Aims:
This study examines the use, perceptions, and inequalities in access to Digital Health Solutions (DHS) among people with diabetes (PwD). It aims to identify factors influencing adoption and explore perceived benefits and barriers to using DHS, focusing on person-important outcomes such as physical health, mental burden, and access to care.

Methods:
The primary objective of this feasibility study was to assess the intervention acceptability, feasibility, and app usability. The secondary aim is to explore preliminary intervention effects.

Methods:
A cross-sectional online survey was conducted in France from April to July 2022. A total of 301 PwD (149 with type 1 diabetes [T1D], 152 with type 2 diabetes [T2D]) completed the study. The survey assessed the use of three DHS categories: information/education (DHS1), self-management support (DHS2), and data-sharing/collaborative care (DHS3). We used univariate and multivariate logistic regression to identify predictors of DHS use, including demographic, socioeconomic, psychological, and medical variables.

Results:
DHS1 was the most commonly used category, followed by DHS2 and DHS3. PwD with T1D were more likely to use multiple DHS. Type of diabetes and perceived health status were the strongest predictors of DHS use. Surprisingly, people in poorer health were less likely to use DHS despite potentially benefiting most from them. DHS-naïve individuals expected more benefits but reported greater concerns, especially about information overload and data security. These concerns were stronger than the perceived benefits. For example, concerns about data security reduced the likelihood of using DHS2 and DHS3 by up to 89%.

Conclusion:
The study highlights disparities in DHS adoption and the critical role of perceived barriers. Addressing these concerns—particularly among PwD in poorer health—and aligning DHS with outcomes that matter to patients may improve equitable adoption and diabetes care.