Is clinician-supported use of a mindfulness smartphone app a feasible treatment for depression? A mixed-methods feasibility study

BACKGROUND Health care systems are increasingly looking to mobile device technologies (mobile health) to improve patient experience and health outcomes. SecondEars is a smartphone app designed to allow patients to audio-record medical consultations to improve recall, understanding, and health care self-management. Novel health interventions such as SecondEars often fail to be implemented post pilot-testing owing to inadequate user experience (UX) assessment, a key component of a comprehensive implementation strategy. OBJECTIVE This study aimed to pilot the SecondEars app within an active clinical setting to identify factors necessary for optimal implementation. Objectives were to (1) investigate patient UX and acceptability, utility, and satisfaction with the SecondEars app, and (2) understand health professional perspectives on issues, solutions, and strategies for effective implementation of SecondEars. METHODS A mixed methods implementation study was employed. Patients were invited to test the app to record consultations with participating oncology health professionals. Follow-up interviews were conducted with all participating patients (or carers) and health professionals, regarding uptake and extent of app use. Responses to the Mobile App Rating Scale (MARS) were also collected. Interviews were analyzed using interpretive descriptive methodology; all quantitative data were analyzed descriptively. RESULTS A total of 24 patients used SecondEars to record consultations with 10 multidisciplinary health professionals. In all, 22 of these patients used SecondEars to listen to all or part of the recording, either alone or with family. All 100% of patient participants reported in the MARS that they would use SecondEars again and recommend it to others. A total of 3 themes were identified from the patient interviews relating to the UX of SecondEars: empowerment, facilitating support in cancer care, and usability. Further, 5 themes were identified from the health professional interviews relating to implementation of SecondEars: changing hospital culture, mitigating medico-legal concerns, improving patient care, communication, and practical implementation solutions. CONCLUSIONS Data collected during pilot testing regarding recording use, UX, and health professional and patient perspectives will be important for designing an effective implementation strategy for SecondEars. Those testing the app found it useful and felt that it could facilitate the benefits of consultation recordings, along with providing patient empowerment and support. Potential issues regarding implementation were discussed, and solutions were generated. CLINICALTRIAL Australia and New Zealand Clinical Trials Registry ACTRN12618000730202; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373915&isClinicalTrial=False

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Exergaming to improve balance and decrease the risk of falling in adults with knee osteoarthritis: a mixed-methods feasibility study

Physiotherapy Theory and Practice ◽

10.1080/09593985.2021.1952670 ◽

2021 ◽

pp. 1-13

Author(s):

Donald G. Manlapaz ◽

Gisela Sole ◽

Prasath Jayakaran ◽

Cathy M. Chapple

Keyword(s):

Mixed Methods ◽

Knee Osteoarthritis ◽

Feasibility Study ◽

Risk Of Falling

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Reamed intramedullary nailing versus circular frame external fixation for segmental tibial fractures (STIFF-F): a mixed methods feasibility study

Pilot and Feasibility Studies ◽

10.1186/s40814-021-00821-3 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Caroline B. Hing ◽

Elizabeth Tutton ◽

Toby O. Smith ◽

Molly Glaze ◽

Jamie R. Stokes ◽

...

Keyword(s):

Mixed Methods ◽

External Fixation ◽

Intramedullary Nailing ◽

Feasibility Study ◽

Online Survey ◽

Tibial Fracture ◽

Tibial Fractures ◽

Circular Frame ◽

Pilot Rct ◽

Randomised Controlled

Abstract Background Segmental tibial fractures are fractures in two or more areas of the tibial diaphysis resulting in a separate intercalary segment of the bone. Surgical fixation is recommended for patients with segmental tibial fractures as non-operative treatment outcomes are poor. The most common surgical interventions are intramedullary nailing (IMN) and circular frame external fixation (CFEF), but evidence about which is better is of poor quality. An adequately powered randomised controlled trial (RCT) to determine optimum treatment is required. STIFF-F aimed to assess the feasibility of a multicentre RCT comparing IMN with CFEF for segmental tibial fracture. Methods STIFF-F was a mixed-methods feasibility study comprising a pilot RCT conducted at six UK Major Trauma Centres, qualitative interviews drawing on Phenomenology and an online survey of rehabilitation. The primary outcome was recruitment rate. Patients, 16 years and over, with a segmental tibial fracture (open or closed) deemed suitable for IMN or CFEF were eligible to participate. Randomisation was stratified by site using random permuted blocks of varying sizes. Participant or assessor blinding was not possible. Interviews were undertaken with patients about their experience of injury, treatment, recovery and participation. Staff were interviewed to identify contextual factors affecting trial processes, their experience of recruitment and the treatment pathway. An online survey was developed to understand the rehabilitation context of the treatments. Results Eleven patients were screened and three recruited to the pilot RCT. Nineteen staff and four patients participated in interviews, and 11 physiotherapists responded to the survey. This study found the following: (i) segmental tibial fractures were rarer than anticipated, (ii) the complexity of the injury, study setup times and surgeon treatment preferences impeded recruitment, (iii) recovery from a segmental tibial fracture is challenging, and rehabilitation protocols are inconsistent and (iv) despite the difficulty recruiting, staff valued this research question and strived to find a way forward. Conclusion The proposed multicentre RCT comparing IMN with CFEF is not feasible. This study highlighted the difficulty of recruiting patients to an RCT of a complex rare injury over a short time period. Trial registration The study was registered with the International Standard Randomised Controlled Trials Number Registry: ISRCTN11229660

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Cardiac rehabilitation for people with sub-acute, mild to moderate stroke: results from a mixed methods feasibility study

Physiotherapy ◽

10.1016/j.physio.2020.03.131 ◽

2020 ◽

Vol 107 ◽

pp. e94

Author(s):

N. Clague-Baker ◽

T. Robinson ◽

C. Gillies ◽

S. Drewry ◽

A. Hagenberg ◽

...

Keyword(s):

Mixed Methods ◽

Cardiac Rehabilitation ◽

Feasibility Study

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Medication Adherence Reminder System for Virtual Home Assistants: Mixed Methods Evaluative Study (Preprint)

10.2196/preprints.27327 ◽

2021 ◽

Author(s):

Cynthia F. Corbett ◽

Elizabeth M. Combs ◽

Peyton S. Chandarana ◽

Isabel Stringfellow ◽

Karen Worthy ◽

...

Keyword(s):

Mixed Methods ◽

Medication Adherence ◽

Feasibility Study ◽

Global Public Health ◽

Constructive Feedback ◽

The Past ◽

Significant Difference ◽

Mcnemar’S Test ◽

Medication Reminder ◽

Mcnemar's Test

BACKGROUND Medication non-adherence is a global public health challenge that results in sub-optimal health outcomes and increases healthcare costs. Forgetting to take medicines is one of the most common reasons for unintentional non-adherence. Research findings indicate that voice-activated virtual home assistants (VHAs), such as Amazon Echo and Google Home devices, may be useful in promoting medication adherence. OBJECTIVE Create a medication adherence app (skill) for Amazon Echo devices and measure the use, usability, and usefulness of that skill. METHODS A single-group mixed methods cohort feasibility study was conducted with females who took oral contraceptives (n=25). Participants were undergraduate students (mean age = 21.8, SD 6.2) at an urban university in the Southeast United States. Participants were given an Amazon Echo Dot with MedBuddy, a new medication reminder skill for Echo devices created by our team, attached to their study account, which they used for 60 days. Participants self-reported baseline and post-study medication adherence. MedBuddy use was objectively evaluated by tracking the participants’ interaction with MedBuddy through Amazon Alexa. The usability and usefulness of MedBuddy were evaluated through a post-study interview with participants responding to both quantitative and qualitative questions. RESULTS Participants’ interactions with MedBuddy, as tracked through Amazon Alexa, only occurred on half of the study days (mean of 50.97, SD 29.5). Compared to baseline, at study end participants reported missing their medication less in the past one and six months (χ 2 = .884 and .420 respectively, McNemar’s test p < .001 for both). However, there was no significant difference in participants’ reported adherence to consistently taking medication within the same two-hour time frame each day the past one or six months at the end of the study compared to baseline (χ 2 = 3.544 and 5.526 respectively, McNemar’s test p = .63 and p = .13 respectively). Overall feedback about usability was positive, and participants provided constructive feedback about features of the skill that could be improved. Participants’ evaluation of the usefulness of Medbuddy was overwhelmingly positive. Most participants (65.2%, n=15) said they would continue to use MedBuddy as a medication reminder in the future if provided the opportunity and the majority (91.3%, n=21) said they would recommend it to others. MedBuddy features that participants enjoyed were an external prompt separate from their phone, being able to hear the reminder prompt from a separate room, multiple reminders, and verbal responses as prompts. CONCLUSIONS The results of this feasibility study indicate the MedBuddy medication reminder skill may be useful in promoting medication adherence, but the skill could benefit from further usability enhancements.

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