Aim: The overall aim of this thesis was to examine currently available evidence on selected digital health technology (DHT) for diabetes self-care support, explore people's experiences with their use for diabetes self-care, and identify relationships between DHT use and psychosocial self-efficacy, eHealth literacy, and other selected variables among adults with type 1 diabetes (T1D).

Methods: In this thesis, an integrative review methodology, along with cross-sectional and qualitative designs, was used to explore perspectives on DHT support for diabetes self-care. The population in focus in all four studies was adults (≥ 18years) with T1D. Outcome measures examined features of mobile health applications (mHealth apps) that promote diabetes self-care, factors affecting mHealth app use in diabetes self-care, reported changes in PROMs in literature, psychosocial self-efficacy, eHealth literacy, and experiences with using DHT for diabetes self-care. 

Main results: The integrative review was inconclusive due to the limited number and heterogeneity of studies reporting on perceptions of mHealth apps. Higher psychosocial self-efficacy was associated with higher well-being and lower HbA1c. Higher eHealth literacy was associated with younger age, higher psychosocial self-efficacy, and lower HbA1c. Using DHTs in diabetes self-care was experienced as empowering yet exasperating.

Conclusion: This thesis showed the importance of measuring psychosocial self-efficacy and eHealth literacy among adults with T1D using DHTs. People described feeling empowered by DHTs. However, there is a need for measures to support people facing exasperating experiences while using DHTs. This is important in improving DHT use and glucose control in this population. This thesis indicates a need for further research in this area.

Type 1 diabetes is a chronic illness, and diabetes self-care measures play a crucial role in disease management. Well-designed digital health technologies (DHTs) can support diabetes self-care, however, their use can be challenging. This thesis explores perspectives on DHT support for diabetes self-care among adults with type 1 diabetes. 

In this thesis, higher psychosocial self-efficacy has been associated with higher well-being scores and better glucose control. In addition, younger age, higher psychosocial self-efficacy, and better glucose control have been associated with higher eHealth literacy. Participants experienced DHTs in diabetes self-care as empowering yet exasperating. The exasperating experiences may contribute to digital health inequities and are therefore important to address. This thesis showed the importance of measuring psychosocial self-efficacy and eHealth literacy among adults with type 1 diabetes using DHTs. More studies in this area among adults with type 1 diabetes is required.