User Centered Design to Improve Information Exchange in Diabetes Care Through eHealth : Results from a Small Scale Exploratory Study.

Heterogeneity of people with diabetes makes maintaining blood glucose control and achieving therapy adherence a challenge. It is fundamental that patients get actively involved in the management of the disease in their living environments. The objective of this paper is to evaluate the use and acceptance of a self-management system for diabetes developed with User Centered Design Principles in community settings. Persons with diabetes and health professionals were involved the design, development and evaluation of the self-management system; which comprised three iterative cycles: scenario definition, user archetype definition and system development. A comprehensive system was developed integrating modules for the management of blood glucose levels, medication, food intake habits, physical activity, diabetes education and messaging. The system was adapted for two types of principal users (personas): Type 1 Diabetes user and Type 2 Diabetes user. The system was evaluated by assessing the use, the compliance, the attractiveness and perceived usefulness in a multicenter randomized pilot study involving 20 patients and 24 treating professionals for a period of four weeks. Usage and compliance of the co-designed system was compared during the first and the last two weeks of the study, showing a significantly improved behaviour of patients towards the system for each of the modules. This resulted in a successful adoption by both type of personas. Only the medication module showed a significantly different use and compliance (p= 0.01) which can be explained by the different therapeutic course of the two types of diabetes. The involvement of patients to make their own decisions and choices form design stages was key for the adoption of a self-management system for diabetes.

Validation of the group tasks uncertainty model (MITAG) in a German sample.

Task uncertainty is a key factor in teamwork research. This study analyzed the psychometric characteristics of the Spanish Model of Group Tasks Uncertainty (MITAG) in two German samples. The participants (501 team members and 104 team leaders from a German research organization) answered the MITAG together with selected items from the German Job Diagnostic Survey (JDS) and the instrument Ambiguity facets of work (Ambiguitätsfacetten der Arbeit, AfA). Confirmatory factor analysis did not reproduce the original 4-factor structure in the German sample, although the 3 newly identified factors unclarity of goals, new situations, and non-routine resemble the original factors. Results showed sound internal consistency and confirmed the convergent and discriminant validity of the new factors. The MITAG offers a concept-based short scale for researchers and practitioners.

How and When Do Leaders Influence Employees' Well-Being? Moderated Mediation Models for Job Demands and Resources.

Following the call of recent reviews on leadership and well-being, the purpose of this study is to examine how and when two contrasting leadership styles, transformational leadership (TFL) and passive-avoidant leadership (PAL), are related to employees' anxiety and thereby either promote or inhibit employees' well-being. Using the prominent job demands-resources (JD-R) model as a theoretical framework, we propose that the relationship between leadership behavior and anxiety is mediated by organizational job demands, namely, role ambiguity (RA), and job resources, namely, team climate for learning (TCL), as well as moderated by autonomy as important job characteristic. A sample of 501 knowledge workers, working in teams in a German research and development (R&D) organization, answered an online survey. We tested moderated multiple mediation models using structural equation modeling (SEM). Results demonstrated that the relationships between TFL as well as PAL on the one hand and anxiety on the other hand were fully mediated by RA and TCL. Job autonomy moderated the quality of the leadership-job demand relationship for TFL and PAL. This paper contributes to understanding the complex relationship between leadership and followers' well-being taking into account a combination of mediating and moderating job demands and resources. This is the first study that examines the effects of TFL and PAL on well-being taking into account the job demand RA and team processes and autonomy as resources.

How Knowledge Worker Teams Deal Effectively with Task Uncertainty: The Impact of Transformational Leadership and Group Development.

The purpose of this paper is to clarify how leadership is able to improve team effectiveness, by means of its influence on group processes (i.e., increasing group development) and on the group task (i.e., decreasing task uncertainty). Four hundred and eight members of 107 teams in a German research and development (R&D) organization completed a web-based survey; they provided measures of transformational leadership, group development, 2 aspects of task uncertainty, task interdependence, and team effectiveness. In 54 of these teams, the leaders answered a web-based survey on team effectiveness. We tested the model with the data from team members, using structural equations modeling. Group development and a task uncertainty measurement that refers to unstable demands from outside the team partially mediate the effect of transformational leadership on team effectiveness in R&D organizations (p < 0.05). Although transformational leaders reduce unclarity of goals (p < 0.05), this seems not to contribute to team effectiveness. The data provided by the leaders was used to assess common source bias, which did not affect the interpretability of the results. Limitations include cross-sectional data and a lower than expected variance of task uncertainty across different job types. This paper contributes to understanding how knowledge worker teams deal effectively with task uncertainty and confirms the importance of group development in this context. This is the first study to examine the effects of transformational leadership and team processes on team effectiveness considering the task characteristics uncertainty and interdependence.

A user centered design approach for patient interfaces to a diabetes IT platform.

Improving patient self-management can have a greater impact than improving any clinical treatment (WHO). We propose here a systematic and comprehensive user centered design approach for delivering a technological platform for diabetes disease management. The system was developed under the METABO research project framework, involving patients from 3 different clinical centers in Parma, Modena and Madrid.