Stakeholder Perspectives on Implementing DiabeText: Exploring Barriers and Facilitators for a Personalized Diabetes Self-Management SMS Intervention in Spain.

Background/Objectives: Mobile health (mHealth) interventions can enhance chronic disease management, but their integration into public healthcare systems remains complex. DiabeText is the first SMS-based intervention in Spain delivering personalized diabetes self-management support using electronic...

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Published in:Diabetology Vol. 7; no. 1; pp. 17 - 33
Main Authors: Gervilla-García, Elena, García-Pazo, Patricia, Guillén-Solà, Mireia, Leguizamo, Federico, Ricci-Cabello, Ignacio, Serrano-Ripoll, María Jesús, Bennasar-Veny, Miquel, Fiol-deRoque, Maria Antònia, Angullo-Martínez, Escarlata, Zamanillo-Campos, Rocío
Format: research tables/charts Journal Article
Published: MDPI Jan2026
Online Access:View this record in EBSCOhost
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        atl: Stakeholder Perspectives on Implementing DiabeText: Exploring Barriers and Facilitators for a Personalized Diabetes Self-Management SMS Intervention in Spain.
      aug:
        au:
          Gervilla-García, Elena
          García-Pazo, Patricia
          Guillén-Solà, Mireia
          Leguizamo, Federico
          Ricci-Cabello, Ignacio
          Serrano-Ripoll, María Jesús
          Bennasar-Veny, Miquel
          Fiol-deRoque, Maria Antònia
          Angullo-Martínez, Escarlata
          Zamanillo-Campos, Rocío
        affil: Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
      sug:
        subj:
          Diabetes Mellitus Drug Therapy
          Individualized Medicine
          Self-Management
          Telemedicine
          Mobile Applications
          Text Messaging Methods
          Program Implementation Psychosocial Factors
          Public Health
          Implementation Science
          Physician Attitudes Evaluation
          Administrative Personnel Psychosocial Factors
          Information Technology Personnel Psychosocial Factors
          Human
          Funding Source
          Spain
          Qualitative Studies
          Diabetic Patients
          Disease Management
          Thematic Analysis
          Data Security
          Uncertainty
          Information Needs
          Computer Literacy
          Health Personnel Education
          Diffusion of Innovation
          Financial Support
          Health Literacy
          Workflow
          Physicians
          Male
          Female
          Nonprobability Sample
          Digital Health
          Purposive Sample
          Snowball Sample
          Semi-Structured Interview
          Data Analysis Software
          Patient Education
          Time
          Health Services Needs and Demand
          Patient Preference
          Empowerment
          Communication
          Medication Compliance
          Feedback
          Health Services Administration
          Diabetes Education
          Electronic Health Records
          Male
          Female
      ab: Background/Objectives: Mobile health (mHealth) interventions can enhance chronic disease management, but their integration into public healthcare systems remains complex. DiabeText is the first SMS-based intervention in Spain delivering personalized diabetes self-management support using electronic health record data. This study explored perceived barriers and facilitators to the implementation of DiabeText in the Spanish public health context from the perspective of key stakeholders. Methods: A qualitative study was conducted using semi-structured interviews with 14 purposively selected stakeholders involved in digital health, diabetes care, data protection, and healthcare management across several Spanish regions. Interviews were thematically analyzed using Braun and Clarke's approach and guided by the Implementation Research Logic Model. Results: Participants reported several barriers, including concerns regarding data protection, uncertainty about long-term sustainability, insufficient training and engagement of healthcare professionals and low digital literacy among certain patient groups. Facilitators included favorable institutional momentum for digital innovation, funding availability, perceived clinical utility and scalability of DiabeText, and growing patient familiarity with digital tools. Recommended strategies included integration into existing healthcare systems and workflows, professional training and use of familiar communication platforms. Conclusions: Effective implementation of DiabeText requires addressing regulatory, organizational, and equity-related barriers while leveraging institutional support and readiness for innovation. Early involvement of healthcare professionals, robust data governance, and investment in digital literacy are essential to ensure sustainable and equitable adoption. These findings provide actionable insights to support the integration of mHealth tools into chronic disease care in Spain and similar settings.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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