*6.1. Limitations*

The current study demonstrates the design and evaluation of a pervasive coaching and gamification platform within a clinical sample of young diabetes patients. However, the findings in this report are limited. The platform evaluated in this research was of a prototype version of the framework. As such, difficulties with usability and seamless functioning of the technology were challenges in evaluating basic research questions regarding user engagement and impact on outcomes. In terms of research design, the small sample size of participants and relatively high attrition rate, seen in similar studies of smartphone apps for health (e.g., [69]), suggest that the results may have limited generalizability to the broad population of potential users. Also, because users of prototypes in our studies were not compared to a control group of users of comparable prototypes, it is not clear how much their feedback was specific to the content and design of the prototypes we tested, or could be attributed to general issues common with early versions of technologies.
