scholarly journals The Development of a Mobile Health App for Breast Cancer Self-Management Support in Taiwan: Design Thinking Approach

10.2196/15780 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e15780 ◽  
Author(s):  
I-Ching Hou ◽  
Min-Fang Lan ◽  
Shan-Hsiang Shen ◽  
Pei Yu Tsai ◽  
King Jen Chang ◽  
...  

Background Evidence has shown that breast cancer self-management support from mobile health (mHealth) apps can improve the quality of life of survivors. Although many breast cancer self-management support apps exist, few papers have documented the procedure for the development of a user-friendly app from the patient’s perspective. Objective This study aimed to investigate the information needs of Taiwanese women with breast cancer to inform the development of a self-management support mHealth app. Methods A 5-step design thinking approach, comprising empathy, define, ideate, prototype, and test steps, was used in the focus groups and individual interviews conducted to collect information on the requirements and expectations of Taiwanese women with breast cancer with respect to the app. A thematic analysis was used to identify information needs. Results A total of 8 major themes including treatment, physical activity, diet, emotional support, health records, social resources, experience sharing, and expert consultation were identified. Minor themes included the desire to use the app under professional supervision and a trustworthy app manager to ensure the credibility of information. Conclusions The strengths of the design thinking approach were user-centered design and cultural sensitivity. The results retrieved from each step contributed to the development of the app and reduction of the gap between end users and developers. An mHealth app that addresses these 8 main themes can facilitate disease self-management for Taiwanese women with breast cancer.

2019 ◽  
Author(s):  
I-Ching Hou ◽  
Min-Fang Lan ◽  
Shan-Hsiang Shen ◽  
Pei Yu Tsai ◽  
King Jen Chang ◽  
...  

BACKGROUND Evidence has shown that breast cancer self-management support from mobile health (mHealth) apps can improve the quality of life of survivors. Although many breast cancer self-management support apps exist, few papers have documented the procedure for the development of a user-friendly app from the patient’s perspective. OBJECTIVE This study aimed to investigate the information needs of Taiwanese women with breast cancer to inform the development of a self-management support mHealth app. METHODS A 5-step design thinking approach, comprising empathy, define, ideate, prototype, and test steps, was used in the focus groups and individual interviews conducted to collect information on the requirements and expectations of Taiwanese women with breast cancer with respect to the app. A thematic analysis was used to identify information needs. RESULTS A total of 8 major themes including treatment, physical activity, diet, emotional support, health records, social resources, experience sharing, and expert consultation were identified. Minor themes included the desire to use the app under professional supervision and a trustworthy app manager to ensure the credibility of information. CONCLUSIONS The strengths of the design thinking approach were user-centered design and cultural sensitivity. The results retrieved from each step contributed to the development of the app and reduction of the gap between end users and developers. An mHealth app that addresses these 8 main themes can facilitate disease self-management for Taiwanese women with breast cancer.


Author(s):  
I-Ching Hou ◽  
Pei-Yu Tsai ◽  
Shan-Hsiang Shen ◽  
King-Jen Chang ◽  
Hao-Chih Tai ◽  
...  

BACKGROUND Breast cancer has a high incidence rate among women in Taiwan and worldwide. Advanced surgery and medical therapies have improved survival rates. Today, smartphones are popular and can be used to develop ubiquitous technology for disease self-management and to maintain patients’ quality of life. In Taiwan, a mobile health self-management support app with eight main features was developed to address breast cancer women’s information needs based on prior research using a design thinking approach. OBJECTIVE The aim of this study was to pilot test Taiwan breast cancer women’s acceptance of the app. METHODS An instrument with confirmed reliability and validity based on the modified technology acceptance model for mobile services and aesthetics preference of interface icons was used. Women with breast cancer were recruited to participate in the pilot test workshop and then answer survey questionnaires. Descriptive statistics and Spearman’s rank correlation coefficient method was used to analyze the data. RESULTS A total of 45 women participated the study. They were mostly aged 41-50(40%, 18/45), bachelor’s degree or equivalent (54.4%, 29/45), married (66.7%, 30/45), stage II breast cancer (37.8%, 17/45), had completed treatment (55.6%, 25/45) and received surgical treatment (93.3%, 42/45). The highest mean scores of user acceptance factors rated on the 5-point Likert scale was perceived ease of use (4.14, SD=0.42), followed by actual use (4.12, SD=0.57), perceived value (4.07, SD=0.62), user satisfaction (4.01, SD=0.51), intention to use (3.89, SD=0.58), and the lowest mean score was trust (3.89, SD=0.58). The Spearman’s rank correlation coefficient indicated positive associations between each factor and statistically significant correlations (p value <0.05). Seven of eight interface feature icons in original app were favored over alternative icon options. CONCLUSIONS This study developed a smartphone app to predict Taiwan breast cancer women’s acceptance of mobile health technology for supporting disease self-management. The results suggest that patients positively accepted the app and would like it to be available in the future. However, data security and individual privacy protection features should be enhanced to increase users’ trust. In addition, the design of most interface icons was accepted by the participants which is consistent with their perceived ease of use of the app.


2020 ◽  
Author(s):  
Kuntal Chowdhary ◽  
Daihua Xie Yu ◽  
Gede Pramana ◽  
Andrea Fairman ◽  
Brad Edward Dicianno ◽  
...  

BACKGROUND Mobile health (mHealth) systems have been shown to be useful in supporting self-management by promoting adherence to schedules and longitudinal health interventions, especially in people with disabilities (PwD). The Interactive Mobile Health and Rehabilitation (iMHere) System was developed to empower PwD and those with chronic conditions with supports needed for self-management and independent living. Since the first iteration of the iMHere 1.0 app, several studies have evaluated accessibility and usability of the system. Potential opportunities to improve and simplify the user interface (UI) were identified, and the iMHere modules were redesigned accordingly. OBJECTIVE The aim of this study was to evaluate the usability of the redesigned modules within iMHere 1.0. METHODS This study evaluated the original and redesigned MyMeds and SkinCare modules. To assess the participants’ dexterity levels, the Purdue Pegboard Test (PPBT) was administered. Participants were then asked to perform a set of tasks using both the original and redesigned MyMeds and SkinCare modules to assess efficiency and effectiveness. Usability was measured using the Telehealth Usability Questionnaire (TUQ) to evaluate 10 new accessibility features that were added to the redesigned app. Participants were also asked which version they preferred. RESULTS Twenty-four participants with disabilities and varied degrees of dexterity impairments completed the entire study protocol. Participants displayed improved efficiency and effectiveness of use when using the redesigned modules, as compared to the original modules. Participants also reported improved usability and preferred the redesigned modules. CONCLUSIONS This study demonstrated that the iMHere System became more efficient, effective, and usable for individuals with dexterity impairments after redesigning it according to user-centered principles.


2019 ◽  
Author(s):  
Leanna Woods ◽  
Jed Duff ◽  
Erin Roehrer ◽  
Kim Walker ◽  
Elizabeth Cummings

BACKGROUND Consumer health care technology shows potential to improve outcomes for community-dwelling persons with chronic conditions, yet health app quality varies considerably. In partnership with patients and family caregivers, hospital clinicians developed Care4myHeart, a mobile health (mHealth) app for heart failure (HF) self-management. OBJECTIVE The aim of this paper was to report the outcomes of the nurse-led design process in the form of the features and functions of the developed app, Care4myHeart. METHODS Seven patients, four family caregivers, and seven multidisciplinary hospital clinicians collaborated in a design thinking process of innovation. The co-design process, involving interviews, design workshops, and prototype feedback sessions, incorporated the lived experience of stakeholders and evidence-based literature in a design that would be relevant and developed with rigor. RESULTS The home screen displays the priority HF self-management components with a reminder summary, general information on the condition, and a settings tab. The health management section allows patients to list health care team member’s contact details, schedule medical appointments, and store documents. The My Plan section contains nine important self-management components with a combination of information and advice pages, graphical representation of patient data, feedback, and more. The greatest strength of the co-design process to achieve the design outcomes was the involvement of local patients, family caregivers, and clinicians. Moreover, incorporating the literature, guidelines, and current practices into the design strengthened the relevance of the app to the health care context. However, the strength of context specificity is also a limitation to portability, and the final design is limited to the stakeholders involved in its development. CONCLUSIONS We recommend health app development teams strategically incorporate relevant stakeholders and literature to design mHealth solutions that are rigorously designed from a solid evidence base and are relevant to those who will use or recommend their use.


2018 ◽  
Author(s):  
I Made Agus Setiawan ◽  
Leming Zhou ◽  
Zakiy Alfikri ◽  
Andi Saptono ◽  
Andrea D Fairman ◽  
...  

BACKGROUND Persons with chronic conditions and disabilities (PwCCDs) are vulnerable to secondary complications. Many of these secondary complications are preventable with proactive self-management and proper support. To enhance PwCCDs' self-management skills and conveniently receive desired support, we have developed a mobile health (mHealth) system called iMHere. In 2 previous clinical trials, iMHere was successfully used to improve health outcomes of adult participants with spina bifida and spinal cord injury. To further expand use of iMHere among people with various types of disabilities and chronic diseases, the system needs to be more adaptive to address 3 unique challenges: 1) PwCCDs have very diverse needs with regards to self-management support, 2) PwCCDs’ self-management needs may change over time, and 3) it is a challenge to keep PwCCDs engaged and interested in long-term self-management. OBJECTIVE The aim of this study was to develop an adaptive mHealth system capable of supporting long-term self-management and adapting to the various needs and conditions of PwCCDs. METHODS A scalable and adaptive architecture was designed and implemented for the new version, iMHere 2.0. In this scalable architecture, a set of mobile app modules was created to provide various types of self-management support to PwCCDs with the ability to add more as needed. The adaptive architecture empowers PwCCDs with personally relevant app modules and allows clinicians to adapt these modules in response to PwCCDs’ evolving needs and conditions over time. Persuasive technologies, social support, and personalization features were integrated into iMHere 2.0 to engage and motivate PwCCDs and support long-term usage. Two initial studies were performed to evaluate the usability and feasibility of the iMHere 2.0 system. RESULTS The iMHere 2.0 system consists of cross-platform client and caregiver apps, a Web-based clinician portal, and a secure 2-way communication protocol for providing interactions among these 3 front-end components, all supported by a back-end server. The client and caregiver apps have 12 adaptive app modules to support various types of self-management tasks. The adaptive architecture makes it possible for PwCCDs to receive personalized app modules relevant to their conditions with or without support from various types of caregivers. The personalization and persuasive technologies in the architecture can be used to engage PwCCDs for long-term usage of the iMHere 2.0 system. Participants of the usability study were satisfied with the iMHere 2.0 client app. The feasibility evaluation revealed several practical issues to consider when implementing the system on a large scale. CONCLUSIONS We developed an adaptive mHealth system as a novel method to support diverse needs in self-management for PwCCDs that can dynamically change over time. The usability of the client app is high, and it was feasible for PwCCDs to use in supporting personalized and evolving self-care needs.


Author(s):  
Anastasius S. Moumtzoglou

Self-care emerged from the concept of health promotion in the 1970s while from 2000 onwards the term self-management gained popularity, with a greater focus on long-term conditions and the trend towards more holistic models of care. Although self-management and self-care are often used interchangeably, a distinction between the two concepts can be made. Both can be considered in terms of a continuum, with self-care at one end as “normal activity” and self-management an extension of this. Self-management support is the assistance given to patients in order to encourage daily decisions that improve health-related behaviors and clinical outcomes. The chapter envisions these concepts on a continuum with one pole representing mobile health and the other self-care. It concludes that self-management support is the nexus of mobile health and self-care.


Stroke ◽  
2022 ◽  
Vol 53 (Suppl_1) ◽  
Author(s):  
Jane Anderson ◽  
Barbara Kimmel ◽  
Shubhada Sansgiry ◽  
Gina Evans-Hudnall ◽  
Anette Ovalle ◽  
...  

Background and Purpose: Self-management Support (SMS) helps stroke survivors control risk factors to prevent second stroke. Little is known about feasibility and effectiveness of using mobile health technology (MHT) for SMS among underserved stroke survivors. The investigators studied feasibility and effectiveness of using a video teleconference mobile application to deliver a SMS program to underserved, hard to reach stroke survivors. Methods: The Video teleconference Self-management TO Prevent stroke (V-STOP) program was evaluated using longitudinal design with measurements at baseline, immediately post intervention (6 weeks), intermediate (12 weeks), and at study end (18 weeks). Medically underserved stroke survivors with uncontrolled stroke risk factors were included. Feasibility was assessed as time in intervention, telehealth satisfaction, stroke knowledge and SMS effectiveness were measured as psychological (depression, PHQ-8; anxiety, GAD-7), social (community integration questionnaire), and stroke self-management (goal attainment) outcomes. Generalized estimating equations were used with site and time in intervention as covariates. Results: V-STOP was successfully delivered to 106 participants using MHT over 2 years. Mean age was 59.3 (±10.9), majority were white (82.1%), males (54.3%), not living alone (85.9%), married (52.8%), with low annual income (<$25,000) ( 58.5%), and health insurance (59.4%). Program feasibility indicated mean number of V-STOP sessions were 4.6 (±1.8), with 4.4 (±2.0) hours of total time for the intervention. Overall satisfaction at 6 weeks with V-STOP (4.8(±0.5)) and telehealth (4.7(±0.5)) was high. Stroke knowledge was high at 12 weeks (9.6(±0.7)). SMS effectiveness indicated improvement in psychological outcomes at 6, 12, and 18 weeks from baseline; depression (18 weeks - β = 0.64 (CI 0.49-0.84)) and anxiety (18 weeks - β = 0.66 (CI 0.51-0.85)). Community integration improved by 18 weeks - β = 1.08 (CI 1.01-1.16) and stroke self-management also improved long term at 12 and 18 weeks (β = 0.92 (CI 0.84-0.99). Conclusion: MHT is feasible to deliver SMS to underserved stroke survivors. It improves psycho-social and self-management goal setting and goal attainment outcomes.


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