Digital Health Solutions for Type 2 Diabetes and Prediabetes: Systematic Review of Engagement Barriers, Facilitators, and Outcomes
Notice bibliographique
Résumé
Background: Digital health interventions, including artificial intelligence (AI)-driven solutions, offer promise for type 2 diabetes mellitus (T2DM) and prediabetes management through enhanced self-management, adherence, and personalization. However, engagement challenges and barriers, particularly among young adults and diverse populations, persist. Existing reviews emphasize clinical outcomes while neglecting engagement factors crucial to intervention success. This review highlights engagement barriers and facilitators, offering insights into improving digital health solutions for diabetes management. Objective: The objective of this systematic literature review is to explore the barriers, facilitators, and outcomes of digital health interventions, focusing on the current state of AI applications while including partial AI and non-AI interventions, for managing and preventing T2DM and prediabetes, to inform the development of user-centered, inclusive digital health interventions for diabetes care. Unlike prior reviews, this review aims to inform the development of user-centered, inclusive digital health interventions for diabetes care, with a focus on engagement across various AI interventions and diverse populations. Methods: A systematic search of PubMed, Scopus, CINAHL, and additional sources was conducted for studies published between January 2016 and October 2025. Eligibility criteria included English-language, peer-reviewed studies focused on digital health interventions for adults with T2DM or prediabetes, reporting engagement, barriers, facilitators, or outcomes. Data were synthesized narratively using thematic analysis, guided by self-determination theory and user-centered design. Quality appraisal was conducted using Critical Appraisal Skills Program, Mixed Methods Appraisal Tool, and AMSTAR-2 tools. Results: From the 37 studies (14 quantitative, 3 qualitative, 7 mixed-methods, and 13 reviews), interventions comprised 19 AI-driven (eg, chatbots, ML models, and conversational agent or hybrid), 3 partially AI-driven, and 15 non-AI solutions (eg, apps and lifestyle programs), mostly from the USA (n=15). Key barriers to engagement included inadequate personalization (15/37, 41%), environmental constraints (11/37, 11%), cultural and language mismatches (14/37, 38%), and AI-specific concerns (eg, bias and privacy). Facilitators included personalized feedback (19/37, 51%), cultural tailoring (17/37, 46%), user-friendly design, and peer support. AI-driven interventions demonstrated moderate improvements in clinical outcomes (eg, lowering HbA1c, weight loss, and normoglycemia conversion). However, these tools often struggled with keeping users involved and building trust. Non-AI solutions performed similarly but lacked adaptive features. Conclusions: This review offers novel insights by synthesizing engagement barriers and facilitators across AI and non-AI intervention domains, often neglected in previous studies. It highlights the necessity for testing adaptive, culturally tailored, and user-centered AI interventions to address engagement challenges in T2DM and prediabetes management. Integrating personalization, precision, and value-based care can improve outcomes and scalability. The findings guide the creation of inclusive, AI-driven solutions aligned with self-determination theory and user-centered design principles.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».