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

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.