Trust Building for Optimal Adoption of Digital Healthcare Technologies for Diabetes Management: Qualitative Analysis

Trust building is essential for effective healthcare, including care delivered using digital health technologies (DHTs). This analysis aimed to develop an understanding of the mechanisms of trust building in relation to DHTs for diabetes using tracking and measuring tools.

This was a multimethod qualitative analysis conducted in Germany, Spain, and the United States, using a behavioral science approach. Interviews were conducted with different groups of participants from June 2022 to August 2022. The interviews consisted of one-on-one interviews (90 min) with experts in the diabetes support system, online dyad interviews (120 min), and online homework (120 min) with adults with type 2 diabetes (T2D) with different mind states (struggling, juggling, and controlling) and their caregivers. Focus group discussions were conducted with healthcare professionals (HCPs; each 150 min), including general physicians, specialists, and nurses, representing a conservative or innovator persona.

Nine interviews were conducted with experts (n=9), 28 dyad interviews were conducted with people with T2D (n=38) and caregivers (n=18), and 15 focus group discussions were conducted with 59 HCPs. Building trust in DHTs appeared to be created differently from building trust in medications, and requires activating, motivating, and sustaining desired behavior change. DHT trust builds systematically in three levels: trust in individual's own role in diabetes management (self-efficacy), trust in data as a tool to create empowerment, and trust in viability of sustained behavior change.

People who had built trust on all three levels felt in control of their diabetes and were motivated and engaged in DHTs. Focus on trust building is important for digital healthcare launch strategies, particularly in user conversion from consideration phase to actual initiation of use of DHTs.