Table 1.

Study Aim, Sample Size, Main Findings, and Limitations From 10 Final Studies Included in the Systematic Qualitative Literature Review.

Year	Authors	Study aim	Sample size	Main findings	Limitations
2020	Baptista et al.	Assessed user-experience of a self-management app for diabetes (My Diabetes Coach [MDC]) over 12 months to understand the daily needs, preferences and what influences engagement with the app.	19 adults with T2D	Self-management behavior can be improved by engaging with diabetes early-on following their diagnosis and providing diabetes education and self-management support (ie, via a digital app as a complement to clinical care).	Type 2 diabetes with less technology experience and who are less automous with self-management were under represented in this study.
2019	Dack et al.	Make transparent the development process and content of a successful digital self-management intervention for type 2 diabetes (HeLP-Diabetes) that is achieving the desired clinical outcomes as a road-map for others.	20 Adults with T2D	The importance of understanding and addressing the overall impact of a long-term condition (ie, type 2 diabetes) on a patient’s life and sense of self, and the impact this has on self-management when developing a digital health initiative.	Type 2 diabetes for whom self-management is a lower priority were under represented in this study.
2017	Klonoff and Kerr	To explain why 5 identified key barriers must first be overcome in order to facilite widespread adoption of digital health initiatives for type 2 diabetes.	Observational / author’s opinions	Digital health initiatives are more likely to be adopted if developers can show usability, effectiveness, safety, sound design, and attention to the needs of diabetes.	There needs to be more of an evidence base with digital health initiatives to demonstrate safety, security, effectiveness and data privacy.
2020	Larbi et al.	To determine how digital health interventions are evaluated and whether type 2 diabetes are involved in these evaluations.	31 studies included in systematic review	The most evaluated criteria for digital health initiatives were cognitive impact, clinical impact, and usability. Evidence showed involving type 2 diabetes in the evaluation process has a positive impact on self-management and engagement.	The search for studies covered a short period (2015-2018).
2021	Mellergard	To explore type 2 diabetes needs, views and barriers toward self-management in order to influence the development of digital health initiatives.	22 Adults with T2D	Type 2 diabetes confirmed their need for accessible, relevant and reliable educational information as influential on their level of engagement with a digital health initiative. The need for emotional support and individualized feedback was also important.	There was no researcher triangulation—only one researcher was involved. Two or more would have been beneficial.
2018	Pal et al.	Explore unmet type 2 diabetes needs for support and self-management, and the role of digital health initiatives in meeting these needs.	20 Adults with T2D	A diabetes diagnosis is a significant burden, which has negative impacts on a partient’s emotional well-being, physical health, social life and work. This emphased the importance of ensuring digital health intiatives address emotional needs in addition to medical needs.	People with lower health literacy and from other cultures were not explored in this study.
2020	Turnbull et al.	Understand why type 2 diabetes use digital health initiatives and how experiences vary.	21 Adults with T2D	Type 2 diabetes used digital health interventions to help them understand and feel more in control of their bodies, by avoiding stigma and by becoming experts in their disease and/or treatment.	The participant sample was predominantly white and well educated.
2021	Turnbull et al.	Understand how type 2 diabetes use digital health initiatives and how experiences differ between individuals and social groups.	21 Adults with T2D	Type 2 diabetes confirmed their healthcare practitioners were not a good source for digital health initiative recommendations or information. Participants relied on their social networks and digital skills instead.	The participant sample was predominantly white and well educated.
2020	Van Rhoon	Which digital health initiatives were effective with achieving clinically significant weight loss and why.	19 studies included in systematic review	The integration of digital features and specific behavior change techniques can optimize digital health initiatives (in this example, by achieving clinically significant weight loss).	There were fewer longer-term studies in this review than shorter-term.
2019	Yingling et al.	Determine the acceptability and feasibility of wearable sensors for type 2 diabetes Hispanics.	21 adults with T2D	Barriers to acceptability were identified (fear, trust, cost, calibration requirements and comfort) and highlighted preferences for both acceptability and feasibility.	The study was limited to a 7-day time frame and specific population (Hispanic).