Introduction
cardiac diseases, DM2
TYPE 2 DIABETES MELLITUS, CARDIAC DISEASES
Type 2 diabetes mellitus (DM2) is a leading cause of morbidity and mortality worldwide and is considered a global epidemic [Initiation and adherence to behavioral change is a complex process. In a previous randomized controlled trial (RCT), we found that long-term follow-up using an app to promote adherence to healthy behavior postcardiac rehabilitation (post-CR) was effective with regard to exercise capacity, exercise performance, exercise habits, and in self-perceived goal achievement [To be able to successfully initiate and adhere to behavioral change by using an app, it is necessary to consider the participants´ motivation for behavioral change as well as the participants’ motivation for using an app as an intervention (or as guidance) in the behavioral change process. In a previous qualitative study on post-CR patient´s experiences of using an app, we found that being followed by a real person and providing individualized feedback, most likely is the most significant success factor in promoting adherence to healthy behavior with an app [Importantly, but not surprisingly, the relationship between health personnel and the patients with DM2 have been shown to influence clinical outcomes [Based on the described experiences and the current existing knowledge base, more knowledge on efficacy of mHealth interventions in prevention of DM2 is needed. Hence, we developed the People Living Under change (Plunde) app, aiming to promote initiation of behavioral change and adherence to healthy behavior. Before commencing a full scale RCT evaluating the effect of this app on risk reduction in people at risk of DM2, we plan to conduct a small scale RCT feasibility study to evaluate whether the full scale RCT can be conducted in the way it is planned or whether it needs to be modified. However, as our experiences with using apps primarily is in patients with cardiac diseases and the fact that experiences and perspectives of the end users need to be implemented in the development and evaluation of apps [