| dc.description.abstract | Diabetes is costly and a leading cause of death and disability in the United States (CDC, 2015). There is no known cure for the disease, however, it can be managed and controlled through self-management. This process involves patients managing a complex set of distinct but related tasks including, but not limited to, monitoring health conditions, tracking medication dosages, food intake, physical activities, complying with treatment regimens, and solving problems that may arise due to illness (Clark et al., 1991; Hill-Briggs, 2003). In recent years, mobile apps and devices (henceforth labeled mobile technologies) have emerged as a promising means to help diabetics manage their conditions. While the number and variety of mobile apps and devices for diabetes self-management continue to rise, their role and effectiveness in helping diabetics self-manage their conditions are relatively unknown (Caburnay et al., 2015; Eng and Lee, 2013). The following dissertation, comprised of three essays, aims at supplying the research with answers by investigating the role of mobile technologies in diabetes self-management. To assist, technology affordances (Gibson, 1986), the self-regulation model of illness representation (Leventhal et al., 2003; 2008), and the self-care behavior framework as advocated by the American Association of Diabetes Educators (AADE7, 2010) act as theoretical foundations. The purpose of this dissertation is to advance the concept of technology affordances in the field of diabetes self-management using mobile technologies. In the first essay, we report on the development and validation of an instrument to measure Perceived and Realized Affordances of Mobile Technologies for Diabetes Self- Management (AMTDS) with a nomological network. It is argued that mobile technology affordances play a significant role in influencing a patient's perception of the usefulness and ease of using mobile technologies for diabetes management. In the second essay, using the selfregulation model of illness representation and coping behavior, two models are developed. One for users and one for non-users of mobile technologies, where a patient's illness perceptions are shown to influence their intention to adopt and continue to use mobile technologies for diabetes management. In the third essay, a model of patient empowerment has been developed where technology affordances are theorized to influence patient empowerment, which in turn influences a patient's well-being. Survey methodology is utilized to collect data and empirically test the models in all the three papers. Relyng on the data collected from over 450 diabetes patients (200 non-users and over 250 users of mobile technologies), we test the hypothesized relationships. This research contributes to the literature by supplying a new instrument for measuring the affordances of mobile technologies for diabetes management. The insights from this study also contribute to the design and development of mobile technology while offering new insights into the role of affordances in influencing a diabetic's adoption and use of mobile technologies for diabetes management. All efforts are in support of inspiring others to further explore and measure the effects of technology affordances for other chronic illnesses. | |
