Co-design of an evidence-based health education diabetes foot app to prevent serious foot complications: a feasibility study

Diabetes is the most common cause of non-traumatic amputations worldwide, and education is key to prevention. Mobile phones and applications (apps) are increasingly being used. This study co-designed and assessed whether a foot health education app would be feasible and acceptable to support people with diabetes (PWD) to prevent serious foot complications. A diabetes foot app was co-designed with PWD, experts, researchers and biomedical engineers following co-design principles. The app was piloted in a convenience sample of adults with diabetes from one community health service in metropolitan Melbourne for 12 weeks. Baseline quantitative data were collected on foot health, knowledge, self-care behaviours and attitudes. Qualitative data were collected post intervention to capture experiences of using the app, using interviews and focus groups. The co-designed app included information on amputation risk and self-care practices to prevent serious foot complications. The content used images and simple wording, focusing on early help-seeking behaviour. Forty participants with a mean age of 66.9±17.1 years were included in the pilot. Seven participants withdrew due to personal and health-related issues. Uptake of the app was low, with 18 participants using the app for any period of time. Qualitative interviews or focus groups were undertaken with 31 participants. Overall, the information was perceived as highly useful for newly-diagnosed PWD and worth pursuing. Future work is needed to identify which PWD would most benefit, and incorporate aspects relating to increased opportunity and motivation for behaviour change and a centralised data management system to provide updates.