scholarly journals Development and Usability Testing of a Physical Activity Mobile Game for Hematopoietic Stem Cell Transplant Patients (Preprint)

2020 ◽  
Author(s):  
Yulan Liang ◽  
Shannon Cerbas ◽  
Arpad Kelemen ◽  
Cecilia Sik-Lanyi ◽  
Barbara Van de Castle
Keyword(s):  
Physical Activity ◽  
Stem Cell ◽  
Cancer Patients ◽  
Mobile Health ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Step Counter ◽  
Mobile Game

BACKGROUND Importance Physical activity mobile applications (apps) may encourage cancer patients to increase exercise, consequently decreasing cancer-related fatigue. While many fitness apps are currently available for download, most of them are not well suited for cancer patients due to unique barriers patients face, such as fatigue, pain, and nausea. OBJECTIVE The aim of this paper is to design, develop, and perform Alpha testing of a physical activity mobile health game for hematopoietic stem cell transplant (HSCT) patients. The ultimate goal of this project is to motivate and track HSCT patient and to increase their awareness of the importance of physical activity and provide them with a safe and fun way to exercise. METHODS A mobile health game called Walking Warrior (WW) was designed as a matching puzzle game with an added feature of a step counter. WW came to fruition after following an iterative process model with several prototypes. Computer programmers and bone marrow transplant nurses were recruited to perform expert heuristic usability evaluation of the WW prototype by completing a heuristics questionnaire and providing qualitative suggestions for improvement. RESULTS Findings from the expert heuristic usability evaluation suggest the game’s assets of clarity, ease of use, appropriateness, quality, motivation, and mental effort were moderately favorable. Experts recommend improvements on speed, movement of tiles, appearance, and accuracy of the step counter. CONCLUSIONS The evaluation provided qualitative information to further improve game design and development. This mobile game could ultimately help patients increase physical activity as an aid to recovery.

scholarly journals A Mobile Health App (Roadmap 2.0) for Patients Undergoing Hematopoietic Stem Cell Transplant: Qualitative Study on Family Caregivers' Perspectives and Design Considerations

10.2196/15775 ◽  
2019 ◽  
Vol 7 (10) ◽  
pp. e15775 ◽  
Author(s):  
Dima Chaar ◽  
Ji Youn Shin ◽  
Amanda Mazzoli ◽  
Rebecca Vue ◽  
Jacob Kedroske ◽  
...  
Keyword(s):  
Stem Cell ◽  
Family Caregivers ◽  
Hematopoietic Stem Cell ◽  
Mobile Health ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
Well Being ◽  
Outpatient Setting ◽  
Cell Transplant ◽  
Hematopoietic Stem

Background Hematopoietic stem cell transplantation (HCT), also referred to as blood and marrow transplantation (BMT), is a high-risk, but potentially curative therapy for a number of cancer and noncancer conditions. BMT Roadmap (Roadmap 1.0) is a mobile health app that was developed as a family caregiver–facing tool to provide informational needs about the health status of patients undergoing inpatient HCT. Objective This study explored the views and perceptions of family caregivers of patients undergoing HCT and their input regarding further technology development and expansion of BMT Roadmap into the outpatient setting (referred to as Roadmap 2.0). Methods Semistructured qualitative interviews were conducted among 24 family caregivers. Questions were developed from existing literature coupled with prior in-depth observations and interviews in hospital-based settings to explore the study objectives. Participants were recruited during routine outpatient clinic appointments of HCT patients, and all interviews were conducted in the participants’ homes, the setting in which Roadmap 2.0 is intended for use. A thematic analysis was performed using a consistent set of codes derived from our prior research. New emerging codes were also included, and the coding structure was refined with iterative cycles of coding and data collection. Results Four major themes emerged through our qualitative analysis: (1) stress related to balancing caregiving duties; (2) learning and adapting to new routines (resilience); (3) balancing one’s own needs with the patient’s needs (insight); and (4) benefits of caregiving. When caregivers were further probed about their views on engagement with positive activity interventions (ie, pleasant activities that promote positive emotions and well-being such as expressing gratitude or engaging in activities that promote positive thoughts, emotions, and behaviors), they preferred a “menu” of positive activities to help support caregiver health and well-being. Conclusions This study involved family caregivers as participants in the development of new components for Roadmap 2.0. Our research provided a further understanding of the many priorities that hematopoietic stem cell transplant family caregivers face while maintaining balance in their lives. Their schedules can often be unpredictable, even more so once the patient is discharged from the hospital. Our findings suggest that expanding Roadmap 2.0 into the outpatient setting may provide critical caregiver support and that HCT caregivers are interested in and willing to engage in positive activities that may enhance well-being and attenuate the stress associated with caregiving. International Registered Report Identifier (IRRID) RR2-10.2196/resprot.4918

Chlorhexidine bathing to reduce CLABSI in hematopoietic stem cell transplant and hematologic malignancy patients.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 119-119
Author(s):  
Christina Reeber ◽  
Kelly Bailey ◽  
Carrie Nemec ◽  
Robert A. Salata ◽  
Kathleen Gonzalez
Keyword(s):  
Stem Cell ◽  
Adverse Effects ◽  
Cancer Patients ◽  
Hematopoietic Stem Cell ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Skin Integrity ◽  
Clabsi Rate

119 Background: At University Hospitals Seidman Cancer Center (UHSCC), adult patients with hematologic malignancies (HM) and those undergoing hematopoietic stem cell transplant (HSCT) require a central venous catheter nearly 100% of the time. According to the National Health Safety Network (NSHN), for permanent and temporary line days, the pooled mean infection rate in 2009 was 3.5 and 4.1, respectively. Catheter-associated bloodstream infections (CLABSI) lead to increased morbidity, mortality, length of stay, and cost. At UHSCC, the CLABSI rate for patients on the HM service from August 2010 through August 2011 was 8.0. Methods: It has been demonstrated that the use of Chlorhexidine (CHG) wipes has decreased the CLABSI rate in ICU and long term care patients. We were unable to identify literature evidence or medical centers currently using CHG bathing wipes in their cancer patients, specifically HSCT. A quality improvement project on the effectiveness of CHG bathing on the HSCT and HM populations commenced on April 2, 2012, at UHSCC. This study is also monitoring skin integrity to determine if there are adverse effects. Patient satisfaction is also being assessed. Results: Early results demonstrate a reduction in overall CLABSI rate to 4.3%, and no vancomycin resistant enterococcus (VRE) infections were observed since early April. Adverse effects on skin integrity have not been noted. An unanticipated obstacle is related to the “culture of bathing.” Specifically, caregivers and patients often do not understanding the importance of daily bathing as a key clinical intervention despite repeated education. The team continues to investigate this issue. Conclusions: CHG bathing appears to be an effective, well-tolerated, and minimally invasive intervention in preventing CLABSI in severely immunocompromised cancer patients. Unanticipated obstacles to implementing daily bathing have been encountered and are being addressed. During the course of this project, we also began tracking our CLABSI rate for the entire patient population on the HM HSCT nursing unit along with the service-based rate noted above.

scholarly journals A Physical Activity Mobile Game for Hematopoietic Stem Cell Transplant Patients: App Design, Development, and Evaluation

JMIRx Med ◽  
10.2196/20461 ◽  
2021 ◽  
Vol 2 (2) ◽  
pp. e20461 ◽  
Author(s):  
Shannon Cerbas ◽  
Arpad Kelemen ◽  
Yulan Liang ◽  
Cecilia Sik-Lanyi ◽  
Barbara Van de Castle
Keyword(s):  
Physical Activity ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
Ease Of Use ◽  
Cell Transplant ◽  
Design Development ◽  
Hematopoietic Stem ◽  
Step Counter ◽  
Patients With Cancer ◽  
Item Responses

Background Physical activity mobile apps may encourage patients with cancer to increase exercise uptake, consequently decreasing cancer-related fatigue. While many fitness apps are currently available for download, most are not suitable for patients with cancer due to the unique barriers these patients face, such as fatigue, pain, and nausea. Objective The aim of this study is to design, develop, and perform alpha testing of a physical activity mobile health game for hematopoietic stem cell transplant (HSCT) patients. The ultimate future goal of this project is to motivate HSCT patients to increase physical activity and provide them with a safe and fun way to exercise. Methods A mobile health game called Walking Warrior was designed as a puzzle game where tiles are moved and matched. Walking Warrior interfaces with an open-source step counter and communicates with a central online MySQL database to record game play and walking performance. The game came to fruition after following an iterative process model with several prototypes. Game developers and bone marrow transplant nurses were recruited to perform an expert usability evaluation of the Walking Warrior prototype by completing a heuristic questionnaire and providing qualitative suggestions for improvement. Experts also made qualitative recommendations for improvements on speed, movement of tiles, appearance, and accuracy of the step counter. We recruited 5 additional usability evaluators who searched for and compared 4 open-source step counter programs, then qualitatively compared them for accuracy, robustness, cheat proofing, ease of use, and battery drain issues. Patient recruitment is planned at a later stage in this project. This paper only describes software design, development, and evaluation, rather than behavioral evaluation (ie, impact on physical activity), which is the long-term goal of this project. Results Internal consistency and the instrument’s reliability evaluation results from 1 clinical expert and 4 technical experts were deemed excellent (Cronbach α=.933). A hierarchical cluster analysis of the questionnaire item responses for similarity/dissimilarity among the experts indicated that the two expert groups were not clustered into two separate groups in the dendrogram. This indicates that the item responses were not affected by profession. Factor analyses indicate that responses from the 40-item questionnaire were classified into five primary factors. The associated descriptive statistics for each of these categories were as follows (on a scale of 1 to 5): clarity and ease (median 4; mean 3.7, SD 0.45), appropriateness (median 4; mean 3.7, SD 0.49), game quality (median 3.5; mean 3.3, SD 0.42), motivation to walk (median 3; mean 3.1, SD 0.58), and mental effort (median 3.5; mean 3.1, SD 1.27). Conclusions The evaluation from experts and clinicians provided qualitative information to further improve game design and development. Findings from the expert usability evaluation suggest the game’s assets of clarity, ease of use, appropriateness, quality, motivation to walk, and mental effort were all favorable. This mobile game could ultimately help patients increase physical activity as an aid to recovery.

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