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Developing a Smart Sensing Sock to Prevent Diabetic Foot Ulcers: Qualitative Focus Group and Interview Study.

Jenny Corser1, Irantzu Yoldi2, Neil D Reeves3

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Summary

A smart sensing sock shows promise for diabetic foot ulcer prevention. Patient and provider feedback highlights the need for integrated interventions and clear guidance to ensure effective long-term use and improved self-care.

Keywords:
behavior changediabetesdiabetic foot ulcerdiabetic neuropathyhealth technologypodiatryprevention

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Area of Science:

  • Biomedical Engineering
  • Digital Health Interventions
  • Diabetic Foot Care

Background:

  • Diabetic foot ulcers (DFUs) are a significant, preventable complication of diabetes, imposing substantial healthcare costs.
  • Current self-care interventions are limited, and emerging technologies often lack patient and provider input in their design.

Purpose of the Study:

  • To explore patient and healthcare provider perspectives on a smart sensing sock designed to detect shear strain and promote behavioral changes.
  • To identify factors influencing the adoption and sustained engagement with the device for diabetic foot self-care.

Main Methods:

  • Qualitative study employing semistructured interviews with patients (n=20) with diabetic neuropathy and podiatrists (n=6), alongside a participant advisory group.
  • Data collection included interviews (in-person, phone, video call) and a virtual focus group, followed by thematic analysis.

Main Results:

  • Key themes identified barriers to sock adoption: patient buy-in (lack of risk awareness), effective engagement (information processing), and sustained use (coping difficulties).
  • Potential solutions include using device data for clinical messaging, providing simple, supportive instructions, and leveraging the early warning system for user control.

Conclusions:

  • The smart sock concept is of interest but requires integration into a broader health intervention for successful uptake and engagement.
  • Recommendations include refining feedback messages, instructions, and supporting healthcare providers in integrating smart devices into practice for better diabetic foot care outcomes.