ArticleJMIR diabetes2026
Bridging the Digital Divide in Diabetes Care With an AI-Powered Health Coaching Intervention: Qualitative Formative Study.
Article in JMIR diabetes, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05344859 (A Feasibility and Pilot Trial of Gamification and AI-based Health Coaching Intervention Components for Diabetes Management Using the GODART Platform), which is not on this map. Not yet cited in PubMed.
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A Feasibility and Pilot Trial of Gamification and AI-based Health Coaching Intervention Components for Diabetes Management Using the GODART Platform
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5 authors.
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Abstract
Background: Despite advancements in digital health coaching (DHC) for type 2 diabetes self-management, a persistent digital divide limits access among underserved populations, necessitating low-tech, telephone-based alternatives. Objective: This formative qualitative study explored the lived experiences of type 2 diabetes mellitus (T2DM) self-management challenges among adults in Alabama and elicited preferences for telephone-based DHC to inform intervention optimization. Methods: This study was part of a larger National Institutes of Health clinical trial (5R01DK129378) that examined the feasibility and needs of a telephone-based DHC intervention for self-management of T2DM. The study employed a qualitative, phenomenological approach to assess patients' needs surrounding digital coaching. Twelve patients diagnosed with T2DM were recruited between August and December 2022. Data collection involved in-depth, semistructured interviews conducted via telephone calls or secure Zoom sessions. All interviews were audio-recorded, professionally transcribed, and verified for accuracy. Two independent coders analyzed the data using NVivo software version 14 Plus. Results: Two themes emerged: (1) multifaceted barriers to diabetes self-management spanning behavioral (dietary adherence and nutritional gaps), physical/environmental (mobility limitations and weather constraints), and structural domains (medication shortages, insurance coverage limiting continuous glucose monitoring); (2) expectations for telephone-based DHC, including targeted education (meal planning, exercise adaptations, and medication effects), health coaches as accountability partners, daily reminders and check-ins via texts/calls, and incentives as extrinsic motivators to adherence. Insights from the study directly shaped the intervention components of a pilot feasibility trial (NCT05344859). Conclusions: Key challenges in day-to-day T2DM management included diet, physical activity, medication unavailability, and lack of insurance coverage for continuous glucose monitors. Expectations for a potential telephone-based DHC intervention included targeted education on diet, exercise, and medication effects; perceptions of health coaches as accountability partners; reminders via texts/calls as beneficial; and monetary incentives as extrinsic motivators for adherence to the intervention.
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