A Delphi study on the design and clinical adoption of internet-based interactive behavioral intervention promoting insulin adherence in adolescents and young adults

Introduction Internet-based interactive behavioral intervention (IBIBI) has the potential to optimize insulin adherence and improve diabetes outcomes.Objectives This study aims to identify the factors and strategies to facilitate the design and clinical adoption of IBIBI by healthcare professionals (HCPs) and organizations in Qatar and other Gulf Cooperation Council countries.Methodology A three-round Delphi study was conducted using mixed purposive, database-based, and snowball sampling strategy was employed to recruit senior experts in diabetes care, eHealth, social and behavioral sciences, health policy, and decision-making. A total of 42, 450, and 46 experts invited to participate in rounds one, two, and three, respectively. The Integrated Change Model, a well-established behavioral theory, was incorporated to guide the intervention design, thereby strengthening its development, implementation, and evaluation.Results Findings indicate that both intervention content and adoption strategies must be tailored to the needs of individuals and organizations involved in the design and implementation processes. Practical implications The study offers practical guidance for HCPs and program developers to design tailored, internet-based behavioral interventions. It addresses barriers to clinical adoption, including usability, accessibility, and integration with existing healthcare systems. The study also identifies actionable strategies to promote eHealth adoption and highlights interactive design elements that support active patient engagement across diverse clinical practice settings.