to people with LHL because those are not tailored to their needs. This study aimed to develop a lifestyle coaching intervention to support a healthy lifestyle in people with LHL and T2D.Methods: We followed a participatory design approach consisting of three phases. In the first phase, the needs for people with LHL were explored by identifying design principles for people with LHL from literature and conducting semi-structured interviews. Fourteen semi-structured interviews were conducted among nine people with LHL, four healthcare professionals and a language expert familiar with the target group. The identified design principles and needs were translated into a list of requirements. In the second phase, a first version of the intervention was developed based on the list of requirements. In the final phase, the intervention was evaluated in think-aloud sessions with a person with LHL and a language expert for people with LHL to assess the comprehensibility and applicability.Findings: Various design principles and needs emerged from the first phase regarding the mode of delivery of the intervention, the comprehensibility of the information and the applicability of the information. People with LHL would like to have the choice between digital (e.g. app) or non-digital (e.g. paper materials) coaching, so that people can choose which form of support suits them. It is important to consider the choice of words, the structure, the use of numbers, and the use of images in the design. To make lifestyle advice applicable, the advice must encourage concrete action with an explicit step-by-step plan. The development phase resulted in two products: an app and a magazine with information, advice and coaching regarding diabetes and lifestyle. Both products incorporate principles that increase the comprehensibility and applicability of the information, such as short sentences with key words in bold, supporting illustrations/videos, a text reading function (only in the app) and concrete instructions that encourage action. The main positive points from the evaluation were the reading function, the large font size, the supporting illustrations and that each sentence was placed on a new line. Some important points for improvement were that the chat function in the app and some recipes were too complex. Some small improvements have already been implemented in both products.Discussion: By involving people with LHL, healthcare professionals and experts in the development, many needs of people with LHL have already been translated into the products and concrete points for improvement have been formulated. Future work should focus on further development and evaluation with the target group and exploring ways in which the products can be implemented

University of Twente Research Information

Participatory Design of Lifestyle Coaching for People with Low Health Literacy and Type 2 Diabetes

https://ris.utwente.nl/ws/files/313147437/Abstract_book_SHBT_2023.pdf

Participatory Design of Lifestyle Coaching for People with Low Health Literacy and Type 2 Diabetes

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University of Twente Research Information