scholarly journals Identifying Mobile Health Engagement Stages: Interviews and Observations for Developing Brief Message Content (Preprint)

2019 ◽  
Author(s):  
Kara Burns ◽  
Rebekah Nicholas ◽  
Amanda Beatson ◽  
Marianella Chamorro-Koc ◽  
Alethea Blackler ◽  
...  
Keyword(s):  
User Experience ◽  
Mobile Health ◽  
Health Care Professionals ◽  
Self Management ◽  
User Engagement ◽  
Message Content ◽  
Sample Group ◽  
Mhealth Technology ◽  
Group 2 ◽  
Person Centered Approach

BACKGROUND Interest in mobile health (mHealth) has increased recently, and research suggests that mHealth devices can enhance end-user engagement, especially when used in conjunction with brief message content. OBJECTIVE This research aims to explore the <i>stages of engagement</i> framework for mHealth devices and develop a method to generate brief message content to promote sustained user engagement. This study uses the framework by O’Brien and Toms as a point of departure, where engagement is defined as the uptake or the use of an mHealth device. The framework is a linear repeatable process, including <i>point of engagement</i>, <i>period of engagement</i>, <i>disengagement</i>, and <i>re-engagement</i>. Each stage is characterized by attributes related to a person’s technology experience. Although the literature has identified stages of engagement for health-related technology, few studies explore mHealth engagement. Furthermore, little research has determined a method for creating brief message content at each stage in this engagement journey. METHODS Interviews and observations from 19 participants who used mHealth technologies (apps, devices, or wellness websites) in a solo capacity were recruited for sample group 1. In sample group 2, interviews, and observations from 25 participants using mHealth technologies in a group capacity through the Global Corporate Challenge were used. These samples were investigated at 3 time points in both research contexts. The results underwent deductive-inductive thematic analysis for the engagement stages’ framework and attributes. RESULTS In addition to the 4 stages identified by O’Brien and Toms, 2 additional stages, self-management and limited engagement, were identified. <i>Self-management</i> captures where users had disengaged from their technology but were still engaged with their health activity. <i>Limited engagement</i> captures where group mHealth users had minimal interaction with their mHealth technology but continued to engage in a group fitness activity. The results revealed that mHealth engagement stages were nonlinear and embedded in a wider engagement context and that each stage was characterized by a combination of 49 attributes that could be organized into 8 themes. Themes documented the total user experience and included technology usability, technology features, technology aesthetics, use motivations, health awareness, goal setting, social support, and interruptions. Different themes were found to have more relevance at different engagement stages. Knowing themes and attributes at all engagement stages allows technology developers and health care professionals to generate relevant brief message content informed by a person-centered approach. CONCLUSIONS This research extends an existing engagement stages framework and identifies attributes and themes relevant to mHealth technology users’ total user experience and incorporates concepts derived from health, business studies, and information systems literature. In addition, we offer a practical 5-step process based on a person-centered approach to develop mHealth technology brief message content for sustained engagement.

scholarly journals Identifying Mobile Health Engagement Stages: Interviews and Observations for Developing Brief Message Content

10.2196/15307 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e15307
Author(s):  
Kara Burns ◽  
Rebekah Nicholas ◽  
Amanda Beatson ◽  
Marianella Chamorro-Koc ◽  
Alethea Blackler ◽  
...  
Keyword(s):  
User Experience ◽  
Mobile Health ◽  
Health Care Professionals ◽  
Self Management ◽  
User Engagement ◽  
Message Content ◽  
Sample Group ◽  
Mhealth Technology ◽  
Group 2 ◽  
Person Centered Approach

Background Interest in mobile health (mHealth) has increased recently, and research suggests that mHealth devices can enhance end-user engagement, especially when used in conjunction with brief message content. Objective This research aims to explore the stages of engagement framework for mHealth devices and develop a method to generate brief message content to promote sustained user engagement. This study uses the framework by O’Brien and Toms as a point of departure, where engagement is defined as the uptake or the use of an mHealth device. The framework is a linear repeatable process, including point of engagement, period of engagement, disengagement, and re-engagement. Each stage is characterized by attributes related to a person’s technology experience. Although the literature has identified stages of engagement for health-related technology, few studies explore mHealth engagement. Furthermore, little research has determined a method for creating brief message content at each stage in this engagement journey. Methods Interviews and observations from 19 participants who used mHealth technologies (apps, devices, or wellness websites) in a solo capacity were recruited for sample group 1. In sample group 2, interviews, and observations from 25 participants using mHealth technologies in a group capacity through the Global Corporate Challenge were used. These samples were investigated at 3 time points in both research contexts. The results underwent deductive-inductive thematic analysis for the engagement stages’ framework and attributes. Results In addition to the 4 stages identified by O’Brien and Toms, 2 additional stages, self-management and limited engagement, were identified. Self-management captures where users had disengaged from their technology but were still engaged with their health activity. Limited engagement captures where group mHealth users had minimal interaction with their mHealth technology but continued to engage in a group fitness activity. The results revealed that mHealth engagement stages were nonlinear and embedded in a wider engagement context and that each stage was characterized by a combination of 49 attributes that could be organized into 8 themes. Themes documented the total user experience and included technology usability, technology features, technology aesthetics, use motivations, health awareness, goal setting, social support, and interruptions. Different themes were found to have more relevance at different engagement stages. Knowing themes and attributes at all engagement stages allows technology developers and health care professionals to generate relevant brief message content informed by a person-centered approach. Conclusions This research extends an existing engagement stages framework and identifies attributes and themes relevant to mHealth technology users’ total user experience and incorporates concepts derived from health, business studies, and information systems literature. In addition, we offer a practical 5-step process based on a person-centered approach to develop mHealth technology brief message content for sustained engagement.

The use of mobile health technology for Parkinson's disease self-management: a Systematic Review (Preprint)

2019 ◽  
Author(s):  
Sylvie Grosjean ◽  
Eliza Bate ◽  
Tiago Mestre
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Mobile Health ◽  
Self Management ◽  
Social Acceptability ◽  
Qualitative Systematic Review ◽  
The Social ◽  
Mhealth Technology

BACKGROUND The use of mobile health (mHealth) technology for Parkinson’s disease management has developed quickly in recent years. Research in this area often focuses on evaluation of the technology in terms of accuracy and reliability. The social dimension and patient perspectives have not been systematically evaluated and are vital considerations in terms of acceptability and long-term use of novel mHealth technologies. OBJECTIVE This qualitative systematic review aims to investigate the barriers to and facilitators of using mHealth technologies for disease self-management from the perspective of People with Parkinson's disease. METHODS MedLine, Embase, PsychInfo, Scopus and CINAHL databases were searched using specific key words, and published peer-reviewed articles from 2008 to 2018 were scanned for inclusion criteria. RESULTS A total of 10 articles were included in this qualitative systematic review. The articles highlight the social and technical factors including: usability, social acceptability, perceived benefits to treatment and quality of life that have the potential to impact mHealth technology use from the perspective of People with Parkinson's disease. CONCLUSIONS The results of this systematic review suggest that it is important to strongly consider social dimensions in the design of mHealth technologies for People with Parkinson's in order to improve their social acceptability, a key feature of mHealth. We suggest that a co-design approach could contribute to the design and development of mHealth technologies that are more socially acceptable to People with Parkinson's, and enable their successful long term use in the context of daily life.

scholarly journals Technology Acceptance Among Patients With Hemophilia in Hong Kong and Their Expectations of a Mobile Health App to Promote Self-management: Survey Study (Preprint)

2021 ◽  
Author(s):  
Yin Ting Cheung ◽  
Pok Hong Lam ◽  
Teddy Tai-Ning Lam ◽  
Henry Hon Wai Lam ◽  
Chi Kong Li
Keyword(s):  
Hong Kong ◽  
Technology Acceptance ◽  
Mobile Technology ◽  
Mobile Health ◽  
Health Care Professionals ◽  
Surrogate Marker ◽  
Mobile App ◽  
Self Management ◽  
Clotting Factors ◽  
Bleeding Events

BACKGROUND The lifelong management of hemophilia is demanding and complex. In July 2019, we published a review in the <i>Journal of Medical Internet Research</i>, summarizing telehealth interventions that facilitate monitoring of bleeding events and promoting the appropriate use of clotting factors among patients with hemophilia. This work has led to the development of a community program that aims to harness technology to promote self-management among patients with hemophilia in Hong Kong. OBJECTIVE Before the inception of this program, we conducted a cross-sectional survey to evaluate the patients’ level of technology acceptance and identify their expectations of the use of mobile technology for self-management of hemophilia. METHODS In total, 56 participants (75% adult patients and 25% parents of pediatric patients; 87.5% with moderate to severe disease) were recruited from a local nongovernmental organization that serves patients with hemophilia. They rated their perceived confidence and acceptance in using the new mobile technology (score 1 to 5 for each item, with a higher score indicating better acceptance) using a structured questionnaire (adapted from the Technology Acceptance Model). They also identified the top features that they perceived to be the most important components of a mobile app for the self-management of hemophilia. The Mann–Whitney <i>U</i> test was used to compare technology acceptance scores across subgroups of different clinical and socioeconomic characteristics. RESULTS In general, the participants considered themselves skilled in using mobile apps (mean 4.3, 95% CI 4.1-4.5). They were willing to learn to use the new mobile app to organize their bleeding records (mean 4.0, 95% CI 3.7-4.3) and to manage their health (mean 4.2, 95% CI 4.1-4.5). Participants who lived in public housing (a surrogate marker for lower socioeconomic status in Hong Kong) reported lower technology acceptance than those who lived in private housing (<i>P</i>=.04). The most important features identified by the participants concerned documenting of infusion logs (n=49, 87.5%), bleeding events (n=48, 85.7%), and the secure delivery of the bleeding information to health care professionals (n=40, 71.4%). CONCLUSIONS It is encouraging to infer that patients with hemophilia in Hong Kong are receptive to the use of mobile health technology. The findings of this survey are applicable in designing the key features of a patient-centered, multimodal program harnessing mobile technology to promote self-management among patients with hemophilia. Future studies should evaluate participants’ acceptability and perceived usability of the mobile app via user metrics and assess clinical and humanistic outcomes of this program.

scholarly journals Real-World Evidence of User Engagement With Mobile Health for Diabetes Management: Longitudinal Observational Study (Preprint)

2020 ◽  
Author(s):  
Anna-Katharina Böhm ◽  
Morten Lind Jensen ◽  
Mads Reinholdt Sørensen ◽  
Tom Stargardt
Keyword(s):  
Mobile Health ◽  
Real World ◽  
Diabetes Management ◽  
Patient Characteristics ◽  
Active Role ◽  
Self Management ◽  
User Engagement ◽  
User Characteristics ◽  
Real World Data ◽  
Average User

BACKGROUND Patient support apps have risen in popularity and provide novel opportunities for self-management of diabetes. Such apps offer patients to play an active role in monitoring their condition, thereby increasing their own treatment responsibility. Although many health apps require active user engagement to be effective, there is little evidence exploring engagement with mobile health (mHealth). OBJECTIVE This study aims to analyze the extent to which users engage with mHealth for diabetes and identify patient characteristics that are associated with engagement. METHODS The analysis is based on real-world data obtained by Novo Nordisk’s Cornerstones4Care Powered by Glooko diabetes support app. User engagement was assessed as the number of active days and using measures expressing the persistence, longevity, and regularity of interaction within the first 180 days of use. Beta regressions were estimated to assess the associations between user characteristics and engagement outcomes for each module of the app. RESULTS A total of 9051 individuals initiated use after registration and could be observed for 180 days. Among these, 55.39% (5013/9051) used the app for one specific purpose. The average user activity ratio varied from 0.05 (medication and food) to 0.55 (continuous glucose monitoring), depending on the module of the app. Average user engagement was lower if modules required manual data entries, although the initial uptake was higher for these modules. Regression analyses further revealed that although more women used the app (2075/3649, 56.86%), they engaged significantly less with it. Older people and users who were recently diagnosed tended to use the app more actively. CONCLUSIONS Strategies to increase or sustain the use of apps and availability of health data may target the mode of data collection and content design and should take into account privacy concerns of the users at the same time. Users’ engagement was determined by various user characteristics, indicating that particular patient groups should be targeted or assisted when integrating apps into the self-management of their disease.

scholarly journals Mobile Health Technology for Hypertension Management: A Systematic Review

2020 ◽  
Author(s):  
Sohrab Almasi ◽  
Azamossadat Hosseini ◽  
Hassan Emami ◽  
Azam Sabahi
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Mobile Health ◽  
Chronic Conditions ◽  
Web Of Science ◽  
Pressure Control ◽  
Self Management ◽  
Hypertension Control ◽  
Mhealth Technology ◽  
Present Systematic Review

Hypertension is a chronic condition, and a major risk factor for other chronic conditions requires management. Considering the growth and extensive use of mobile health (mHealth) technologies and their capabilities, it is essential to examine the effects of these technologies on hypertension control and self-management. The present systematic review examined the effect of using mHealth technologies in controlling blood pressure and investigated the functionalities of mHealth technology on self-management aspects of patients with hypertension. A systematic search was conducted on PubMed, Web of Science, Embase, and Scopus databases. Clinical trials in English investigating the use of mHealth technologies for blood pressure control published from 2005 to 2018 were included in this study. The functionalities of these technologies were also investigated. These functionalities were divided into five categories of monitoring, alarms, feedbacks, education, and communication. The most frequently used technology for hypertension control was smartphones in the 15 articles examined. Moreover, the most frequent functionalities used for self-management of hypertension were communications and reminders, education, monitoring, and feedback, respectively. In the majority of the studies, these functionalities were employed in combination with mHealth technologies, a feature that affects hypertension control and self-management. The use of mHealth technologies, such as smartphones, positively affects hypertension self-management and reduces blood pressure. Functionalities such as communication and reminders, education, monitoring, and feedback are effective in hypertension self-management programs. The simultaneous use of these functionalities combined will be more effective in hypertension self-management programs.

scholarly journals Engagement with Manage My Pain mobile health application among patients at the Transitional Pain Service

2020 ◽  
Vol 6 ◽  
pp. 205520762096229
Author(s):  
P Maxwell Slepian ◽  
Michael Peng ◽  
Tahir Janmohamed ◽  
Yuvaraj Kotteeswaran ◽  
Varuna Manoo ◽  
...  
Keyword(s):  
Mobile Health ◽  
Management Program ◽  
Self Management ◽  
User Engagement ◽  
Pain Management Program ◽  
Mobile Health Application ◽  
Multidisciplinary Clinic ◽  
Treatment Predictors ◽  
Health Application ◽  
Current Report

Objective Mobile health platforms have become an important component of pain self-management programs and hundreds of mobile applications are commercially available for patients to monitor pain. However, few of these applications have been developed in collaboration with healthcare professionals or have been critically evaluated. Manage My Pain is a user-driven mobile health platform developed by ManagingLife in collaboration with clinician researchers. Manage My Pain allows patients to keep a “pain record” and supports communication of this information with clinicians. The current report describes a user engagement study of Manage My Pain among patients at the Transitional Pain Service (TPS) at Toronto General Hospital, a multidisciplinary clinic for patients at high risk of developing postsurgical pain. Methods Patients at the TPS were encouraged to register on Manage My Pain as one component of a larger, non-randomized prospective study of treatment predictors and treatment enhancement. Uptake of the application and rates of registration, use, and retention were tracked for 90 days. Results Of the 196 patients who consented to the larger study, 132 (67%) also provided consent to the Manage My Pain component, indicating that they found this to be an acceptable treatment adjunct, and 119 (61%) completed registration. Of those who used the app, 67.9% and 43.2% continued to use Manage My Pain beyond 30 and 90 days, respectively. On average, users engaged with the app for 93.14 days (SD = 151.9 days) logged an average of 47.39 total records (SD = 136.1). Conclusions Manage My Pain was found acceptable by a majority of patients at an academic pain management program. Rates of user registration and retention were favorable compared to those reported by other applications. Further research is needed to develop strategies to retain users and maximize patient benefit.

scholarly journals Association Between User Engagement of a Mobile Health App for Gout and Improvements in Self-Care Behaviors: Randomized Controlled Trial

10.2196/15021 ◽  
2019 ◽  
Vol 7 (8) ◽  
pp. e15021 ◽  
Author(s):  
Anna Serlachius ◽  
Kiralee Schache ◽  
Anel Kieser ◽  
Bruce Arroll ◽  
Keith Petrie ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Mobile Health ◽  
Illness Perceptions ◽  
Self Care ◽  
Mean Difference ◽  
Trial Registration ◽  
Self Management ◽  
User Engagement ◽  
The Impact

Background Mobile health (mHealth) apps represent a promising approach for improving health outcomes in patients with chronic illness, but surprisingly few mHealth interventions have investigated the association between user engagement and health outcomes. We aimed to examine the efficacy of a recommended, commercially available gout self-management app for improving self-care behaviors and to assess self-reported user engagement of the app in a sample of adults with gout. Objective Our objective was to examine differences in self-reported user engagement between a recommended gout app (treatment group) and a dietary app (active control group) over 2 weeks as well as to examine any differences in self-care behaviors and illness perceptions. Methods Seventy-two adults with gout were recruited from the community and three primary and secondary clinics. Participants were randomized to use either Gout Central (n=36), a self-management app, or the Dietary Approaches to Stop Hypertension Diet Plan (n=36), an app based on a diet developed for hypertension, for 2 weeks. The user version of the Mobile Application Rating Scale (uMARS, scale: 1 to 5) was used after the 2 weeks to assess self-reported user engagement, which included an open-ended question. Participants also completed a self-report questionnaire on self-care behaviors (scale: 1-5 for medication adherence and diet and 0-7 for exercise) and illness perceptions (scale: 0-10) at baseline and after the 2-week trial. Independent samples t tests and analysis of covariance were used to examine differences between groups at baseline and postintervention. Results Participants rated the gout app as more engaging (mean difference –0.58, 95% CI –0.96 to –0.21) and more informative (mean difference –0.34, 95% CI –0.67 to –0.01) than the dietary app at the 2-week follow-up. The gout app group also reported a higher awareness of the importance of gout (mean difference –0.64, 95% CI –1.27 to –0.003) and higher knowledge/understanding of gout (mean difference –0.70, 95% CI –1.30 to –0.09) than the diet app group at follow-up. There were no significant differences in self-care behaviors between the two groups postintervention. The gout app group also demonstrated stronger negative beliefs regarding the impact of gout (mean difference –2.43, 95% CI –3.68 to –1.18), stronger beliefs regarding the severity of symptoms (mean difference –1.97, 95% CI –3.12 to –0.82), and a stronger emotional response to gout (mean difference –2.38, 95% CI –3.85 to –0.90) at follow-up. Participant feedback highlighted the importance of tracking health-related information, customizing to the target group/individual, providing more interactive features, and simplifying information. Conclusions Participants found the commercially available gout app more engaging. However, these findings did not translate into differences in self-care behaviors. The gout app group also demonstrated stronger negative illness perceptions at the follow-up. Overall, these findings suggest that the development of gout apps would benefit from a user-centered approach with a focus on daily, long-term self-care behaviors as well as modifying illness beliefs. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12617001052325; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373217.

scholarly journals Mobile Health to Maintain Continuity of Patient-Centered Care for Chronic Kidney Disease: Content Analysis of Apps (Preprint)

2018 ◽  
Author(s):  
Ying-Li Lee ◽  
Yan-Yan Cui ◽  
Ming-Hsiang Tu ◽  
Yu-Chi Chen ◽  
Polun Chang
Keyword(s):  
Health Care ◽  
Kidney Disease ◽  
Mobile Health ◽  
Health Care Professionals ◽  
Patient Centered Care ◽  
Self Management ◽  
Patient Centered ◽  
Health Apps ◽  
Centered Care ◽  
Mobile Health Apps

BACKGROUND Chronic kidney disease (CKD) is a global health problem with a high economic burden, which is particularly prevalent in Taiwan. Mobile health apps have been widely used to maintain continuity of patient care for various chronic diseases. To slow the progression of CKD, continuity of care is vital for patients’ self-management and cooperation with health care professionals. However, the literature provides a limited understanding of the use of mobile health apps to maintain continuity of patient-centered care for CKD. OBJECTIVE This study identified apps related to the continuity of patient-centered care for CKD on the App Store, Google Play, and 360 Mobile Assistant, and explored the information and frequency of changes in these apps available to the public on different platforms. App functionalities, like patient self-management and patient management support for health care professionals, were also examined. METHODS We used the CKD-related keywords “kidney,” “renal,” “nephro,” “chronic kidney disease,” “CKD,” and “kidney disease” in traditional Chinese, simplified Chinese, and English to search 3 app platforms: App Store, Google Play, and 360 Mobile Assistant. A total of 2 reviewers reached consensus on coding guidelines and coded the contents and functionalities of the apps through content analysis. After coding, Microsoft Office Excel 2016 was used to calculate Cohen kappa coefficients and analyze the contents and functionalities of the apps. RESULTS A total of 177 apps related to patient-centered care for CKD in any language were included. On the basis of their functionality and content, 67 apps were recommended for patients. Among them, the most common functionalities were CKD information and CKD self-management (38/67, 57%), e-consultation (17/67, 25%), CKD nutrition education (16/67, 24%), and estimated glomerular filtration rate (eGFR) calculators (13/67, 19%). In addition, 67 apps were recommended for health care professionals. The most common functionalities of these apps were comprehensive clinical calculators (including eGFR; 30/67; 45%), CKD medical professional information (16/67, 24%), stand-alone eGFR calculators (14/67, 21%), and CKD clinical decision support (14/67, 21%). A total of 43 apps with single- or multiple-indicator calculators were found to be suitable for health care professionals and patients. The aspects of patient care apps intended to support self-management of CKD patients were encouraging patients to actively participate in health care (92/110, 83.6%), recognizing and effectively responding to symptoms (56/110, 50.9%), and disease-specific knowledge (53/110, 48.2%). Only 13 apps contained consulting management functions, patient management functions or teleconsultation functions designed to support health care professionals in CKD patient management. CONCLUSIONS This study revealed that the continuity of patient-centered care for CKD provided by mobile health apps is inadequate for both CKD self-management by patients and patient care support for health care professionals. More comprehensive solutions are required to enhance the continuity of patient-centered care for CKD.

scholarly journals Real-World Evidence of User Engagement With Mobile Health for Diabetes Management: Longitudinal Observational Study

10.2196/22212 ◽  
2020 ◽  
Vol 8 (11) ◽  
pp. e22212
Author(s):  
Anna-Katharina Böhm ◽  
Morten Lind Jensen ◽  
Mads Reinholdt Sørensen ◽  
Tom Stargardt
Keyword(s):  
Mobile Health ◽  
Real World ◽  
Diabetes Management ◽  
Patient Characteristics ◽  
Active Role ◽  
Self Management ◽  
User Engagement ◽  
User Characteristics ◽  
Real World Data ◽  
Average User

Background Patient support apps have risen in popularity and provide novel opportunities for self-management of diabetes. Such apps offer patients to play an active role in monitoring their condition, thereby increasing their own treatment responsibility. Although many health apps require active user engagement to be effective, there is little evidence exploring engagement with mobile health (mHealth). Objective This study aims to analyze the extent to which users engage with mHealth for diabetes and identify patient characteristics that are associated with engagement. Methods The analysis is based on real-world data obtained by Novo Nordisk’s Cornerstones4Care Powered by Glooko diabetes support app. User engagement was assessed as the number of active days and using measures expressing the persistence, longevity, and regularity of interaction within the first 180 days of use. Beta regressions were estimated to assess the associations between user characteristics and engagement outcomes for each module of the app. Results A total of 9051 individuals initiated use after registration and could be observed for 180 days. Among these, 55.39% (5013/9051) used the app for one specific purpose. The average user activity ratio varied from 0.05 (medication and food) to 0.55 (continuous glucose monitoring), depending on the module of the app. Average user engagement was lower if modules required manual data entries, although the initial uptake was higher for these modules. Regression analyses further revealed that although more women used the app (2075/3649, 56.86%), they engaged significantly less with it. Older people and users who were recently diagnosed tended to use the app more actively. Conclusions Strategies to increase or sustain the use of apps and availability of health data may target the mode of data collection and content design and should take into account privacy concerns of the users at the same time. Users’ engagement was determined by various user characteristics, indicating that particular patient groups should be targeted or assisted when integrating apps into the self-management of their disease.

scholarly journals Opportunities and Challenges of a Self-Management App to Support People With Spinal Cord Injury in the Prevention of Pressure Injuries: Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Julia Amann ◽  
Maddalena Fiordelli ◽  
Anke Scheel-Sailer ◽  
Mirjam Brach ◽  
Sara Rubinelli
Keyword(s):  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Focus Groups ◽  
Mobile Health ◽  
Health Care Professionals ◽  
Self Management ◽  
Motivational Support ◽  
Cord Injury ◽  
Study Participants

BACKGROUND Mobile health applications can offer tailored self-management support to individuals living with chronic health conditions. However, there are several challenges to the adoption of these technologies in practice. Co-design is a promising approach to overcoming some of these challenges by enabling the development of solutions that meet the actual needs and preferences of the relevant stakeholder groups. OBJECTIVE Taking spinal cord injury as a case in point, the overall objectives of this study were to identify the perceived benefits of a co-designed self-management app that could promote its uptake and to explore the factors that may impede adoption. METHODS We adopted a qualitative research approach guided by the Technology Acceptance Model. Data were collected through semistructured interviews with individuals with spinal cord injury (n=15) and two focus groups with health care professionals specialized in spinal cord injury (n=7, n=5). Prior to the interviews and focus groups, study participants were given time to explore the app prototype. All interviews were transcribed verbatim and analyzed using inductive thematic analysis. RESULTS Findings of our analysis indicate that study participants perceived the app prototype as potentially useful for supporting individuals with spinal cord injury in preventing pressure injuries. In particular, we identified three concrete use cases highlighting the benefits of the app for different audiences: (1) a companion for newly injured individuals, (2) an emergency kit and motivational support, and 3) a guide for informal caregivers and family members. We also uncovered several challenges that might impede the adoption of the self-management app in practice, including (1) challenges in motivating individuals to use the app, (2) concerns about the misuse and abuse of the app, and (3) organizational and maintenance challenges. CONCLUSIONS This study adds to a growing body of research that investigates individuals’ adoption and nonadoption behavior regarding mobile health solutions. Building on earlier work, we make recommendations on how to address the barriers to the adoption of mobile health solutions identified by this study. In particular, there is a need to foster trust in mobile health among prospective users, including both patients and health care professionals. Moreover, increasing personal relevance of mobile health solutions through personalization may be a promising approach to promote uptake. Last but not least, organizational support also plays an instrumental role in mobile health adoption. We conclude that even though co-design is promoted as a promising approach to develop self-management tools, co-design does not guarantee adoption. More research is needed to identify the most promising strategies to promote the adoption of evidence-based mobile health solutions in practice.

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