How continuous glucose monitoring may support behaviour change: perceived mechanisms and app feature attribution in a cross-sectional survey
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Aims
To understand how users believe continuous glucose monitoring (CGM) changes their behaviour, which app features they credit, and whether endorsing more mechanisms of action (MoAs) is linked to reported diet and physical activity change.
Methods
We surveyed 112 U.S. adults with type 1 or type 2 diabetes who had used a Dexcom or Abbott Libre CGM within 12 months. Participants rated 26 MoA statements mapped to the Capability, Opportunity, Motivation-Behaviour (COM-B) dominance CIs and ranking frequencies model, identified contributing app features, and reported CGM-attributed diet and physical activity change. Logistic regression examined MoA count and COM-B domains as predictors of behaviour change.
Results
Participants (mean age 54.5 years; 60.7% female) reported dietary (82.1%) and physical activity (46.4%) change and endorsed a median of 18 MoAs, most often relating to knowledge, skills and behavioural consequences. Real-time glucose and graphs were attributed to many MoAs. Each additional MoA was associated with higher odds of dietary (OR 1.27, 95% CI 1.15–1.44) and physical activity change (OR 1.27, 95% CI 1.16–1.43). Motivation made the strongest distinct contribution among COM-B domains.
Conclusions
Users perceive CGM as engaging many behavioural mechanisms; endorsing more was linked to behaviour change. Motivation may be a key target for CGM-based behavioural support.
