Relationship Between Digital Health App Engagement and Physical Activity Adherence in Adults With Type 2 Diabetes: A Correlational Study

Abstract

Background: Type 2 diabetes mellitus requires sustained self-management, and digital health applications are increasingly used to support behavioral monitoring, education, and lifestyle modification. However, evidence remains limited regarding the relationship between app usability and physical activity adherence in adults with established type 2 diabetes, particularly in clinical populations from lower-resource settings. Objective: To determine the relationship between digital health app usability and physical activity adherence in adults with type 2 diabetes mellitus. Methods: This descriptive correlational study included 42 adults with type 2 diabetes recruited through non-probability convenience sampling from diabetes and endocrinology clinics in Lahore, Pakistan. App usability was assessed using the mHealth App Usability Questionnaire, while physical activity adherence was measured using the International Physical Activity Questionnaire and expressed as total MET-minutes per week. Data were analyzed in SPSS version 27.0 using descriptive statistics, the Shapiro-Wilk test for normality, and Pearson correlation. Results: The mean age of participants was 54.38 ± 6.39 years, and 69.0% were female. Most participants had used digital health applications for 3-6 months (45.2%), and 78.6% were classified as moderately active. A statistically significant moderate positive correlation was observed between app usability and physical activity adherence (r = 0.564, p < 0.001), indicating that better perceived usability was associated with higher physical activity levels. Conclusion: Better usability of digital health applications was associated with greater physical activity adherence among adults with type 2 diabetes. These findings support the potential role of user-centered mobile health tools in diabetes self-management, although larger longitudinal studies using objective outcome measures are needed.