Assessing the Behaviour Change Potential of Diabetes Self-Management Apps in Saudi Arabia Using the App Behaviour Change Scale (ABACUS)

Abstract

Background: Diabetes affects approximately 23% of adults in Saudi Arabia, yet the behaviour change potential of diabetes self-management apps available in the Saudi market remains largely unexamined despite near-universal smartphone and internet access in the population. Objective: This study aimed to evaluate diabetes self-management mobile applications available in the Saudi Arabian Apple App Store and Google Play Store. Specifically, it evaluated behaviour change features using the App Behaviour Change Scale (ABACUS) and described application characteristics including language support, accessibility features, privacy policy availability, diabetes type support, advertising presence, data input functions and self-monitoring capabilities. Methods: A cross-sectional descriptive content analysis was conducted in December 2025. Apps were identified through keyword searches in English and Arabic, screened against predefined eligibility criteria, and evaluated through direct use. Each app was assessed for general characteristics, self-monitoring features, accessibility, privacy practices, and behaviour change potential across the four ABACUS domains: Knowledge and Information, Goals and Planning, Feedback and Monitoring, and Actions. Results: A total of 103 apps met the inclusion criteria. English was the dominant language, with 92.2% of apps offering no Arabic support. Accessibility features were minimal across the sample. Blood glucose logging was universal, while nutrition and medication features were inconsistently implemented. Most apps (65%) did not specify a target diabetes type. The mean ABACUS score was 6.29 out of 21 (SD 2.63). Feedback and Monitoring was the strongest domain (mean 2.08), while Goals and Planning was the weakest (mean 0.73) . Conclusion: Diabetes self-management apps available in Saudi Arabia demonstrate limited linguistic inclusivity, inconsistent coverage of self-monitoring, and low potential for behaviour change. Future development should prioritise Arabic language support, accessibility, and stronger integration of goal-setting and action-planning techniques to better serve the Saudi population.