Leveraging User-Centered Design and Usability and Skills Testing for a Novel Diabetes Survival Skills Toolkit.

Purpose: With the expansion of telemedicine, patient-centered approaches for delivering diabetes mellitus (DM) self-care education in both in-person and remote settings are needed. A novel Diabetes Survival Skills Toolkit (Kit) (physical toolkit, website, paper guide) was developed, using a user-centered design approach. The aim of this study was to develop a hybrid protocol to assess the perceived usability of the Kit and the skills attainment of its users. Methods: Adults without prior exposure to DM self-care were recruited. User tests were conducted between January 2021 and July 2022. Initially, the usability of the website alone was tested. Then, usability and skills attainment tests were conducted with all 3 components delivered together. Usability was measured by the System Usability Scale (SUS) and skills attainment was measured thorough simulated insulin injection and lancing device use. Results: User tests (N = 43) were conducted remotely (27/43; 63%) and in-person (16/43; 37%). SUS scores were largely excellent (35%) or acceptable (47%). Users who completed skills attainment testing (N = 32) all successfully injected insulin with simulation supplies. However, SUS scores and skills attainment were poorly correlated: users with unacceptable SUS scores (4/32, 13%) successfully attained the tested skills, while 2 of the 3 users who did not demonstrate successful lancing device use had excellent SUS scores. Conclusion: Hybrid user testing of a multi-component Kit to teach DM survival skills showed high skills attainment among adult users new to DM self-care. Pairing usability and skills attainment testing can help optimize the design of DM education interventions.