Appropriation of Mobile Health for Diabetes Self-Management: Lessons From Two Qualitative Studies.

BACKGROUND: To achieve clarity on mobile health's (mHealth's) potential in the diabetes context, it is necessary to understand potential users' needs and expectations, as well as the factors determining their mHealth use. Recently, a few studies have examined the user perspective in the mHealth context, but their explanatory value is constrained because of their limitation to adoption factors. OBJECTIVE: This paper uses the mobile phone appropriation model to examine how individuals with type 1 or type 2 diabetes integrate mobile technology into their everyday self-management. The study advances the field beyond mere usage metrics or the simple dichotomy of adoption versus rejection. METHODS: Data were gathered in 2 qualitative studies in Singapore and Germany, with 21 and 16 respondents, respectively. Conducting semistructured interviews, we asked respondents about their explicit use of diabetes-related apps, their general use of varied mobile technologies to manage their disease, and their daily practices of self-management. RESULTS: The analysis revealed that although some individuals with diabetes used dedicated diabetes apps, most used tools across the entire mobile-media spectrum, including lifestyle and messaging apps, traditional health information websites and forums. The material indicated general barriers to usage, including financial, technical, and temporal restrictions. CONCLUSIONS: In sum, we find that use patterns differ regarding users' evaluations, expectancies, and appropriation styles, which might explain the inconclusive picture of effects studies in the diabetes mHealth context.

Understanding tie strength in social networks using a local "bow tie" framework.

Understanding factors associated with tie strength in social networks is essential in a wide variety of settings. With the internet and cellular phones providing additional avenues of communication, measuring and inferring tie strength has become much more complex. We introduce the social bow tie framework, which consists of a focal tie and all actors connected to either or both of the two focal nodes on either side of the focal tie. We also define several intuitive and interpretable metrics that quantify properties of the bow tie which enable us to investigate associations between the strength of the "central" tie and properties of the bow tie. We combine the bow tie framework with machine learning to investigate what aspects of the bow tie are most predictive of tie strength in two very different types of social networks, a collection of medium-sized social networks from 75 rural villages in India and a nationwide call network of European mobile phone users. Our results show that tie strength depends not only on the properties of shared friends, but also on non-shared friends, those observable to only one person in the tie, hence introducing a fundamental asymmetry to social interaction.

Digital disparities and vulnerability: mobile phone use, information behaviour, and disaster preparedness in Southeast Asia.

This paper proposes an ecological view to investigate how disparities in mobile technology use reflect vulnerabilities in communities vis-à-vis disaster preparedness. Data (n=1,603) were collected through a multi-country survey conducted equally in rural and urban areas of Indonesia, Myanmar, Philippines, and Vietnam, where mobile technology has become a dominant and ubiquitous communication and information medium. The findings show that smartphone users' routinised use of mobile technology and their risk perception are significantly associated with disaster preparedness behaviour indirectly through disaster-related information sharing. In addition to disaster-specific social support, smartphone users' disaster-related information repertoires are another strong influencing factor. In contrast, non-smartphone users are likely to rely solely on receipt of disaster-specific social support as the motivator of disaster preparedness. The results also reveal demographic and rural-urban differences in disaster information behaviour and preparedness. Given the increasing shift from basic mobile phone models to smartphones, the theoretical and policy-oriented implications of digital disparities and vulnerability are discussed.