Adolescent Preferences and Design Recommendations for an Asthma Self-Management App: Mixed-Methods Study (Preprint)

BACKGROUND Approximately 10% of adolescents in the United States have asthma. Adolescents widely use apps on mobile phones and tablet technology for social networking and gaming purposes. Given the increase in recreational app use among adolescents, leveraging apps to support adolescent asthma disease management seems warranted. However, little empirical research has influenced asthma app development; adolescent users are seldom involved in the app design process. OBJECTIVE The aim of this mixed-methods study was to assess adolescent preferences and design recommendations for an asthma self-management app. METHODS A total of 20 adolescents with persistent asthma (aged 12-16 years) provided feedback on two asthma self-management apps during in-person semistructured interviews following their regularly scheduled asthma clinic visit and via telephone 1 week later. Interviews were audiorecorded, transcribed verbatim, analyzed using SPSS v24, and coded thematically using MAXQDA 11. RESULTS Regarding esthetics, app layout and perceived visual simplicity were important to facilitate initial app use. Adolescents were more likely to continually engage with apps that were deemed useful and met their informational needs. Adolescents also desired app features that fit within their existing paradigm or schema and included familiar components (eg, medication alerts that appear and sound like FaceTime notifications and games modeled after Quiz Up and Minecraft), as well as the ability to customize app components. They also suggested that apps include other features, such as an air quality tracker and voice command. CONCLUSIONS Adolescents desire specific app characteristics including customization and tailoring to meet their asthma informational needs. Involving adolescents in early stages of app development is likely to result in an asthma app that meets their self-management needs and design preferences and ultimately the adoption and maintenance of positive asthma self-management behaviors.

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Adolescent Preferences and Design Recommendations for an Asthma Self-Management App: Mixed-Methods Study

JMIR Formative Research ◽

10.2196/10055 ◽

2018 ◽

Vol 2 (2) ◽

pp. e10055 ◽

Cited By ~ 7

Author(s):

Courtney Roberts ◽

Adam Sage ◽

Lorie Geryk ◽

Betsy Sleath ◽

Delesha Carpenter

Keyword(s):

Mixed Methods ◽

Mixed Methods Study ◽

Self Management ◽

Design Recommendations

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Patients’ information needs and attitudes about post-treatment surveillance for colorectal cancer in the United States: a multi-perspective, mixed methods study

BMJ Open ◽

10.1136/bmjopen-2018-025888 ◽

2019 ◽

Vol 9 (8) ◽

pp. e025888 ◽

Cited By ~ 1

Author(s):

Lisa M Lowenstein ◽

Robert J Volk ◽

Amanda Cuddy ◽

Andrea P Hempstead ◽

Y Nancy You ◽

...

Keyword(s):

Colorectal Cancer ◽

Mixed Methods ◽

Safety Net ◽

The United States ◽

Post Treatment ◽

Mixed Methods Study ◽

Survey Study ◽

Informational Needs ◽

Safety Net Hospital ◽

Patient Advocates

ObjectiveWe sought to determine patients’ informational needs for post-treatment surveillance and elicit clinicians’ and patient advocates’ (ie, stakeholders) opinions regarding what patients should know about post-treatment surveillance in the USA.DesignA mixed-methods study, using semi-structured interviews followed by a survey study.SettingParticipants for the interviews were from two large academic medical centres and a safety-net hospital. The stakeholders were recruited from attendees at the Alliance for Clinical Trials in Oncology Network Spring 2016 meeting.ParticipantsParticipants for the in-depth interviews were purposively sampled. Eligible patients were 6 months to 5 years post curative resection for colorectal cancer and were fluent in English. Participants for the anonymous survey were stakeholders.Main outcome(s) and measure(s)The main outcome was patients’ with colorectal cancer informational needs for post-treatment surveillance, using an interview guide. The second outcome was the importance of the identified informational needs using an anonymous survey.ResultsOf the 67 patients approached, 31 were interviewed (response rate=46%), the majority were between 1 and 3 years post-treatment (81%) and diagnosed at stage III (74%). Despite a desire to monitor for cancer recurrence, patients had little understanding of the concept of post-treatment surveillance, equating surveillance with screening and a belief that if a recurrence was found early there would be a higher likelihood of cure. The survey suggested that clinicians (n=38) and patient advocates (n=11) had some differing opinions regarding what patients should know about surveillance to be active in decisions. For example, compared with clinicians, patient advocates felt that patients should know recurrence treatment options (100% vs 58%) and likelihood for cure following recurrence treatment (100% vs 38%).ConclusionsThe results of this exploratory mixed-methods study suggest that novel educational interventions targeting both patients and clinicians are needed to address the informational needs for post-treatment surveillance of colorectal cancer.

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Type 2 diabetes patients’ views on prevention of hypoglycaemia – a mixed methods study investigating self-management issues and self-identified causes of hypoglycaemia

BMC Family Practice ◽

10.1186/s12875-021-01466-0 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Stijn Crutzen ◽

Tessa van den Born-Bondt ◽

Petra Denig ◽

Katja Taxis

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Mixed Methods ◽

Food Intake ◽

Mixed Methods Study ◽

Self Management ◽

Hypoglycaemic Event ◽

Glucose Levels ◽

Management Issues

Abstract Background Hypoglycaemia is a common and potentially avoidable adverse event in people with type 2 diabetes (T2D). It can reduce quality of life, increase healthcare costs, and reduce treatment success. We investigated self-management issues associated with hypoglycaemia and self-identified causes of hypoglycaemia in these patients. Methods In this mixed methods study qualitative semi-structured interviews were performed, which informed a subsequent quantitative survey in T2D patients. All interviews were audio recorded, transcribed verbatim and coded independently by two coders using directed content analysis, guided by the Theoretical Domains Framework. Descriptive statistics were used to quantify the self-management issues and causes of hypoglycaemia collected in the survey for the respondents that had experienced at least one hypoglycaemic event in the past. Results Sixteen participants were interviewed, aged 59–84 years. Participants perceived difficulties in managing deviations from routine, and they sometimes lacked procedural knowledge to adjust medication, nutrition or physical activity to manage their glucose levels. Grief and loss of support due to the loss of a partner interfered with self-management and lead to hypoglycaemic events. Work ethic lead some participant to overexerting themselves, which in turn lead to hypoglycaemic events. The participants had difficulties preventing hypoglycaemic events, because they did not know the cause, suffered from impaired hypoglycaemia awareness and/or did not want to regularly measure their blood glucose. When they did recognise a cause, they identified issues with nutrition, physical activity, stress or medication. In total, 40% of respondents reported regular stress as an issue, 24% reported that they regularly overestimated their physical abilities, and 22% indicated they did not always know how to adjust their medication. Around 16% of patients could not always remember whether they took their medication, and 42% always took their medication at regular times. Among the 83 respondents with at least one hypoglycaemic event, common causes for hypoglycaemia mentioned were related to physical activity (67%), low food intake (52%), deviations from routine (35%) and emotional burden (28%). Accidental overuse of medication was reported by 10%. Conclusion People with T2D experience various issues with self-managing their glucose levels. This study underlines the importance of daily routine and being able to adjust medication in relation to more physical activity or less food intake as well as the ability to reduce and manage stress to prevent hypoglycaemic events.

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Correction: Combined Use of Web-Based and In-Person Education on Ill Health Self-management Skills in Adults With Bipolar Disorder: Protocol for a Mixed Methods Study

JMIR Research Protocols ◽

10.2196/33506 ◽

2021 ◽

Vol 10 (9) ◽

pp. e33506

Author(s):

Anna Hatzioannou ◽

Andreas Chatzittofis ◽

Virginia Sunday Koutroubas ◽

Evridiki Papastavrou ◽

Maria Karanikola

Keyword(s):

Bipolar Disorder ◽

Mixed Methods ◽

Mixed Methods Study ◽

Self Management ◽

Management Skills ◽

Web Based ◽

Combined Use

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Secure Messaging, Diabetes Self‐Management, and the Importance of Patient Autonomy: A Mixed Methods Study

Health Services Research ◽

10.1111/1475-6773.13383 ◽

2020 ◽

Vol 55 (S1) ◽

pp. 41-42

Author(s):

S. Robinson ◽

M. Zocchi ◽

D. Netherton ◽

A. Ash ◽

C. Purington ◽

...

Keyword(s):

Mixed Methods ◽

Patient Autonomy ◽

Mixed Methods Study ◽

Self Management ◽

Secure Messaging

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Teaching self-management support in Dutch Bachelor of Nursing education: A mixed methods study of the curriculum

Nurse Education Today ◽

10.1016/j.nedt.2018.06.005 ◽

2018 ◽

Vol 68 ◽

pp. 146-152 ◽

Cited By ~ 1

Author(s):

Susanne M. van Hooft ◽

Yvonne N. Becqué ◽

Jolanda Dwarswaard ◽

AnneLoes van Staa ◽

Roland Bal

Keyword(s):

Nursing Education ◽

Mixed Methods ◽

Mixed Methods Study ◽

Self Management ◽

Management Support

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3361 Feasibility, Acceptability, and Appropriateness of an Insertable Vaginal Cup to Manage Urinary Incontinence Among Women with Obstetric Fistula in Ghana: A Mixed Methods Study

Journal of Clinical and Translational Science ◽

10.1017/cts.2019.105 ◽

2019 ◽

Vol 3 (s1) ◽

pp. 44-45

Author(s):

Nessa E Ryan

Keyword(s):

Urinary Incontinence ◽

Mixed Methods ◽

Repeated Measures ◽

Obstetric Fistula ◽

Mixed Methods Study ◽

Relative Advantage ◽

Self Management ◽

Future Research ◽

Leakage Reduction ◽

The Mean

OBJECTIVES/SPECIFIC AIMS: 1. To assess feasibility (efficacy, safety, acceptability) of the menstrual cup for managing urinary incontinence among women with obstetric fistula 2. To examine pre-implementation facilitators and barriers (including appropriateness) among additional stakeholders METHODS/STUDY POPULATION: Sequential explanatory mixed methods study whereby repeated measures clinical trial results are explained by subsequent interviews with additional women with OF on coping and stigma and other stakeholders on perceptions of fistula self-management. RESULTS/ANTICIPATED RESULTS: Of the 32 patients screened, 11 were eligible (100% consent rate). At baseline, mean (±SD) leakage in ml was 63.2 (±49.2) (95% CI: 30.2-96.3) over two hours, while the mean leakage over two hours of use of the cup was 16.8 (±16.5) (95% CI: 5.7-27.9). The mean difference of 46.4 (±52.1) ml with use of the cup (95% CI: 11.4-81.4) was statistically significant (p = 0.02). With the cup, women experienced an average 61.0% (±37.4) (95% CI: 35.9-86.2) leakage reduction, a difference 10/11 users (91.0%) perceived in reduced leakage. One participant, reporting four previous surgical attempts, experienced a 78.7% leakage reduction. Acceptability was high–women could easily insert (8/11), remove (8/11), and comfortably wear (11/11) the cup and most (10/11) would recommend it. No adverse effects attributable to the intervention were observed on exam, although some women perceived difficulties with insertion and removal. Data collection tools were appropriate with slight modification advised. Interviews highlighted that women were already using various active coping and resistance strategies but lacked access to tools to support coping. Additional stakeholders reported the innovation was a simple, low-cost device that is an appropriate fit with ongoing fistula programming. Pre-implementation facilitators include the clear relative advantage to existing self-management strategies, the potential to build upon existing partnerships to implement, and a tension for change to address surgical gaps. Barriers included additional stakeholder’s perceptions of low user acceptability and appropriateness in some cases and the need for additional study data to inform decision making for practice and policy. DISCUSSION/SIGNIFICANCE OF IMPACT: The innovation is efficacious, acceptable, adds to current coping strategies, and fits within existing fistula programs. Stakeholders’ pre-implementation perceptions highlight the importance of partnerships and the need for an evidence base related to effectiveness, acceptability, and cost. Challenges to address include access to resources within these contexts (water, soap, and safe space to empty cup) and development of a culturally appropriate counseling message. Future research warranted.

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