Evaluating the usability of Diactive-1: mHealth for personalized exercise and education in children and adolescents with type 1 diabetes.

Background: Managing physical activity alongside glucose levels is challenging for children and adolescents with type 1 diabetes mellitus (T1DM). This study aimed to evaluate the usability of the Diactive-1 app, which was designed to support muscle-strengthening training in children and adolescents with T1DM in accordance with guidelines from the International Society for Pediatric and Adolescent Diabetes (ISPAD) and the American Diabetes Association (ADA). Methods: Twenty-seven patients aged 8-18 years with T1DM were randomly selected. Recruitment was conducted through the Pediatric Endocrinology Unit of the University Hospital of Navarra (Spain). All participants were enrolled in a randomized controlled trial and used the Diactive-1 app during the intervention. The study lasted 24 weeks, during which the app provided personalized muscle-strengthening exercise sessions, glucose monitoring, and motivational features such as gamification. Usability of the app was assessed using the User Version of the Mobile Application Rating Scale (uMARS). Results: The Diactive-1 app demonstrated high usability, with an overall quality mean score of 4.33 [standard deviation (SD) =0.36] out of 5.00. uMARS objective domains ratings were: functionality [4.52 (SD =0.40)], aesthetics [4.43 (SD =0.45)], engagement [4.07 (SD =0.51)], information quality [4.29 (SD =0.75)], and subjective quality score was 3.94 (SD =0.61). Usability scores showed no meaningful variation across patient demographics, including sex, age, glycated hemoglobin, engagement in muscle-strengthening activities, and fear of hypoglycemia, suggesting consistent app performance among different user groups. Conclusions: The Diactive-1 app is a promising tool for integrating muscle-strengthening training and educating patients about safe physical exercise into the management of T1DM in children and adolescents. Its high usability and positive user feedback underscore its potential as an effective supportive strategy for managing the disease in this population. Further refinement of personalization features may enhance its effectiveness.