IAI-CGM: A Novel Theoretical Framework for Internet of Things -Enabled Continuous Glucose Monitoring Adoption for Self-Empowerment Perspectives Among Saudi Patients with Type 1 Diabetes

Abstract

Background: The alarming surge in the occurrence of diabetes in Saudi Arabia has been primarily linked to the adoption of a "westernised" lifestyle, especially in dietary practices. Despite the existence of treatment facilities, projections indicate that diabetes will affect approximately 25% of Saudi Arabia's adult population by 2030. Addressing this worrying situation regarding type 1 diabetes mellitus (T1DM) requires a paradigm shift in health control dynamics. The emphasis is moving from relying solely on doctors and physicians to placing greater responsibility in the hands of patients. This shift implies that patients should possess enhanced knowledge and the means for self-empowerment over their diet and nutrition to address their health-related issues. This is where smart technology assumes significance, empowering patients to adopt self-care management roles with Internet of Things (IoT)- enabled devices. However, it is imperative that use of IoT-enabled continuous glucose monitoring (IoT-CGM) be implemented at diabetes primary care centres in order for this practice to be normalized among all patients in Saudi Arabia. It is challenging to accurately assess the current rate of smart technology adoption by patients and IoT integration in the Saudi healthcare sector. Patients’ IoT-CGM adoption may be caused by numerous factors, such as practical, technological, and user behaviour factors. The study seeks to gauge the extent to which Saudi Arabian patients with diabetes are ready to embrace IoT-CGM for self- empowerment. Aims and Objectives: The research aims to assess the readiness and willingness of primary diabetes care patients in Saudi Arabia to wear CGM devices, thereby allowing self-empowerment. This research examines the literature that represents the challenges and concerns influencing the adoption of IoT-CGM, taking into account the experiences of T1DM patients in the environment of Saudi Arabia. The theoretical framework of the adoption of IoT-CGM is based on the technology acceptance model (TAM). Consequently, a theoretical framework is proposed as intention to adopt internet of things-enabled continuous glucose monitoring (IAI-CGM) to assess the willingness of Saudi Arabian T1DM patients for self- empowerment. Methods: The quantitative primary data were collected from 873 T1DM patients in Saudi Arabia, aged at least 18 years old. Primary data were analysed using the research IAI-CGM framework. Next, the validity and reliability of instrument were measured after checking data normality in SPSS and then the hypotheses were analysed using structural equation modelling (SEM) in AMOS. In the following step, qualitative data were collected through 15 comprehensive semi-structured interviews to capture the viewpoints of T1DM patients. A thematic analysis was performed to explore themes grounded on the theoretical IAI-CGM framework to identify the significance of practical, technological, and user behaviour factors that influence the adoption intention of T1DM patients. Results: The results consolidate the critical factors into the proposed IAI-CGM framework, identifying the main elements crucial for the framework in the context of T1DM patients in Saudi Arabia. The comprehensive theoretical IAI-CGM framework, based on the TAM, was applied and extended to comprehend the factors affecting the intention to adopt IoT-CGM in the context of Saudi Arabia. The results indicate the significance of practical, technological, and user behaviour factors, both quantitatively and qualitatively. Conclusion: This study investigated the critical factors found in the theoretical IAI-CGM framework, such as practical, technological, and user behaviour factors, in the environment of Saudi Arabia. The research findings give valuable information regarding the willingness of Saudi Arabian T1DM patients to adopt IoT-CGM, which necessitates its integration into the Saudi healthcare system.