The Adaptation, Usability, and Feasibility of a Mobile Health (mHealth) System to Improve Type 2 Diabetes Self-management in Thailand

It refers to glycated haemoglobin, which identifies average plasma glucose concentration.

It will be measured using the emotional and regimen subscales of a Thai translation of the well-validated Diabetes Distress Scale. This is a reliable and validated scale, and correlates with other measures of emotional distress. The responses range from 1-6. The higher scores indicate a greater degree of distress.

It refers to blood glucose levels after refraining eating or drinking for at least 8 hours.

It will be assessed using the same single item used during the IVR assessment, along with the PROMIS Sleep Disturbance-Short Form. The PROMIS (Patient-Report Outcomes Information System) Sleep Disturbance-Short Form is a 4-item self-report instrument covering the quality of sleep-wake functioning. Responses are scored on a 5-point Likert scale. The higher scores indicating a greater degree of sleep disturbance.

It will be assessed using the same single item used during the IVR assessment. The responses range from 0 to 7 (days).

It will be assessed using the Stanford Leisure-Time Activity Categorical Item (Kiernan et al., 2013), which consists of 6 descriptive categories ranging from inactive (1) to very active, almost daily physical activity (6).

It will be assessed using the same single item used during the IVR assessment. The responses range from 0 to 7 (days).

It will be assessed using a 7 items that ask about low blood sugar symptoms, the same that the study team describe in the IVR calls. The responses range from 0 (not at all) to 4 (6-7 days a week). The higher scores indicate a greater degree of hypoglycemic symptoms.

It will be assessed using the Patient Health Questionnaire-8 (PHQ-8) (Kroenke et al., 2009). It consists of 8 items with a 4-point Likert scale ranging from 0 (not at all) to 3 (nearly every day). Higher scores indicate greater depressive symptom severity.

It will be assessed using 5 items from our prior research that is specifically worded to measure participants'preparedness to change the 5 diabetes self-care behaviors that our program targets, which are answered using a 7-point Likert scale ranging from 1 (not at all) to 7 (very much so). Higher scores indicate greater readiness for change.

It will be assessed with the Self-Efficacy for Diabetes Scale (Ritter et al., 2016). The scale consists of 8 items with 10- point Likert scale ranging from 1 (not at all confident) to 10 (totally confident). Higher scores indicate greater self-efficacy.

It will be assessed using the Hill-Bone Compliance Scale (Kim et al., 2000), assesses how often patients miss taking medications, rated on a 4-point Likert scale ranging from 1(none of the time) to 4 (all of the time). In the study, only 8 items of Hill-Bone Compliance scale will be used. Reverse coded before analysis will be performed. Higher scores indicate greater medication adherence. In addition, 1-item of the Brief Medication Questionnaire will be used, which allows calculation of percent adherence over the past 2 weeks

It will be assessed using selected items from the Norbeck Social Support Questionnaire, which is a validated measure of number, type, and quality of relationships (Norbeck, 1983). For the purpose of this study, the 6 items (item 3-8) will be scored on a 5-point Likert scale ranging from 0 (not at all) to 4 (a great deal). Higher scores indicate better social support.

It will be assessed using the 3-item screener developed by Chew et al. for detecting probable inadequate health literacy (45, 46). Higher scores indicate better health literacy.

will be measured using the Client Satisfaction Questionnaire (CSQ-8) (Attkisson, Zwick, 1982), which assesses satisfaction with specific providers, settings, and time intervals, along with open-ended items (within the exit interview) adapted from prior mHealth research studies. Higher scores indicate greater satisfaction of the program.

It will be measured using Nurse Self-efficacy for Diabetes Care using 11 items developed for this study that correspond to patients' IVR content areas.