• Keresi Rokorua Bako, Masoud Mohammadnezhad, Dianne Sika-Paotonu, Sharon Sime, and Louise Signal.
• Health Promotion & Policy Research Unit, Department of Public Health, University of Otago, Wellington, New Zealand. Electronic address: bakke870@student.otago.ac.nz.
• Am J Prev Med. 2024 May 1; 66 (5): 909913909-913.

IntroductionThe prevalence of Type 2 Diabetes Mellitus (T2DM) is rapidly increasing throughout the world. T2DM is primarily a self-managed disease yet clinical studies indicate that a large proportion of adults with T2DM struggle to self-manage their diabetes. This puts them at high risk of developing diabetes-related complications. This study presents Diabetes Cam, a new methodology to objectively study T2DM self-management and identify its barriers and facilitators.MethodsThirty adults with diabetes of i-taukei descent from the 4 medical divisions throughout Fiji wore a camera for 4 days that automatically recorded images every 7 seconds. They also participated in in-depth photo-elicitation interviews to explore their experiences and perceptions of T2DM self-management. Data was collected between October 2021 and May 2022, and the analysis was done in August 2023.ResultsApproximately 11,500 images per participant were generated providing rich data. The method is ethical, legal, and acceptable for adults with T2DM, their families, and the wider community. The images can be readily coded for food availability and consumption, physical activity, transportation, medication use, and foot care. Photo-elicitation enabled further information on what was occurring within the images and about participants' perspectives on diabetes self-management.ConclusionsThe Diabetes Cam methodology enabled automated, objective observation of participants' T2DM self-management and their perspectives on self-management. It provides unique insights into diabetes self-management and ways to improve diabetes self-management. It provides valuable data to develop strategies to enhance diabetes self-management for people living with diabetes, their families, the wider community, health professionals, and policymakers.Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

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