Table 9.

Participant focus group results.

Focus Group Theme	Participant Quote
Health Coaching Intervention
Knowledge—Impact on understanding of peripheral neuropathy, foot monitoring and care.	“It (health coaching intervention) certainly made us more aware of our feet…and I would say, I’m washing now, I get the mirror and have a look to see if there’s any ulcers. Just a simple thing like that. I hadn’t thought of it. But I do it now.” P1a. “I knew nothing about my feet ‘till (the) podiatrist explained it to me.” P2a “Well, it was probably a revelation to the problems that can occur that I wasn’t aware of—that you had to keep checking your feet, because ulcers and stuff just crop up out of nowhere. I didn’t have a full understanding of the situation until I spoke to the podiatrist…It (health coaching session) was more specific…where before it was just general foot care. Now all of a sudden…the balls been thrown in our court and it’s saying, ‘you’ve got to dry between your toes, you’ve got to use cream, have a look for ulcers.’ So now I’m doing that where I wasn’t previously.” P3a “I think this time it was more in-depth. So before even if the other podiatrist would have told you something. It was just general. This time it was specific…It explained what could happen… if you don’t take really good care of your feet…It was really more informative than it had been before.” P4a “I’m fairly comfortable with where I’m at. It (health coaching in foot monitoring) probably reinforced what I already know.” P1b “I knew a fair bit of that (nature of peripheral neuropathy) before hand.” P2b “It (health coaching session) confirmed that what I was doing was correct. Because I had already had two situations where I had ulcers on my toes.” P2b “I found I was doing pretty well everything anyway, just as a matter of course.” P3b
Knowledge—Smart insole usage explanation	“…there was more than enough information to do the test (trial of insole) without any problems.” P1a “Yeah…there were no problems (understanding how to use the insole).” P3a “I didn’t have any problems of understanding what we had to do (to use the smart insole).” P1b” “Yeah, that (smart insole instruction) was fine.” P3b “The only thing I would do differently…about the training… would be to change (the insole into different shoes). I wore the same shoes because the innersole was in these shoes…rather than taking them out and putting them in other shoes.” P2b
Knowledge—Smart insole written information	“That (laminated response to alerts guide) was probably the most crucial! …I would have been lost without it.” P1a “(A quick reference trouble shooting guide)…would have been a good thing to have…troubleshooting charts would have been more helpful (than a booklet).” P3a “At that time, I really think that the booklet should have had more information in it and written more simply and explain it more the use and what could go wrong.” P4a “I read it (SurroSense Rx written information) when I went home, and just reinforced it.” P1b “I don’t reckon I even looked at it (written smart insole information). (The smart insoles) function(ed) properly…and what they (the podiatrist) said was going to happen happened.” P2b “It (instructions on resetting insole sensitivity) was augmented by the book.” P3b
Podiatrist communication style during health coaching intervention	“I couldn’t fault his (podiatrists’) approach…he’s made himself very available if there was any problems.” P1b “I felt, (the podiatrist went to) quite great lengths to make sure that what he was saying was got through and with this particular issue…to calm me down, and then another way to make sure that I was dealing with it. Well, that was well done.” P3b
Performance Expectancy	“I thought it would be a very good diagnostic tool for a podiatrist…But I don’t see how I’d use it personally. Unless, as you say you had ulcers and then you’re getting renewed ulcers…” P3a “…it’s got to be more user friendly, more discreet, and I felt that the sole was too thin, and needs to be more of a comfort sole built that you can put in any shoe quickly. And the recharging system needs to be a lot easier…” P3a “Just how specific do we know it is? Has it been proven that it works correctly?” P3a “I really felt it (smart insole) made me more aware of how I position my feet. It went off mostly when I was sitting down, and I thought how can it go off sitting down? And then I realized…when I sit down, I…put pressure on my toes…and so now I try not to do that. ” P4a “Well mine alerted a lot, but it didn’t show me anything… There were no surprises in what it alerted to. But I suppose the frustrating thing for me was that…it could alert and I could change things but…It (pressure) would go back, it goes back to that anyway.” P1b “I don’t mind about the alarms…(but) I found that watch cumbersome to wear…” P1b “I think it (smart insole) was beneficial for me because it alerted me and when it alerts me, I change it.” P2b “I think though there’s value there (in a smart insole). In my case it would show up (pressure)…before I was aware of…changes that…would cause long term problems.” P3b
Trust	“I believed that the pressure was on my feet…big toe area mainly come up…” P2a “it (smart insole) was good in the fact that it was actually showing you whether it was the heel or the toe. And it (pressure) was (caused by) the way I was…sitting.” P2b “You’d be just sitting there and they’d (smart insoles) go off, like you’ve got pressure on the foot. I’m thinking how can I when I’m sitting down? So, I never had a lot of confidence in what it was supplying.” P3a “I think that it didn’t work properly…because… the pressure…wasn’t there for that long…to give me an alarm…I was supposed to go and put my feet up. I didn’t do that.” P4a
Effort Expectancy	“Well, I thought it was all easy to use. I had no complicating factors. I did have to change mine into another pair of shoes on the second day. And that was easy…It was probably time consuming…You just couldn’t (get out of) bed and put shoes on…You had to…get connected to the world…so that was time consuming.” P1b “There was nothing difficult. It (smart insole) was annoying at times, but nothing difficult…connecting it was quite easy, provided that it stayed together (alluding to occasions when transmission pod came unglued).” P2b The daily routine (was easy). The charging of it (smart insole) and that sort of thing and connecting from it.” P3b
Insole faults and technical issues	“Well I tried resetting it (sensitivity)…(but) no matter what you do, that alarm will go off.” P1a “…one of them (smart insole) stopped completely…there was a slight crimping of the sole which had caused some connections in there to malfunction…” P3b “It’s not soldier proof.” P1a “Once in a while when you try to connect them and only one blue light comes on, and the other is red. And you have to start again, and again. And it does that three or four times you get really sick of it at the end.” P4a
Intrusiveness	“I initially started making notes on when it went off, what the actions were. And after an hour, I gave up. You know, I’d be using a ream of paper a day, just trying to keep on track with it.” P1a “…when you’re driving…your buzzer going off—there’s pressure on your feet. Well you just can’t pull up anywhere, get out and walk around for 20 min or 10 min.” P2a “At one stage I put them in my shooting shoes. I shoot competitively on the weekend. Well, I’m about to take a shot and this is going buzz, buzz, buzz putting me off. So, I had to stop wearing it on the weekend…I found that interfering with everyday routine and things that you were doing…” P3a “It was a nuisance because it went off. Every time I was trying to prepare dinner, standing up maybe, every time I was hanging out the clothes, and it went off in the car. So maybe it was too sensitive.” P4a
Social Influence	“The watch was a nuisance with the audible alarm. I was alone in the hotel having a beer and it went off and half the people were jumping over the bar thinking there was a bomb. It frightened the blooming life out of them. They didn’t know what it was.” P1a “It (smart insole) has to be more user friendly, so it doesn’t have components on top of me shoes like I’m walking out there like I’m Santa Claus with lights going off, and blokes going—‘what are those things?’…It’s got to be…more discreet.” P3a
Facilitating Conditions—patient centred
Footwear	“Well, we weren’t given a time limit on it (how many hours a day to wear the smart insole), but (as) soon as I get home the first thing that goes is the shoes and the thongs come out, you know…(However) I thought, Oh, yeah, I better wear them until tonight anyway. So, I was over wearing what I normally would.” P3a
Behavioural Intention to adopt smart insole	“The technology definitely needs work. Particularly…with the pressurisation and the alarms, you know, they’re gonna decide what’s an alarm…” P1a “…it may do a great job in the future…with more development. But at the moment, I just don’t think it’s there” P3a “as it is now, I wouldn’t wear it. I found it too annoying. But if you could improve that…” P4a “I don’t think it (smart insole) would solve the problem that I’ve got. Maybe further down the track it might. But I need to do a lot of other things before I do something like that.” P1b “I wouldn’t want to be using it every day! Modify it to make it stronger, so it wouldn’t come apart. Having the top thing…smaller in size, so it isn’t so obvious, or not there at all (might change participant’s mind about adopting a smart insole in the future).” P2b “I think…there’s value there…if there is something going wrong in the feet then I’d like an early warning. And if that’s (smart insole) a way of doing it then fine.” P3b
Attitude towards trialling other forms of electronic foot monitoring devices	“Well personally, more broadly. I would love to see technology that can give you really good feedback… I think yes. In the future technology (participant would consider adoption)” P3a “Yeah, that (smart sock) could be good.” P3b “I can’t find a decent pair of socks—so (smart socks) would be good!” P2b

Identifier convention: ‘P’ refers to participant, the numeral denotes the order in which each participant first spoke during the focus group, ‘a’ denotes the private arm focus group and ‘b’ denotes the public arm focus group.