scholarly journals Co-Design in the Development of a Mobile Health App for the Management of Knee Osteoarthritis by Patients and Physicians: Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Kelly J Mrklas ◽  
Tanya Barber ◽  
Denise Campbell-Scherer ◽  
Lee A Green ◽  
Linda C Li ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Mobile Health ◽  
Management Strategies ◽  
Family Physicians ◽  
Research Process ◽  
User Preferences ◽  
Self Management ◽  
Functional Requirements ◽  
User Integration ◽  
Study Participants

BACKGROUND Despite a doubling of osteoarthritis-targeted mobile health (mHealth) apps and high user interest and demand for health apps, their impact on patients, patient outcomes, and providers has not met expectations. Most health and medical apps fail to retain users longer than 90 days, and their potential for facilitating disease management, data sharing, and patient-provider communication is untapped. An important, recurrent criticism of app technology development is low user integration design. User integration ensures user needs, desires, functional requirements, and app aesthetics are responsive and reflect target user preferences. OBJECTIVE This study aims to describe the co-design process for developing a knee osteoarthritis minimum viable product (MVP) mHealth app with patients, family physicians, and researchers that facilitates guided, evidence-based self-management and patient-physician communication. METHODS Our qualitative co-design approach involved focus groups, prioritization activities, and a pre-post quality and satisfaction Kano survey. Study participants included family physicians, patient researchers and patients with knee osteoarthritis (including previous participants of related collaborative research), researchers, key stakeholders, and industry partners. The study setting was an academic health center in Southern Alberta. RESULTS Distinct differences exist between what patients, physicians, and researchers perceive are the most important, convenient, desirable, and actionable app functional requirements. Despite differences, study participants agreed that the MVP should be electronic, should track patient symptoms and activities, and include features customized for patient- and physician-identified factors and international guideline-based self-management strategies. Through the research process, participants negotiated consensus on their respective priority functional requirements. The highest priorities were a visual symptom graph, setting goals, exercise planning and daily tracking, and self-management strategies. The structured co-design with patients, physicians, and researchers established multiple collaborative processes, grounded in shared concepts, language, power, rationale, mutual learning, and respect for diversity and differing opinions. These shared team principles fostered an open and inclusive environment that allowed for effective conceptualization, negotiation, and group reflection, aided by the provision of tangible and ongoing support throughout the research process, which encouraged team members to question conventional thinking. Group-, subgroup-, and individual-level data helped the team reveal how and for whom perspectives about individual functional requirements changed or remained stable over the course of the study. This provided valuable insight into how and why consensus emerged, despite the presence of multiple and differing underlying rationales for functional requirement prioritization. CONCLUSIONS It is feasible to preserve the diversity of perspectives while negotiating a consensus on the core functional requirements of an mHealth prototype app for knee osteoarthritis management. Our study sample was purposely constructed to facilitate high co-design interactivity. This study revealed important differences between the patient, physician, and researcher preferences for functional requirements of an mHealth app that did not preclude the development of consensus.

scholarly journals Co-Design in the Development of a Mobile Health App for the Management of Knee Osteoarthritis by Patients and Physicians: Qualitative Study

10.2196/17893 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e17893
Author(s):  
Kelly J Mrklas ◽  
Tanya Barber ◽  
Denise Campbell-Scherer ◽  
Lee A Green ◽  
Linda C Li ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Mobile Health ◽  
Management Strategies ◽  
Family Physicians ◽  
Research Process ◽  
User Preferences ◽  
Self Management ◽  
Functional Requirements ◽  
User Integration ◽  
Study Participants

Background Despite a doubling of osteoarthritis-targeted mobile health (mHealth) apps and high user interest and demand for health apps, their impact on patients, patient outcomes, and providers has not met expectations. Most health and medical apps fail to retain users longer than 90 days, and their potential for facilitating disease management, data sharing, and patient-provider communication is untapped. An important, recurrent criticism of app technology development is low user integration design. User integration ensures user needs, desires, functional requirements, and app aesthetics are responsive and reflect target user preferences. Objective This study aims to describe the co-design process for developing a knee osteoarthritis minimum viable product (MVP) mHealth app with patients, family physicians, and researchers that facilitates guided, evidence-based self-management and patient-physician communication. Methods Our qualitative co-design approach involved focus groups, prioritization activities, and a pre-post quality and satisfaction Kano survey. Study participants included family physicians, patient researchers and patients with knee osteoarthritis (including previous participants of related collaborative research), researchers, key stakeholders, and industry partners. The study setting was an academic health center in Southern Alberta. Results Distinct differences exist between what patients, physicians, and researchers perceive are the most important, convenient, desirable, and actionable app functional requirements. Despite differences, study participants agreed that the MVP should be electronic, should track patient symptoms and activities, and include features customized for patient- and physician-identified factors and international guideline-based self-management strategies. Through the research process, participants negotiated consensus on their respective priority functional requirements. The highest priorities were a visual symptom graph, setting goals, exercise planning and daily tracking, and self-management strategies. The structured co-design with patients, physicians, and researchers established multiple collaborative processes, grounded in shared concepts, language, power, rationale, mutual learning, and respect for diversity and differing opinions. These shared team principles fostered an open and inclusive environment that allowed for effective conceptualization, negotiation, and group reflection, aided by the provision of tangible and ongoing support throughout the research process, which encouraged team members to question conventional thinking. Group-, subgroup-, and individual-level data helped the team reveal how and for whom perspectives about individual functional requirements changed or remained stable over the course of the study. This provided valuable insight into how and why consensus emerged, despite the presence of multiple and differing underlying rationales for functional requirement prioritization. Conclusions It is feasible to preserve the diversity of perspectives while negotiating a consensus on the core functional requirements of an mHealth prototype app for knee osteoarthritis management. Our study sample was purposely constructed to facilitate high co-design interactivity. This study revealed important differences between the patient, physician, and researcher preferences for functional requirements of an mHealth app that did not preclude the development of consensus.

scholarly journals Qualitative study to elicit patients’ and primary care physicians’ perspectives on the use of a self-management mobile health application for knee osteoarthritis

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e024016 ◽  
Author(s):  
Tanya Barber ◽  
Behnam Sharif ◽  
Sylvia Teare ◽  
Jean Miller ◽  
Brittany Shewchuk ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Mobile Health ◽  
Family Physicians ◽  
Self Management ◽  
Mobile Health Application ◽  
Patient Resources ◽  
Health Application

ObjectiveTo elicit perspectives of family physicians and patients with knee osteoarthritis (KOA) on KOA, its treatment/management and the use of a mobile health application (app) to help patients self-manage their KOA.DesignA qualitative study using Cognitive Task Analysis for physician interviews and peer-to-peer semistructured interviews for patients according to the Patient and Community Engagement Research (PaCER) method.SettingPrimary care practices and patient researchers at an academic centre in Southern Alberta.ParticipantsIntentional sampling of family physicians (n=4; 75% women) and patients with KOA who had taken part in previous PaCER studies and had experienced knee pain on most days of the month at any time in the past (n=5; 60% women).ResultsPhysician and patient views about KOA were starkly contrasting. Patient participants expressed that KOA seriously impacted their lives and lifestyles, and they wanted their knee pain to be considered as important as other health problems. In contrast, physicians uniformly conceptualised KOA as a relatively minor health problem, although they still recognised it as a painful condition that often limits patients’ activities. Consequently, physicians did not regard KOA as a condition to be proactively and aggressively managed. The gap between physicians’ and patients’ conceptualisation of KOA and its treatment extended to the use of an app for self-management. While patients were supportive of the app, physicians were sceptical of its use and focused more on accountability and patient resources.ConclusionsThe clear discord between physicians’ mental models and patients’ lived experience and perceived needs around KOA emphasised a gap in understanding and communication about treatment and management of KOA. As such, this preliminary and formative research will inform a codesign approach to develop an app that will act as a communications tool between patients and physicians, enabling patient–physician discussions regarding modifiable self-management options based on a patient’s perspectives and needs.

scholarly journals Making Self-Management Mobile Health Apps Accessible to People With Disabilities: Qualitative Single-Subject Study

10.2196/15060 ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. e15060 ◽  
Author(s):  
Leming Zhou ◽  
Andi Saptono ◽  
I Made Agus Setiawan ◽  
Bambang Parmanto
Keyword(s):  
Mobile Health ◽  
Motor Impairment ◽  
People With Disabilities ◽  
Self Management ◽  
Fine Motor ◽  
Single Subject ◽  
Study Results ◽  
Cord Injury ◽  
Study Participants ◽  
Mhealth Apps

Background Over the past decade, a large number of mobile health (mHealth) apps have been created to help individuals to better manage their own health. However, very few of these mHealth apps were specifically designed for people with disabilities, and only a few of them have been assessed for accessibility for people with disabilities. As a result, people with disabilities have difficulties using many of these mHealth apps. Objective The objective of this study was to identify an approach that can be generally applied to improve the accessibility of mHealth apps. Methods We recruited 5 study participants with a primary diagnosis of cerebral palsy or spinal cord injury. All the participants had fine motor impairment or lack of dexterity, and hence, they had difficulties using some mHealth apps. These 5 study participants were first asked to use multiple modules in the client app of a novel mHealth system (iMHere 2.0), during which their performance was observed. Interviews were conducted post use to collect study participants’ desired accessibility features. These accessibility features were then implemented into the iMHere 2.0 client app as customizable options. The 5 participants were asked to use the same modules in the app again, and their performance was compared with that in the first round. A brief interview and a questionnaire were then performed at the end of the study to collect the 5 participants’ comments and impression of the iMHere 2.0 app in general and of the customizable accessibility features. Results Study results indicate that the study participants on their first use of the iMHere 2.0 client app experienced various levels of difficulty consistent with the severity of their lack of dexterity. Their performance was improved after their desired accessibility features were added into the app, and they liked the customizable accessibility features. These participants also expressed an interest in using this mHealth system for their health self-management tasks. Conclusions The accessibility features identified in this study improved the accessibility of the mHealth app for people with dexterity issues. Our approach for improving mHealth app accessibility may also be applied to other mHealth apps to make those apps accessible to people with disabilities.

scholarly journals Using Mobile Health Tools to Engage Rural Underserved Individuals in a Diabetes Education Program in South Texas: Feasibility Study (Preprint)

2019 ◽  
Author(s):  
Zenong Yin ◽  
Janna Lesser ◽  
Kristi A Paiva ◽  
Jose Zapata Jr ◽  
Andrea Moreno-Vasquez ◽  
...  
Keyword(s):  
Rural Communities ◽  
Feasibility Study ◽  
Mobile Health ◽  
Education Program ◽  
Financial Incentives ◽  
Diabetes Education ◽  
South Texas ◽  
Self Management ◽  
Study Participants

BACKGROUND Access to diabetes education and resources for diabetes self-management is limited in rural communities, despite higher rates of diabetes in rural populations compared with urban populations. Technology and mobile health (mHealth) interventions can reduce barriers and improve access to diabetes education in rural communities. Screening, Brief Intervention, and Referral to Treatment (SBIRT) and financial incentives can be used with mHealth interventions to increase the uptake of diabetes education; however, studies have not examined their combined use for diabetes self-management in rural settings. OBJECTIVE This two-phase Stage 1 feasibility study aimed to use a mixed methods design to examine the feasibility and acceptability of an mHealth diabetes education program combining SBIRT and financial incentives to engage rural individuals. METHODS In Phase 1, we aimed to develop, adapt, and refine the intervention protocol. In Phase 2, a 3-month quasi-experimental study was conducted with individuals from 2 rural communities in South Texas. Study participants were individuals who attended free diabetes screening events in their community. Those with low or medium risk received health education material, whereas those with high risk or those with a previous diagnosis of diabetes participated in motivational interviewing and enrolled in the 6-week mHealth Diabetes Self-Management Education Program under either an unconditional or aversion incentive contract. The participants returned for a 3-month follow-up. Feasibility and acceptability of the intervention were determined by the rate of participant recruitment and retention, the fidelity of program delivery and compliance, and the participant’s satisfaction with the intervention program. RESULTS Of the 98 screened rural community members in South Texas, 72 individuals met the study eligibility and 62 individuals agreed to enroll in the study. The sample was predominately female and Hispanic, with an average age of 52.6 years. The feedback from study participants indicated high levels of satisfaction with the mHealth diabetes education program. In the poststudy survey, the participants reported high levels of confidence to continue lifestyle modifications, that is, weight loss, physical activity, and diet. The retention rate was 50% at the 3-month follow-up. Participation in the intervention was high at the beginning and dissipated in the later weeks regardless of the incentive contract type. Positive changes were observed in weight (mean -2.64, SD 6.01; <i>P</i>&lt;.05) and glycemic control index (-.30; <i>P</i>&lt;.05) in all participants from baseline to follow-up. CONCLUSIONS The finding showed strong feasibility and acceptability of study recruitment and enrollment. The participants’ participation and retention were reasonable given the unforeseen events that impacted the study communities during the study period. Combining mHealth with SBIRT has the potential to reach individuals with need to participate in diabetes education in rural communities.

scholarly journals Pain and Its Management: Strategies and Outcomes in Older Adults With or at Risk for Knee Osteoarthritis

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 204-204
Author(s):  
Alisa Johnson ◽  
Staja Booker ◽  
Josue Cardoso ◽  
Burel Goodin ◽  
Kimberly Sibille ◽  
...  
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Knee Osteoarthritis ◽  
Short Form ◽  
Management Strategies ◽  
Analysis Of Covariance ◽  
Self Management ◽  
Mcgill Pain Questionnaire ◽  
Pain Mechanisms ◽  
Race Ethnicity

Abstract Knee osteoarthritis (KOA) is a leading cause of mobility disability that is characterized by chronic pain among older adults. Non-Hispanic Blacks (NHBs) suffer disproportionately from non-Hispanic Whites (NHWs), reporting higher pain intensity and disability. It is unclear how these differences in symptomatology translate into different patterns of utilization for self-management (SM) of pain, and if such patterns are associated with underlying biological pain mechanisms. This multisite observational study examined (1) use of self-management strategies among older NHB and NHW adults with/at risk for KOA and (2) associations among self-management strategies, clinical and experimental pain. After approval from institutional IRBs, NHB and NHW older adults (N= 202) with knee pain completed the McGill Pain Questionnaire-Short Form, questions on treatment strategies (e.g., massage, ice, heat, medications), and quantitative sensory testing. Covariates included study site and education. On average, participants reported using 2 ± 1.65 SM strategies, with 79% endorsing at least one SM strategy. Analysis of covariance revealed that clinical pain differed by race/ethnicity and use of SM and/or medical treatments (p’s &lt; 0.01). SM use did not differ by race/ethnicity, p = 0.15, but did differ significantly by gender, p &lt; 0.05. Multiple linear regression demonstrated significant positive associations between SM and heat pain sensitivity for both NHBs and NHWs, (p &lt; 0.05). SM is an important component of OA management for NHBs and NHWs. Our study is one of the first to show that SM use is significantly associated with pain mechanisms. Improved understanding will facilitate better mechanism-targeted pain management.

scholarly journals Using Mobile Health Tools to Engage Rural Underserved Individuals in a Diabetes Education Program in South Texas: Feasibility Study

10.2196/16683 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e16683
Author(s):  
Zenong Yin ◽  
Janna Lesser ◽  
Kristi A Paiva ◽  
Jose Zapata Jr ◽  
Andrea Moreno-Vasquez ◽  
...  
Keyword(s):  
Rural Communities ◽  
Feasibility Study ◽  
Mobile Health ◽  
Education Program ◽  
Financial Incentives ◽  
Diabetes Education ◽  
South Texas ◽  
Self Management ◽  
Study Participants

Background Access to diabetes education and resources for diabetes self-management is limited in rural communities, despite higher rates of diabetes in rural populations compared with urban populations. Technology and mobile health (mHealth) interventions can reduce barriers and improve access to diabetes education in rural communities. Screening, Brief Intervention, and Referral to Treatment (SBIRT) and financial incentives can be used with mHealth interventions to increase the uptake of diabetes education; however, studies have not examined their combined use for diabetes self-management in rural settings. Objective This two-phase Stage 1 feasibility study aimed to use a mixed methods design to examine the feasibility and acceptability of an mHealth diabetes education program combining SBIRT and financial incentives to engage rural individuals. Methods In Phase 1, we aimed to develop, adapt, and refine the intervention protocol. In Phase 2, a 3-month quasi-experimental study was conducted with individuals from 2 rural communities in South Texas. Study participants were individuals who attended free diabetes screening events in their community. Those with low or medium risk received health education material, whereas those with high risk or those with a previous diagnosis of diabetes participated in motivational interviewing and enrolled in the 6-week mHealth Diabetes Self-Management Education Program under either an unconditional or aversion incentive contract. The participants returned for a 3-month follow-up. Feasibility and acceptability of the intervention were determined by the rate of participant recruitment and retention, the fidelity of program delivery and compliance, and the participant’s satisfaction with the intervention program. Results Of the 98 screened rural community members in South Texas, 72 individuals met the study eligibility and 62 individuals agreed to enroll in the study. The sample was predominately female and Hispanic, with an average age of 52.6 years. The feedback from study participants indicated high levels of satisfaction with the mHealth diabetes education program. In the poststudy survey, the participants reported high levels of confidence to continue lifestyle modifications, that is, weight loss, physical activity, and diet. The retention rate was 50% at the 3-month follow-up. Participation in the intervention was high at the beginning and dissipated in the later weeks regardless of the incentive contract type. Positive changes were observed in weight (mean -2.64, SD 6.01; P<.05) and glycemic control index (-.30; P<.05) in all participants from baseline to follow-up. Conclusions The finding showed strong feasibility and acceptability of study recruitment and enrollment. The participants’ participation and retention were reasonable given the unforeseen events that impacted the study communities during the study period. Combining mHealth with SBIRT has the potential to reach individuals with need to participate in diabetes education in rural communities.

scholarly journals User Preferences for Privacy Protection Methods in Mobile Health Apps: A Mixed-Methods Study

2020 ◽  
Vol 12 (2) ◽  
pp. 13-26
Author(s):  
Leming Zhou ◽  
Bambang Parmanto
Keyword(s):  
Mobile Health ◽  
Privacy Protection ◽  
Care Delivery ◽  
Statistical Significance ◽  
User Preferences ◽  
Preference Rating ◽  
Health Apps ◽  
Preference Ratings ◽  
Study Participants ◽  
Mhealth Apps

Background: Mobile health (mHealth) apps have the potential to facilitate convenient health care delivery and self-management of health. However, many users have concerns about their privacy when they use mHealth apps. Different apps provide different solutions for protecting users’ privacy. Objective: The purpose of this study was to determine user preferences among the several privacy protection methods used in current mHealth apps and the reasons behind their preferences. Methods: Five privacy protection methods currently used in mHealth apps were presented to a group of study participants who had mild or moderate depression and expressed concerns about privacy of information when they used mental health apps. After a demonstration of the methods, study participants were asked to fill out a questionnaire and indicate their perceived privacy protection level (PPPL) of each method, their preference rating for each method, and the privacy protection methods they had used in the past. A brief interview was then conducted to collect study participants’ comments on these methods and elicit the reasons for their preference ratings. Statistical analysis was performed to determine the statistical significance of differences in participants’ preference ratings and in the PPPLs obtained for the five methods. Study participants’ comments on the privacy protection methods and suggestions were noted and summarized. Results: Forty (40) study participants were selected from a large candidate pool using the IRB approved selection criteria. All study participants viewed the app demonstration and understood the five privacy protection methods properly, which was indicated by their correct sorting of the PPPL of the five methods in their answers to the questionnaire. All study participants specified their preferences with respect to these methods and provided the rationale behind their selections on the questionnaire and during the brief interview. The results indicate that the users preferred privacy protection methods with customizable modules in multi-purpose apps because of their convenience and strong privacy protection, where the customization can be done either in the app or via a Web portal. Conclusions: This study identified user preferred privacy protection methods. These identified privacy protection methods may be used in many types of apps that perform sensitive health information management to better protect users’ privacy and encourage more users to adopt these mHealth apps.

PP115 A Mobile Health App To Improve Knee Osteoarthritis Self-Management

2018 ◽  
Vol 34 (S1) ◽  
pp. 109-110 ◽  
Author(s):  
Deborah Marshall ◽  
Tanya Barber ◽  
Brittany Shewchuk ◽  
Kelly Mrklas ◽  
Jean Miller ◽  
...  
Keyword(s):  
Primary Care ◽  
Knee Osteoarthritis ◽  
Mobile Health ◽  
Group Process ◽  
Cognitive Task ◽  
Nominal Group ◽  
Management Tool ◽  
Self Management ◽  
Structured Interviews ◽  
Patient Centered

Introduction:A gap exists between the evidence for reducing risk of knee osteoarthritis (KOA) progression and its application in patients’ daily lives. We aimed to bridge this gap by identifying patient and family physician (FP) self-management priorities to conceptualize and develop a mobile-health application (m-health app). Our co-design approach combined priorities and concerns solicited from patients and FPs with evidence on risk of progression to design and develop a KOA self-management tool.Methods:Parallel qualitative research of patient and FP perspectives was conducted to inform the co-design process. Researchers from the Enhancing Alberta Primary Care Research Networks (EnACT) evaluated the mental models of FPs using cognitive task analysis through structured interviews with four FPs. Using grounded theory methods, patient researchers from the Patient and Community Engagement Research (PaCER) program interviewed five patients to explore their perspectives about needs and interactions within primary care. In three co-design sessions relevant stakeholders (four patients, five FPs, and thirteen researchers) participated to: (i) identify user needs with regard to KOA self-management; and (ii) conceptualize and determine design priorities and functionalities of an m-health app using a modified nominal group process.Results:Priority measures for symptoms, activities, and quality of life from the user perspective were determined in the first two sessions. The third co-design session with our industry partner resulted in finalization of priorities through interactive patient and FP feedback. The top three features were: (i) a symptoms graph and summary; (ii) information and strategies; and (iii) setting goals. These features were used to inform the development of a minimum viable product.Conclusions:The novel use of co-design created directive dialog around the needs of patients, highlighting the contrasting views that exist between patients and FPs and emphasizing how exploring these differences might lead to strong design options for patient-oriented m-health apps. Characterizing these disjunctions has important implications for operationalizing patient-centered health care.

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.

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

10.2196/22452 ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. e22452
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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