Developing an expanded version of My Diabetes Care in English and Spanish: A design and formative usability study

To expand the My Diabetes Care (MDC) patient portal intervention by enhancing its user interface to display additional diabetes health metrics and developing a culturally adapted Spanish-language version to improve accessibility for Spanish-speaking patients.

We applied a five-phase Design Sprint methodology and formative usability testing to guide the redesign of MDC. The expanded prototype incorporated additional health metrics (weight, BMI, and urine microalbumin) and educational resources. Usability testing was conducted remotely with 12 adult patients with type 2 diabetes recruited from primary care clinics. Participants completed standardized tasks using the MDC prototype and provided feedback via interviews and validated scales. A Community Engagement Studio (CES) with Spanish-speaking consultants informed cultural and linguistic adaptation of the Spanish-language prototype.

Twelve participants (50% female; 25% ≥65 years; 33% with limited health literacy) completed two rounds of formative usability testing. Iterative refinements addressed terminology and layout issues, improving task performance and usability. Task performance improved across rounds, with all participants successfully completing tasks in the final round. System Usability Scale scores averaged 92 in Round 1 and 95 in Round 2, indicating excellent usability. CES participants emphasized culturally sensitive language, visual design, and onboarding support, guiding the development of the Spanish-language prototype.

User-centered design and formative testing supported development of an expanded, culturally responsive MDC intervention. Future work will include iterative usability testing and pilot evaluation of the Spanish-language version to assess real-world usability and implementation alongside further English-language testing. MDC demonstrates potential as a scalable digital health intervention for supporting diabetes self-management across diverse populations.