The increased pervasiveness of ICT and increasing internet access create anticipation for how contemporary technologies can address critical developmental problems. Non-communicable diseases are the leading cause of death globally, even though more than 40% of the deaths are premature and avoidable (Zhao et al. 2016). Diabetes is a disease that causes 80% of non-communicable disease deaths in low and middle-income countries (World Health Organization, 2016). Diabetes is also the leading cause of death in the Western Cape province of South Africa (Statistics South Africa, 2016). 

Diabetes thus constitutes a challenge to achieve Sustainable Development Goal 3 which focuses on health and well-being for all people, of all ages. The potential of technology, such as the use of mobile health (m-health) applications, is recognised as a means to advance the Sustainable Development Goals by supporting health systems in all countries (United Nations, 2015). This can be accomplished by improving the accessibility, quality and affordability of health services. However, despite the potential of digital technologies, the use of m-health applications remains low (Petersen et al., 2019). 

I have suggested using positive deviance as an innovative approach. Positive deviance is “the observation that in most settings a few at-risk individuals follow uncommon, beneficial practices and consequently experience better outcomes than their neighbours who share similar risks” (Marsh et al., 2004:1177). This approach has been used successfully in areas of health, such as cases to improve nutritional status, newborn care, rates of contraception and safe sexual practices (Marsh et al., 2004). In addition, a positive deviance lens can be applied to explain why certain projects in public sector reforms, in developing countries, were successful while the majority were not. The author claims that the “Positive deviance approach has emerged as a way of identifying workable solutions to development’s toughest problems. It emphasizes the importance of learning from the positive deviants within the contexts where failure is more normal; and focuses especially on learning about the strategies adopted to find and fit effective solutions” (Andrews, 2015:198). 

The benefit of this approach is that it is a low-cost method of identifying beneficial strategies used by a few and then encouraging the rest of the community to adopt them (Marsh et al., 2004). Based on the literature reviewed, the preceding design considerations, and the notion of positive deviance, I have proposed a model as a foundation for a user-centred mobile health intervention. My model can be used as an extension of my research in future to assist with critical health challenges in chronic disease management. I have published in the Conversation as a means to make my PhD findings more accessible to a wider audience. 

In addition, I presented at the Western Cape Department of Health. I believe that my PhD uses diabetes as it is an area I care deeply about because I was diagnosed with juvenile-onset diabetes at the age of seven. I believe that my research should not only supply a piece of paper for my wall but should be making a difference in the lives of others. I used the meeting with the Department of Health to provide my PhD findings as well as practical recommendations that would not require significant funding to implement.

Journal articles

Petersen, F. (2024). Diabetic patients’ use of mobile applications for physical activity: An age comparison. Information Development. https://doi.org/10.1177/02666669231222927 

Jacobs-Basadien, M., Pather, S., Petersen, F. (2022) The role of culture in the adoption of mobile applications for the self-management of diabetes in low resourced urban communities. Universal Access in the Information Society journal.

https://trebuchet.public.springernature.app/get_content/d8e88f4b-0475-42e2-8596-a7e085bc3cbb

Petersen, F., Brown, A., Pather, S. and Tucker, W.D. (2019). Challenges for the adoption of ICT for diabetes self-management in South Africa. Electronic Journal of Information Systems in Developing Countries (EJISDC) https://onlinelibrary.wiley.com/doi/full/10.1002/isd2.12113

 Conference proceedings

Petersen, F. (2021). Impact of culture on the adoption of mobile diabetes applications. IFIP 9.4 Virtual Conference. 26 – 28 May 2021. https://arxiv.org/abs/2108.09953

​Petersen, F.; Baker, A.; Pather, S. and Tucker, W.D. (2020). Impact of socio-demographic factors on the acceptance of Information Communication and Technology (ICT) for diabetes self-care. In Conference on e-Business, e-Services and e-Society (pp. 73-83). Springer, Cham. https://link.springer.com/chapter/10.1007/978-3-030-45002-1_7

​Petersen, F.; Jacobs, M. and Pather, S. (2020). Barriers for User Acceptance of Mobile Health Applications for Diabetic Patients: Applying the UTAUT Model. In Conference on e-Business, e-Services and e-Society (pp. 61-72). Springer, Cham. https://link.springer.com/chapter/10.1007/978-3-030-45002-1_6

Petersen, F., Luckan, Z. and Pather, S. (2020). Impact of demographics on patients' acceptance of ICT for diabetes self-management: Applying the UTAUT model in low socio-economic areas. The 2020 International Conference on Information Communications Technology and Society (ICTAS) https://ieeexplore.ieee.org/document/9082459/

​Petersen, F.; Pather, S. and Tucker, W.D. (2018). A case for analysing user acceptance of ICT for diabetes self-management in the Western Cape, South Africa. Applying the UTAUT Model. African Conference on Information Systems & Technology (ACIST) conference https://www.researchgate.net/publication/326368952_User_acceptance_of_ICT_for_diabetes_self-management_in_the_Western_Cape_South_Africa

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Petersen, F.; Pather, S. and Tucker, W.D. (2017). A health informatics model for a user-centred design using a positive deviance approach: A case for diabetes self-management. African Conference on Information Systems & Technology (ACIST) conference. https://www.researchgate.net/publication/321211951_A_health_informatics_model_for_user-centred_design_using_a_positive_deviance_approach_A_case_for_diabetes_self-management

Conference abstracts and presentations

Petersen, F. (2021). Analysing the level of diabetes self-management: City of Cape Town. PHASA Conference.

Petersen, F. (2021). Key determinants for the acceptance and use of mobile health applications: Diabetic patients in the Western Cape, South Africa. PHASA Conference.

Symposia

Jacobs, M.; Petersen, F. and Pather, S. (2019). The effect of culture on m-health acceptance of diabetes self-management in the Western Cape. ID4A Postgraduate ICT4D symposium.

Petersen, F.; Pather, S. and Tucker, W.D. (2019). Using Information Communication and Technology (ICT) to achieve developmental goals in low socio-economic communities: Diabetic patients in the Western Cape, South Africa. South Africa Sweden University Forum (SASUF).