scholarly journals Selecting Evidence-Based Content for Inclusion in Self-Management Apps for Pressure Injuries in Individuals With Spinal Cord Injury: Participatory Design Study (Preprint)

2019 ◽  
Author(s):  
Maddalena Fiordelli ◽  
Claudia Zanini ◽  
Julia Amann ◽  
Anke Scheel-Sailer ◽  
Mirjam Brach ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Community Dwelling ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Self Management ◽  
Evidence Based ◽  
Chronic Health ◽  
Cord Injury ◽  
Selection Of

BACKGROUND Technological solutions, particularly mobile health (mHealth), have been shown to be potentially viable approaches for sustaining individuals’ self-management of chronic health conditions. Theory-based interventions are more successful, as evidence-based information is an essential prerequisite for appropriate self-management. However, several reviews have shown that many existing mobile apps fail to be either theoretically grounded or based on evidence. Although some authors have attempted to address these two issues by focusing on the design and development processes of apps, concrete efforts to systematically select evidence-based content are scant. OBJECTIVE The objective of this study was to present a procedure for the participatory identification of evidence-based content to ground the development of a self-management app. METHODS To illustrate the procedure, we focused on the prevention and management of pressure injuries (PIs) in individuals with spinal cord injury (SCI). The procedure involves the following three steps: (1) identification of existing evidence through review and synthesis of existing recommendations on the prevention and self-management of PIs in SCI; (2) a consensus meeting with experts from the field of SCI and individuals with SCI to select the recommendations that are relevant and applicable to community-dwelling individuals in their daily lives; and (3) consolidation of the results of the study. RESULTS In this case study, at the end of the three-step procedure, the content for an mHealth intervention was selected in the form of 98 recommendations. CONCLUSIONS This study describes a procedure for the participatory identification and selection of disease-specific evidence and professional best practices to inform self-management interventions. This procedure might be especially useful in cases of complex chronic health conditions, as every recommendation in these cases needs to be evaluated and considered in light of all other self-management requirements. Hence, the agreement of experts and affected individuals is essential to ensure the selection of evidence-based content that is considered to be relevant and applicable.

scholarly journals Selecting Evidence-Based Content for Inclusion in Self-Management Apps for Pressure Injuries in Individuals With Spinal Cord Injury: Participatory Design Study

10.2196/15818 ◽  
2020 ◽  
Vol 8 (5) ◽  
pp. e15818 ◽  
Author(s):  
Maddalena Fiordelli ◽  
Claudia Zanini ◽  
Julia Amann ◽  
Anke Scheel-Sailer ◽  
Mirjam Brach ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Community Dwelling ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Self Management ◽  
Evidence Based ◽  
Chronic Health ◽  
Cord Injury ◽  
Selection Of

Background Technological solutions, particularly mobile health (mHealth), have been shown to be potentially viable approaches for sustaining individuals’ self-management of chronic health conditions. Theory-based interventions are more successful, as evidence-based information is an essential prerequisite for appropriate self-management. However, several reviews have shown that many existing mobile apps fail to be either theoretically grounded or based on evidence. Although some authors have attempted to address these two issues by focusing on the design and development processes of apps, concrete efforts to systematically select evidence-based content are scant. Objective The objective of this study was to present a procedure for the participatory identification of evidence-based content to ground the development of a self-management app. Methods To illustrate the procedure, we focused on the prevention and management of pressure injuries (PIs) in individuals with spinal cord injury (SCI). The procedure involves the following three steps: (1) identification of existing evidence through review and synthesis of existing recommendations on the prevention and self-management of PIs in SCI; (2) a consensus meeting with experts from the field of SCI and individuals with SCI to select the recommendations that are relevant and applicable to community-dwelling individuals in their daily lives; and (3) consolidation of the results of the study. Results In this case study, at the end of the three-step procedure, the content for an mHealth intervention was selected in the form of 98 recommendations. Conclusions This study describes a procedure for the participatory identification and selection of disease-specific evidence and professional best practices to inform self-management interventions. This procedure might be especially useful in cases of complex chronic health conditions, as every recommendation in these cases needs to be evaluated and considered in light of all other self-management requirements. Hence, the agreement of experts and affected individuals is essential to ensure the selection of evidence-based content that is considered to be relevant and applicable.

Poster 407 Chronic Health Conditions among Persons with Spinal Cord Injury

PM&R ◽  
2014 ◽  
Vol 6 (9) ◽  
pp. S328
Author(s):  
Alexander Clarke ◽  
Lee Saunders ◽  
Denise Tate ◽  
Martin Forchheimer ◽  
James Krause
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health ◽  
Cord Injury

Lifetime Prevalence of Chronic Health Conditions Among Persons With Spinal Cord Injury

2015 ◽  
Vol 96 (4) ◽  
pp. 673-679 ◽  
Author(s):  
Lee L. Saunders ◽  
Alexander Clarke ◽  
Denise G. Tate ◽  
Martin Forchheimer ◽  
James S. Krause
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Lifetime Prevalence ◽  
Chronic Health ◽  
Cord Injury

scholarly journals Association of Secondary Health Conditions With Future Chronic Health Conditions Among Persons With Traumatic Spinal Cord Injury

2020 ◽  
Vol 26 (4) ◽  
pp. 283-289
Author(s):  
Yue Cao ◽  
Nicole DiPiro ◽  
James S. Krause
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Anxiety Disorder ◽  
Chronic Health Conditions ◽  
Blood Cholesterol ◽  
Health Conditions ◽  
Traumatic Spinal Cord Injury ◽  
Chronic Health ◽  
Cord Injury

Background: Secondary health conditions (SHC) are physical and mental health conditions that are causally related to disabilities. Studies have found that SHC increase risk of negative health outcomes among people with traumatic spinal cord injury (TSCI). However, little has been done to assess the association of SHC with the risk of chronic health conditions (CHC) after TSCI. Objectives: To identify the prevalence of CHC in adults with TSCI, changes in CHC at follow-up, and the associations of baseline SHC with future CHC. Methods: Participants included 501 adults with TSCI of at least 1-year duration, identified through a population-based surveillance system. Baseline and follow-up self-report assessments were completed. We measured seven SHC: fatigue, spasticity, pain, pressure ulcers, subsequent injury, fracture, and anxiety disorder, and measured seven CHC: diabetes, heart attack, coronary artery disease, stroke, cancer, hypertension, and high blood cholesterol. Control variables included gender, race/ethnicity, age at injury, years post injury, injury severity, smoking status, binge drinking, and taking prescription medication. We implemented a Poisson regression model for the multivariate analyses. Results: The total number of CHC, the percentage of participants having at least one CHC, and prevalence of three individual CHC (diabetes, cancer, and high cholesterol) increased from baseline to follow-up. After controlling for demographic, injury characteristics, and behavioral factors, pain interference and anxiety disorder at baseline were associated with the total number of CHC at follow-up. Conclusion: CHC are common among adults with TSCI and increase significantly over time. Pain and anxiety disorders appear to be risk factors for future CHC.

scholarly journals Co-designing a Self-Management App Prototype to Support People With Spinal Cord Injury in the Prevention of Pressure Injuries: Mixed Methods Study (Preprint)

2020 ◽  
Author(s):  
Julia Amann ◽  
Maddalena Fiordelli ◽  
Mirjam Brach ◽  
Sue Bertschy ◽  
Anke Scheel-Sailer ◽  
...  
Keyword(s):  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Health Care Professionals ◽  
Usability Testing ◽  
Design Approach ◽  
Self Management ◽  
Evidence Based ◽  
High Fidelity ◽  
Cord Injury

BACKGROUND Spinal cord injury is a complex chronic health condition that requires individuals to actively self-manage. Therefore, an evidence-based, self-management app would be of value to support individuals with spinal cord injury in the prevention of pressure injuries. OBJECTIVE The main objectives of this study were to (1) establish a co-design approach for developing a high-fidelity prototype app for the self-management of individuals with spinal cord injury, (2) design the prototype that resulted from this process, and (3) conduct the first usability assessment of the prototype app. METHODS We adopted a co-design approach to develop an evidence-based app prototype. Starting from a preliminary content model (based on clinical guidelines for the prevention of pressure injuries) and three research-based user personas, we conducted an ideation workshop involving individuals with spinal cord injury and health care professionals. The ideation workshop formed the basis for two consecutive design sprints. The result of this co-design phase was an interactive app prototype. The prototype was evaluated in two rounds of usability testing (N=4 and N=15, respectively) using a combination of qualitative and quantitative methods. RESULTS The co-design process resulted in a high-fidelity prototype with two key components: a self-management component and a communication component. The final prototype included a combination of features to support individuals with spinal cord injury in the prevention of pressure injuries, namely a smart camera, pressure injury diary, expert consultation, reminders, and knowledge repository. Findings of the usability testing showed that most participants navigated the app fluently with little back and forth navigation and were able to successfully complete a set of assigned tasks. These positive results are supported by the average system usability score achieved (78.5/100; range 47.5-95.0) and our qualitative analysis of the semistructured interviews. Despite an overall positive evaluation of the app prototype, we identified areas for improvement (eg, inclusion of a search function). CONCLUSIONS Individuals with spinal cord injury often need to navigate competing interests and priorities, paired with uncertainty about the accuracy and relevance of clinical recommendations. Understanding what matters to individuals with spinal cord injury can help guide the design of behavioral interventions that are useful and acceptable to these individuals in their daily lives. This study shows that involving individuals with spinal cord injury and health care professionals in co-designing a self-management app can foster knowledge cocreation at the intersection of lived experience, medical expertise, and technical solutions.

scholarly journals Co-designing a Self-Management App Prototype to Support People With Spinal Cord Injury in the Prevention of Pressure Injuries: Mixed Methods Study

10.2196/18018 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e18018 ◽  
Author(s):  
Julia Amann ◽  
Maddalena Fiordelli ◽  
Mirjam Brach ◽  
Sue Bertschy ◽  
Anke Scheel-Sailer ◽  
...  
Keyword(s):  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Health Care Professionals ◽  
Usability Testing ◽  
Design Approach ◽  
Self Management ◽  
Evidence Based ◽  
High Fidelity ◽  
Cord Injury

Background Spinal cord injury is a complex chronic health condition that requires individuals to actively self-manage. Therefore, an evidence-based, self-management app would be of value to support individuals with spinal cord injury in the prevention of pressure injuries. Objective The main objectives of this study were to (1) establish a co-design approach for developing a high-fidelity prototype app for the self-management of individuals with spinal cord injury, (2) design the prototype that resulted from this process, and (3) conduct the first usability assessment of the prototype app. Methods We adopted a co-design approach to develop an evidence-based app prototype. Starting from a preliminary content model (based on clinical guidelines for the prevention of pressure injuries) and three research-based user personas, we conducted an ideation workshop involving individuals with spinal cord injury and health care professionals. The ideation workshop formed the basis for two consecutive design sprints. The result of this co-design phase was an interactive app prototype. The prototype was evaluated in two rounds of usability testing (N=4 and N=15, respectively) using a combination of qualitative and quantitative methods. Results The co-design process resulted in a high-fidelity prototype with two key components: a self-management component and a communication component. The final prototype included a combination of features to support individuals with spinal cord injury in the prevention of pressure injuries, namely a smart camera, pressure injury diary, expert consultation, reminders, and knowledge repository. Findings of the usability testing showed that most participants navigated the app fluently with little back and forth navigation and were able to successfully complete a set of assigned tasks. These positive results are supported by the average system usability score achieved (78.5/100; range 47.5-95.0) and our qualitative analysis of the semistructured interviews. Despite an overall positive evaluation of the app prototype, we identified areas for improvement (eg, inclusion of a search function). Conclusions Individuals with spinal cord injury often need to navigate competing interests and priorities, paired with uncertainty about the accuracy and relevance of clinical recommendations. Understanding what matters to individuals with spinal cord injury can help guide the design of behavioral interventions that are useful and acceptable to these individuals in their daily lives. This study shows that involving individuals with spinal cord injury and health care professionals in co-designing a self-management app can foster knowledge cocreation at the intersection of lived experience, medical expertise, and technical solutions.

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