scholarly journals Patients’ Experiences of Using a Consumer mHealth App for Self-Management of Heart Failure: Mixed-Methods Study (Preprint)

2018 ◽  
Author(s):  
Leanna Sarah Woods ◽  
Jed Duff ◽  
Erin Roehrer ◽  
Kim Walker ◽  
Elizabeth Cummings
Keyword(s):  
Heart Failure ◽  
Mixed Methods ◽  
Mobile Health ◽  
Medical Information ◽  
Rating Scale ◽  
Health Behavior Change ◽  
Self Management ◽  
Smart Device ◽  
Fluid Restriction ◽  
Home Setting

BACKGROUND To support the self-management of heart failure, a team of hospital clinicians, patients, and family caregivers have co-designed the consumer mobile health app, Care4myHeart. OBJECTIVE This research aimed to determine patient experiences of using the app to self-manage heart failure. METHODS Patients with heart failure used the app for 14 days on their own smart device in a home setting, following which a mixed-methods evaluation was performed. Eight patients were recruited, of whom six completed the Mobile Application Rating Scale and attended an interview. RESULTS The overall app quality score was “acceptable” with 3.53 of 5 points, with the aesthetics (3.83/5) and information (3.78/5) subscales scoring the highest. The lowest mean score was in the app-specific subscale representing the perceived impact on health behavior change (2.53/5). Frequently used features were weight and fluid restriction tracking, with graphical representation of data particularly beneficial for improved self-awareness and ongoing learning. The use of technology for self-management will fundamentally differ from current practices and require a change in daily routines. However, app use was correlated with potential utility for daily management of illness with benefits of accurate recording and review of personal health data and as a communication tool for doctors to assist with care planning, as all medical information is available in one place. Technical considerations included participants’ attitudes toward technology, functionality and data entry issues, and relatively minor suggested changes. CONCLUSIONS The findings from this usability study suggest that a significant barrier to adoption is the lack of integration of technology into everyday life in the context of already established disease self-management routines. Future studies should explore the barriers to adoption and sustainability of consumer mobile health interventions for chronic conditions, particularly whether introducing such apps is more beneficial at the commencement of a self-management regimen.

scholarly journals Evaluating the Use of Mobile Health Technology in Older Adults With Heart Failure: Mixed-Methods Study (Preprint)

2018 ◽  
Author(s):  
Leanne L Lefler ◽  
Sarah J Rhoads ◽  
Melodee Harris ◽  
Ashley E Funderburg ◽  
Sandra A Lubin ◽  
...  
Keyword(s):  
Heart Failure ◽  
Older Adults ◽  
Mixed Methods ◽  
Mobile Health ◽  
Call Center ◽  
Standard Care ◽  
Ease Of Use ◽  
Self Management ◽  
Limited Information ◽  
Post Intervention

BACKGROUND Heart failure (HF) is associated with high rates of hospitalizations, morbidity, mortality, and costs. Remote patient monitoring (mobile health, mHealth) shows promise in improving self-care and HF management, thus increasing quality of care while reducing hospitalizations and costs; however, limited information exists regarding perceptions of older adults with HF about mHealth use. OBJECTIVE This study aimed to compare perspectives of older adults with HF who were randomized to either (1) mHealth equipment connected to a 24-hour call center, (2) digital home equipment, or (3) standard care, with regard to ease and satisfaction with equipment, provider communication and engagement, and ability to self-monitor and manage their disease. METHODS We performed a pilot study using a mixed-methods descriptive design with pre- and postsurveys, following participants for 12 weeks. We augmented these data with semistructured qualitative interviews to learn more about feasibility, satisfaction, communication, and self-management. RESULTS We enrolled 28 patients with HF aged 55 years and above, with 57% (16/28) male, 79% (22/28) non-Hispanic white, and with multiple comorbid conditions. At baseline, 50% (14/28) rated their health fair or poor and 36% (10/28) and 25% (7/28) were very often/always frustrated and discouraged by their health. At baseline, 46% (13/28) did not monitor their weight, 29% (8/28) did not monitor their blood pressure, and 68% (19/28) did not monitor for symptoms. Post intervention, 100% of the equipment groups home monitored daily. For technology anxiety, 36% (10/28) indicated technology made them nervous, and 32% (9/28) reported fear of technology, without significant changes post intervention. Technology usability post intervention scored high (91/100), reflecting ease of use. A majority indicated that a health care provider should be managing their health, and 71% reported that one should trust and not question the provider. Moreover, 57% (16/28) believed it was better to seek professional help than caring for oneself. Post intervention, mHealth users relied more on themselves, which was not mirrored in the home equipment or standard care groups. Participants were satisfied with communication and engagement with providers, yet many described access problems. Distressing symptoms were unpredictable and prevailed over the 12 weeks with 79 provider visits and 7 visits to emergency departments. The nurse call center received 872 readings, and we completed 289 telephone calls with participants. Narrative data revealed the following main themes: (1) traditional communication and engagement with providers prevailed, delaying access to care; (2) home monitoring with technology was described as useful, and mHealth users felt secure knowing that someone was observing them; (3) equipment groups felt more confident in self-monitoring and managing; and finally, (4) uncertainty and frustration with persistent health problems. CONCLUSIONS mHealth equipment is feasible with potential to improve patient-centered outcomes and increase self-management in older adults with HF.

scholarly journals Design of a Consumer Mobile Health App for Heart Failure: Findings From the Nurse-Led Co-Design of Care4myHeart (Preprint)

2019 ◽  
Author(s):  
Leanna Woods ◽  
Jed Duff ◽  
Erin Roehrer ◽  
Kim Walker ◽  
Elizabeth Cummings
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Family Caregivers ◽  
Design Process ◽  
Mobile Health ◽  
Design Thinking ◽  
Graphical Representation ◽  
Community Dwelling ◽  
Self Management ◽  
Data Feedback

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.

scholarly journals Mobile Health Features Supporting Self-Management Behavior in Patients With Chronic Arthritis: Mixed-Methods Approach on Patient Preferences (Preprint)

2018 ◽  
Author(s):  
Jonas Geuens ◽  
Luc Geurts ◽  
Thijs W Swinnen ◽  
Rene Westhovens ◽  
Vero Vanden Abeele
Keyword(s):  
Mixed Methods ◽  
Mobile Health ◽  
Disease Status ◽  
Chronic Arthritis ◽  
Adult Patients ◽  
Self Management ◽  
Structured Interviews ◽  
Management Behavior ◽  
Mixed Methods Approach ◽  
Related Data

BACKGROUND Patients with chronic arthritis (CA) ideally apply self-management behaviors between consultations. This enduring, tedious task of keeping track of disease-related parameters, adhering to medication schemes, and engaging in physical therapy may be supported by using a mobile health (mHealth) app. However, further research is needed to determine which self-management features are valued most by adult patients with CA patients. OBJECTIVE The aim of this study was to determine the preference of features for an mHealth app to support self-management behavior in patients with CA. In addition, we aimed to explore the motives behind these ratings. METHODS A mixed-methods approach was used to gather information from 31 adult patients (14 females), aged 23 to 71 years (mean 51 [SD 12.16]), with CA. Structured interviews were conducted to gather data pertaining to preferences of app features. Interviews were analyzed qualitatively, whereas ratings for each of the 28 features studied were analyzed quantitatively. RESULTS In general, patients with CA favored the use of features pertaining to supporting active and direct disease management, (eg, medication intake and detecting and alarming of bad posture), helping them to keep a close watch on their disease status and inform their health care professional (eg, providing a means to log and report disease-related data) and receiving personalized information (eg, offering tailored information based on the patient’s health data). Patients strongly disliked features that provide a means of social interaction or provide incentivization for disease-related actions (eg, being able to compare yourself with other patients, cooperating toward a common goal, and receiving encouragement from friends and/or family). Driving these evaluations is the finding that every patient with CA hurts in his/her own way, the way the disease unfolds over time and manifests itself in the patient and social environment is different for every patient, and patients with CA are well aware of this. CONCLUSIONS We have offered an insight into how patients with CA favor mHealth features for self-management apps. The results of this research can inform the design and development of prospective self-management apps for patients with CA.

scholarly journals Needs, Experiences, and Views of People With Rheumatic and Musculoskeletal Diseases on Self-Management Mobile Health Apps: Mixed Methods Study (Preprint)

2019 ◽  
Author(s):  
Aurelie Najm ◽  
Heidi Lempp ◽  
Laure Gossec ◽  
Francis Berenbaum ◽  
Elena Nikiphorou
Keyword(s):  
United States ◽  
Mixed Methods ◽  
Focus Group ◽  
Mobile Health ◽  
Musculoskeletal Diseases ◽  
The United States ◽  
European Countries ◽  
Self Management ◽  
Long Term Conditions ◽  
Mhealth Apps

BACKGROUND Despite the growing interest and exponential popularity of mobile health (mHealth) apps for long-term conditions such as rheumatic and musculoskeletal diseases (RMDs) and their self-management, patients are rarely directly consulted and involved in the app development process. OBJECTIVE This study aims to explore the needs, experiences, and views of people diagnosed with RMDs on mHealth apps. METHODS The study used a mixed methods approach: (1) an initial qualitative phase via a patient focus group in the UK and (2) a survey disseminated through national organizations for patients with RMDs across European countries, the United States, Canada, and Australia. RESULTS The focus group included six patients with life-long musculoskeletal conditions. Half had used a self-management app at least once. The use of existing apps was reported as time-consuming due to a lack of functionality. The need for bespoke apps was voiced by all participants. Among 424 patients across European countries, the United States, Canada, and Australia, the main age group was 45 to 54 years (122/424, 28.7%), and 86.8% (368/424) were women. Half of the respondents were aware of the existence of apps to support self-management of their RMDs (188/355, 53%), with 42% (79/188) of them currently using such devices. Patients were mostly interested in an app to self-monitor their health parameters (259/346, 74.9%) and disease activity (221/346, 63.9%) or communicate directly with their health care provider (200/346, 57.8%). CONCLUSIONS Patients considered that using an app could help them to self-manage their RMD condition if it was tailored to their needs and co-developed with health professionals. The development of such apps will require standardization and regular quality control.

The Acceptability of a Palliative Care Mobile Application for Older Adults with Heart Failure and Caregivers (Preprint)

2021 ◽  
Author(s):  
Jennifer Paola Villalobos ◽  
Sheana Salyers Bull ◽  
Jennifer Dickman Portz
Keyword(s):  
Heart Failure ◽  
Older Adults ◽  
Palliative Care ◽  
Mobile Application ◽  
Rating Scale ◽  
Digital Health ◽  
Descriptive Analysis ◽  
Advanced Heart Failure ◽  
Self Management ◽  
Smart Watch

BACKGROUND Digital health provides opportunities for patients with advanced heart failure and their caregivers to engage in palliative care, but is relatively underexplored. OBJECTIVE To test the acceptability and usability of Convoy-Pal, a mobile palliative care solution for older adults and their family and informal caregivers, i.e., their “social convoy”. METHODS Convoy-Pal includes tablet based and smart watch tools facilitating self-management and access to palliative care resources. Older adults and convoy caregivers completed an acceptability and usability interview via Zoom including open ended questions and the Mobile Application Rating Scale: User Version (uMars). Descriptive analysis was conducted to summarize the results of open-ended feedback and self-reported acceptability and usability. RESULTS Overall, the feedback from users was good (uMars M=3.96, out of 5). Open ended feedback from the interviews included improving graphs and adding monitoring features. CONCLUSIONS Convoy-Pal is perceived acceptable with good usability for both older adults and their caregivers.

scholarly journals User-Centered Evaluations with Older Adults: Testing the Usability of a Mobile Health System for Heart Failure Self-Management

2017 ◽  
Vol 61 (1) ◽  
pp. 6-10 ◽  
Author(s):  
Victor P. Cornet ◽  
Carly N. Daley ◽  
Preethi Srinivas ◽  
Richard J. Holden
Keyword(s):  
Heart Failure ◽  
Older Adults ◽  
Mobile Health ◽  
Self Management ◽  
Task Load ◽  
Usability Test ◽  
Mobile Health Application ◽  
System Usability Scale ◽  
Health Products ◽  
And Performance

Many older adults living with heart failure struggle to follow recommended self-management routines. To help older adults with heart failure more effectively and efficiently self-manage their disease, we developed Engage, a mobile health application promoting the performance, logging, and sharing of routine self-management behaviors. This paper reports on the usability evaluation of the Engage system with 15 older adults with heart failure and informal caregivers. In two phases, participants used Engage during a task-based usability test (n=5) and a scenario-based usability test (n=10). Usability and performance data were assessed through video-recorded observation and the administration of the system usability scale (SUS) and NASA Task Load Index (TLX). We found that task-based testing was useful in quickly identifying problems within our application, but scenario-based testing elicited more valuable feedback from older adults. A comparison of the different evaluation methods used and the discussion of the challenges encountered provide multiple implications for the practice of usability testing of mobile health products with older adults.

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