Thesis Open Access

Analysis of system usage and knowledge development of the current PAL system for children with Type 1 Diabetes Mellitus

Boelhouwer, Anika

Children who are diagnosed with type 1 diabetes mellitus need to learn a lot about diabetes and selfmanagement in a short period of time. A large problem in the support of this process is that health
institutions cannot provide help at any given moment in the child life and are bounded by set face to
face appointments. While digital interventions may address this issue by providing help and
knowledge online which may be used at all times, this help and knowledge is general and not tailored
to the individual. Also, actual usage of (digital) diabetes interventions has shown to be either
extremely low or quickly decreasing. The Personal Assistant for a healthy Lifestyle project (PAL)
strives to address these issues by providing a digital application with personalised communication and
content. This study evaluated the current PAL application during a prolonged period of time with
children diagnosed with type 1 diabetes mellitus between the ages of 6 and 12 years old. The main
goals were to identify trends and possible predictors for both system usage and diabetes knowledge
development. Three main trends were found in the system usage in which the majority of the users
showed an overall low usage or quickly decreasing usage. A small number of users showed
continuous and consistent usage throughout the entire experiment. As the personalisation was only
minimally implemented the results are in line with common (digital) diabetes interventions. The
results did not allow us to explore possible system usage and knowledge development predictors.
They do however provide a solid baseline for further versions of the system in which the
personalisation is further implemented. The main recommendations are to focus on the
implementation of basic game design elements and personalised content to foster user engagement
and continuous use. Maintaining the used measures (while adding some psychological predictors) and
longitudinal experiment design will allow for comparative analysis in the further research cycles.

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