Co-designing a digital solution to help people manage their diabetes

According to Diabetes UK, 3.6 million people in the UK are diagnosed with type 2 diabetes. A further 13.6 million are at increased risk of developing the disease.

At the same time, it is becoming harder for patients to get the support they need to manage their condition. Digital solutions available on demand could go some way to making diabetes care and support more accessible.

ROMI (relational online motivational intervention) is a digital solution called a ‘conversational agent’. Patients with type 2 diabetes can talk to or text ROMI about their condition, using their phone, tablet or computer. ROMI will then send personalised advice to the patient. This can be delivered verbally, as a text or as a graphic.

Research shows that many users see conversational agents like ROMI as positive. This is because they are easy to use, accessible at any time and helpful. One of the great benefits of conversational agents is that they allow the user to speak naturally about their own issues.

Project aims

This project aims to co-develop a digital solution to help improve how those living with type 2 diabetes in underserved communities manage their condition. We will work with people who have type 2 diabetes, healthcare professionals, our industry partner’s technical team and experts in public and patient involvement (PPI) to co-design ROMI.

This approach puts users at the centre of our project and will give us a good understanding of the content they want ROMI to offer. Healthcare professionals will give us ideas on how to empower patients to be experts in their own self-management. We will test our solution during a feasibility trial and assess its clinical effectiveness during a formal randomised controlled trial.

What we’ve done so far

In 2022 we carried out three PPI workshops in Bristol. We did this to get a better understanding of why people may not be engaging with educational content about diabetes despite its potential to help them manage their condition better.

We discovered that lack of flexibility around the mode of delivery, especially the time pressures associated with face-to-face interventions, was a key issue. Difficulties with adapting general advice to personal circumstances was another key issue.

Patients and healthcare professionals were positive about our proposal to create a user-friendly, informative and supportive digital system delivered via a phone.

The team

The PPI team will be led by Professor Andy Gibson of the University of the West of England, a recognised national leader in the development of PPI methods.

Dr Michelle Griffiths will map the workshops into the COM-B behaviour change framework. She will do this to ensure we follow best practice from a health psychological perspective when developing this new digital solution. The COM-B model for behaviour change sees capability (C), opportunity (O), and motivation (M) as three factors that help us change our behaviour. Capability refers to a person’s ability to participate in an activity. Opportunity refers to external factors that make a behaviour possible. Motivation refers to the thought processes that direct and inspire behaviour.

Dr Duane Mellor is a double award-winning registered dietitian and science communicator. They are the Aston University Medical School lead for Nutrition and Evidence Based Medicine.

The conversational agent will be built by Elzware Ltd who have 20 plus years’ experience in building such systems. Rik Lander, on the Elzware team, is an expert in creating participatory media.