Dataset Information

Mobile App for Monitoring 3-Month Postoperative Functional Outcome After Hip Fracture: Usability Study.

ABSTRACT: BACKGROUND:As a result of an aging population, there has been an increasing incidence of hip fractures worldwide. In the Netherlands, in order to improve the quality of care for elderly patients with hip fractures, the multidisciplinary Centre for Geriatric Traumatology was established in 2008 at the Department of Trauma Surgery at Ziekenhuisgroep Twente hospital (located in Almelo and Hengelo in the Netherlands). OBJECTIVE:Though the Dutch Hip Fracture audit is used to monitor the quality of care for patients with fractures of the hip, only 30.7% of patients complete registration in the 3-month follow-up period. Mobile apps offer an opportunity for improvement in this area. The aim of this study was to investigate the usability and acceptance of a mobile app for gathering indicators of quality of care in a 3-month follow-up period after postoperative treatment of hip fracture. METHODS:From July 2017 to December 2017, patients who underwent surgical treatment for hip fracture were recruited. Patients and caregivers, who were collectively considered the participant cohort, were asked to download the app and answer a questionnaire. Participants were divided into two groups-those who downloaded the app and those who did not download the app. A telephone interview that was based upon the Unified Theory of Acceptance and Use of Technology was conducted with a subset of participants from each group (1:1 ratio). This study was designated as not being subject to the Dutch Medical Research Involving Human Subjects Act according to the appropriate medical research ethics committees. RESULTS:Of the patients and caregivers who participated, 26.4% (29/110) downloaded the app, whereas 73.6% (81/110) did not. Telephone interviews with the subset of participants (n=24 per group) revealed that 54.0% (13/24) of the group of participants who did not download the app had forgotten the study. Among the group who downloaded the app, 95.8% (23/24) had the intention of completing the questionnaire, but only 4.2% (1/24) did so. The reasons for not completing the questionnaire included technical problems, cognitive disorders, or patient dependency on caregivers. Most participants in the group who downloaded the app self-reported a high level of expertise in using a smartphone (22/24, 91.7%), and sufficient facilitating conditions for using a smartphone were self-reported in both groups (downloaded the app: 23/24, 95.8%; did not download the app: 21/24, 87.5%), suggesting that these factors were not barriers to completion. CONCLUSIONS:Despite self-reported intention to use the app, smartphone expertise, and sufficient facilitating conditions for smartphone use, implementation of the mobile app was infeasible for daily practice. This was due to a combination of technical problems, factors related to the implementation process, and the population of interest having cognitive disorders or a dependency on caregivers for mobile technology.

SUBMITTER: Geerds MAJ

PROVIDER: S-EPMC7522745 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Mobile App for Monitoring 3-Month Postoperative Functional Outcome After Hip Fracture: Usability Study.

Geerds Merle A J MAJ Nijmeijer Wieke S WS Hegeman J H JH Vollenbroek-Hutten Miriam M R MMR

JMIR human factors 20200914 3

<h4>Background</h4>As a result of an aging population, there has been an increasing incidence of hip fractures worldwide. In the Netherlands, in order to improve the quality of care for elderly patients with hip fractures, the multidisciplinary Centre for Geriatric Traumatology was established in 2008 at the Department of Trauma Surgery at Ziekenhuisgroep Twente hospital (located in Almelo and Hengelo in the Netherlands).<h4>Objective</h4>Though the Dutch Hip Fracture audit is used to monitor th ...[more]

PMID: 32924949

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Project description:BACKGROUND:In the past years, a mobile health (mHealth) app called the Dutch Talking Touch Screen Questionnaire (DTTSQ) was developed in The Netherlands. The aim of development was to enable Dutch physical therapy patients to autonomously complete a health-related questionnaire regardless of their level of literacy and digital skills. OBJECTIVE:The aim of this study was to evaluate the usability (defined as the effectiveness, efficiency, and satisfaction) of the prototype of the DTTSQ for Dutch physical therapy patients with diverse levels of experience in using mobile technology. METHODS:The qualitative Three-Step Test-Interview method, including both think-aloud and retrospective probing techniques, was used to gain insight into the usability of the DTTSQ. A total of 24 physical therapy patients were included. The interview data were analyzed using a thematic content analysis approach aimed at analyzing the accuracy and completeness with which participants completed the questionnaire (effectiveness), the time it took the participants to complete the questionnaire (efficiency), and the extent to which the participants were satisfied with the ease of use of the questionnaire (satisfaction). The problems encountered by the participants in this study were given a severity rating that was used to provide a rough estimate of the need for additional usability efforts. RESULTS:All participants within this study were very satisfied with the ease of use of the DTTSQ. Overall, 9 participants stated that the usability of the app exceeded their expectations. The group of 4 average-/high-experienced participants encountered only 1 problem in total, whereas the 11 little-experienced participants encountered an average of 2 problems per person and the 9 inexperienced participants an average of 3 problems per person. A total of 13 different kind of problems were found during this study. Of these problems, 4 need to be addressed before the DTTSQ will be released because they have the potential to negatively influence future usage of the tool. The other 9 problems were less likely to influence future usage of the tool substantially. CONCLUSIONS:The usability of the DTTSQ needs to be improved before it can be released. No problems were found with satisfaction or efficiency during the usability test. The effectiveness needs to be improved by (1) making it easier to navigate through screens without the possibility of accidentally skipping one, (2) enabling the possibility to insert an answer by tapping on the text underneath a photograph instead of just touching the photograph itself, and (3) making it easier to correct wrong answers. This study shows the importance of including less skilled participants in a usability study when striving for inclusive design and the importance of measuring not just satisfaction but also efficiency and effectiveness during such studies.

Project description:BackgroundAlthough we are living in an era of transparency, medical documents are often still difficult to access. Blockchain technology allows records to be both immutable and transparent.ObjectiveUsing blockchain technology, the aim of this study was to develop a medical document monitoring system that informs patients of changes to their medical documents. We then examined whether patients can effectively verify the monitoring of their primary care clinical medical records in a system based on blockchain technology.MethodsWe enrolled participants who visited two primary care clinics in Korea. Three substudies were performed: (1) a survey of the recognition of blockchain medical records changes and the digital literacy of participants; (2) an observational study on participants using the blockchain-based mobile alert app; and (3) a usability survey study. The participants' medical documents were profiled with HL7 Fast Healthcare Interoperability Resources, hashed, and transacted to the blockchain. The app checked the changes in the documents by querying the blockchain.ResultsA total of 70 participants were enrolled in this study. Considering their recognition of changes to their medical records, participants tended to not allow these changes. Participants also generally expressed a desire for a medical record monitoring system. Concerning digital literacy, most questions were answered with "good," indicating fair digital literacy. In the second survey, only 44 participants-those who logged into the app more than once and used the app for more than 28 days-were included in the analysis to determine whether they exhibited usage patterns. The app was accessed a mean of 5.1 (SD 2.6) times for 33.6 (SD 10.0) days. The mean System Usability Scale score was 63.21 (SD 25.06), which indicated satisfactory usability.ConclusionsPatients showed great interest in a blockchain-based system to monitor changes in their medical records. The blockchain system is useful for informing patients of changes in their records via the app without uploading the medical record itself to the network. This ensures the transparency of medical records as well as patient empowerment.

Project description:BackgroundThe link between chronic diseases and the Big 6 lifestyle risk behaviors (ie, poor diet, physical inactivity, smoking, alcohol use, sedentary recreational screen time, and poor sleep) is well established. It is critical to target these lifestyle risk behaviors, as they often co-occur and emerge in adolescence. Smartphones have become an integral part of everyday life, and many adolescents already use mobile apps to monitor their lifestyle behaviors and improve their health. Smartphones may be a valuable platform for engaging adolescents with interventions to prevent key chronic disease risk behaviors.ObjectiveThe aim of this paper is to describe the development, usability, and acceptability of the Health4Life app, a self-monitoring smartphone app for adolescents that concurrently targets the Big 6 lifestyle behaviors.MethodsThe development of the Health4Life app was an iterative process conducted in collaboration with adolescents and experts. The development process consisted of three stages: scoping the literature; end user consultations, which included a web-based survey (N=815; mean age 13.89, SD 0.89 years) and a focus group (N=12) among adolescents; and app development and beta testing. Following this development work, 232 adolescents were asked to rate the usability and acceptability of the app.ResultsThe process resulted in a self-monitoring smartphone app that allows adolescent users to track and set goals for the Big 6 health behaviors, using in-app rewards and notifications to enhance engagement. The overall adolescent feedback was positive in terms of user-friendly design, content, relevance, and helpfulness. Commonly identified areas for improvement were to increase interactive features and display recorded health behaviors differently to improve interpretability.ConclusionsThe Health4Life app is a co-designed, self-monitoring smartphone app for adolescents that concurrently targets the Big 6 lifestyle behaviors. Adolescents rated the app as highly acceptable and usable. The app has the potential to efficiently and effectively modify important risk factors for chronic disease among young people and is currently being evaluated in a world-first trial of 6640 secondary school students in 71 schools across Australia.

Project description:BackgroundThere is currently limited evidence on the level and intensity of physical activity in individuals with hemophilia A. Mobile technologies can offer a rigorous and reliable alternative to support data collection processes but they are often associated with poor user retention. The lack of longitudinal continuity in their use can be partly attributed to the insufficient consideration of stakeholder inputs in the development process of mobile apps. Several user-centered models have been proposed to guarantee that a thorough knowledge of the end user needs is considered in the development process of mobile apps.ObjectiveThe aim of this study is to design and validate an electronic patient-reported outcome mobile app that requires sustained active input by individuals during POWER, an observational study that aims at evaluating the relationship between physical activity levels and bleeding in patients with hemophilia A.MethodsWe adopted a user-centered design and engaged several stakeholders in the development and usability testing of this mobile app. During the concept generation and ideation phase, we organized a need-assessment focus group (FG) with patient representatives to elicit specific design requirements for the end users. We then conducted 2 exploratory FGs to seek additional inputs for the app's improvement and 2 confirmatory FGs to validate the app and test its usability in the field through the mobile health app usability questionnaire.ResultsThe findings from the thematic analysis of the need-assessment FG revealed that there was a demand for sense making, for simplification of app functionalities, for maximizing integration, and for minimizing the feeling of external control. Participants involved in the later stages of the design refinement contributed to improving the design further by upgrading the app's layout and making the experience with the app more efficient through functions such as chatbots and visual feedback on the number of hours a wearable device had been worn, to ensure that the observed data were actually registered. The end users rated the app highly during the quantitative assessment, with an average mobile health app usability questionnaire score of 5.32 (SD 0.66; range 4.44-6.23) and 6.20 (SD 0.43; range 5.72-6.88) out of 7 in the 2 iterative usability testing cycles.ConclusionsThe results of the usability test indicated a high, growing satisfaction with the electronic patient-reported outcome app. The adoption of a thorough user-centered design process using several types of FGs helped maximize the likelihood of sustained retention of the app's users and made it fit for data collection of relevant outcomes in the observational POWER study. The continuous use of the app and the actual level of engagement will be evaluated during the ongoing trial.Trial registrationClinicalTrials.gov NCT04165135; https://clinicaltrials.gov/ct2/show/NCT04165135.

Project description:BACKGROUND:Cardiac rehabilitation (CR) improves outcomes for patients with ischemic heart disease or heart failure but is underused. New strategies to improve access to and engagement in CR are needed. There is considerable interest in technology-facilitated home CR. However, little is known about patient acceptance and use of mobile technology for CR. OBJECTIVE:The aim of this study was to develop a mobile app for technology-facilitated home CR and seek to determine its usability. METHODS:We recruited patients eligible for CR who had access to a mobile phone, tablet, or computer with Internet access. The mobile app includes physical activity goal setting, logs for tracking physical activity and health metrics (eg, weight, blood pressure, and mood), health education, reminders, and feedback. Study staff demonstrated the mobile app to participants in person and then observed participants completing prespecified tasks with the mobile app. Participants completed the System Usability Scale (SUS, 0-100), rated likelihood to use the mobile app (0-100), questionnaires on mobile app use, and participated in a semistructured interview. The Unified Theory of Acceptance and Use of Technology and the Theory of Planned Behavior informed the analysis. On the basis of participant feedback, we made iterative revisions to the mobile app between users. RESULTS:We conducted usability testing in 13 participants. The first version of the mobile app was used by the first 5 participants, and revised versions were used by the final 8 participants. From the first version to revised versions, task completion success rate improved from 44% (11/25 tasks) to 78% (31/40 tasks; P=.05), SUS improved from 54 to 76 (P=.04; scale 0-100, with 100 being the best usability), and self-reported likelihood of use remained high at 76 and 87 (P=.30; scale 0-100, with 100 being the highest likelihood). In interviews, patients expressed interest in tracking health measures ("I think it'll be good to track my exercise and to see what I'm doing"), a desire for introductory training ("Initially, training with a technical person, instead of me relying on myself"), and an expectation for sharing data with providers ("It would also be helpful to share with my doctor, it just being a matter of clicking a button and sharing it with my doctor"). CONCLUSIONS:With participant feedback and iterative revisions, we significantly improved the usability of a mobile app for CR. Patient expectations for using a mobile app for CR include tracking health metrics, introductory training, and sharing data with providers. Iterative mixed-method evaluation may be useful for improving the usability of health technology.

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Dataset Information

Mobile App for Monitoring 3-Month Postoperative Functional Outcome After Hip Fracture: Usability Study.

Publications

Mobile App for Monitoring 3-Month Postoperative Functional Outcome After Hip Fracture: Usability Study.

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