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Byrne T, Murray N, McDonnell-Naughton M, Rowan NJ. Perceived factors informing the pre-acceptability of digital health innovation by aging respiratory patients: a case study from the Republic of Ireland. Front Public Health 2023; 11:1203937. [PMID: 37942252 PMCID: PMC10628059 DOI: 10.3389/fpubh.2023.1203937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 09/22/2023] [Indexed: 11/10/2023] Open
Abstract
It is appreciated that digital health is increasing in interest as an important area for efficiently standardizing and developing health services in Ireland, and worldwide. However, digital health is still considered to be in its infancy and there is a need to understand important factors that will support the development and uniform uptake of these technologies, which embrace their utility and ensure data trustworthiness. This constituted the first study to identify themes believed to be relevant by respiratory care and digital health experts in the Republic of Ireland to help inform future decision-making among respiratory patients that may potentially facilitate engagement with and appropriate use of digital health innovation (DHI). The study explored and identified expert participant perceptions, beliefs, barriers, and cues to action that would inform content and future deployment of living labs in respiratory care for remote patient monitoring of people with respiratory diseases using DHI. The objective of this case study was to generate and evaluate appropriate data sets to inform the selection and future deployment of an ICT-enabling technology that will empower patients to manage their respiratory systems in real-time in a safe effective manner through remote consultation with health service providers. The co-creation of effective DHI for respiratory care will be informed by multi-actor stakeholder participation, such as through a Quintuple Helix Hub framework combining university-industry-government-healthcare-society engagements. Studies, such as this, will help bridge the interface between top-down digital health policies and bottom-up end-user engagements to ensure safe and effective use of health technology. In addition, it will address the need to reach a consensus on appropriate key performance indicators (KPIs) for effective uptake, implementation, standardization, and regulation of DHI.
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Affiliation(s)
- Tara Byrne
- Saolta University Healthcare Group, HSE, Galway, Ireland
- Department of Nursing and Healthcare, Technological University of the Shannon (TUS), Athlone, Ireland
- Faculty of Engineering and Informatics, Technological University of the Shannon, (TUS), Athlone, Ireland
| | - Niall Murray
- Faculty of Engineering and Informatics, Technological University of the Shannon, (TUS), Athlone, Ireland
| | - Mary McDonnell-Naughton
- Department of Nursing and Healthcare, Technological University of the Shannon (TUS), Athlone, Ireland
| | - Neil J. Rowan
- Department of Nursing and Healthcare, Technological University of the Shannon (TUS), Athlone, Ireland
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Amiri P, Pirnejad H, Bahaadinbeigy K, Baghini MS, Khazaee PR, Niazkhani Z. A qualitative study of factors influencing ePHR adoption by caregivers and care providers of Alzheimer's patients: An extension of the unified theory of acceptance and use of technology model. Health Sci Rep 2023; 6:e1394. [PMID: 37425233 PMCID: PMC10323167 DOI: 10.1002/hsr2.1394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 05/06/2023] [Accepted: 06/21/2023] [Indexed: 07/11/2023] Open
Abstract
Background and Aims As the nowadays provision of many healthcare services relies on technology, a better understanding of the factors contributing to the acceptance and use of technology in health care is essential. For Alzheimer's patients, an electronic personal health record (ePHR) is one such technology. Stakeholders should understand the factors affecting the adoption of this technology for its smooth implementation, adoption, and sustainable use. So far, these factors have not fully been understood for Alzheimer's disease (AD)-specific ePHR. Therefore, the present study aimed to understand these factors in ePHR adoption based on the perceptions and views of care providers and caregivers involved in AD care. Methods This qualitative study was conducted from February 2020 to August 2021 in Kerman, Iran. Seven neurologists and 13 caregivers involved in AD care were interviewed using semi-structured and in-depth interviews. All interviews were conducted through phone contacts amid Covid-19 imposed restrictions, recorded, and transcribed verbatim. The transcripts were coded using thematic analysis based on the unified theory of acceptance and use of technology (UTAUT) model. ATLAS.ti8 was used for data analysis. Results The factors affecting ePHR adoption in our study comprised subthemes under the five main themes of performance expectancy, effort expectancy, social influence, facilitating conditions of the UTAUT model, and the participants' sociodemographic factors. From the 37 facilitating factors and 13 barriers identified for ePHR adoption, in general, the participants had positive attitudes toward the ease of use of this system. The stated obstacles were dependent on the participants' sociodemographic factors (such as age and level of education) and social influence (including concern about confidentiality and privacy). In general, the participants considered ePHRs efficient and useful in increasing neurologists' information about their patients and managing their symptoms in order to provide better and timely treatment. Conclusion The present study gives a comprehensive insight into the acceptance of ePHR for AD in a developing setting. The results of this study can be utilized for similar healthcare settings with regard to technical, legal, or cultural characteristics. To develop a useful and user-friendly system, ePHR developers should involve users in the design process to take into account the functions and features that match their skills, requirements, and preferences.
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Affiliation(s)
- Parastoo Amiri
- Student Research CommitteeKerman University of Medical SciencesKermanIran
| | - Habibollah Pirnejad
- Patient Safety Research Center, Clinical Research InstituteUrmia University of Medical SciencesUrmiaIran
- Erasmus School of Health Policy and ManagementErasmus University RotterdamRotterdamThe Netherlands
| | - Kambiz Bahaadinbeigy
- Medical Informatics Research Center, Institute of Futures Studies in HealthKerman University of Medical SciencesKermanIran
| | - Mahdie Shojaei Baghini
- Medical Informatics Research Center, Institute of Futures Studies in HealthKerman University of Medical SciencesKermanIran
| | | | - Zahra Niazkhani
- Nephrology and Kidney Transplant Research Center, Clinical Research InstituteUrmia University of Medical SciencesUrmiaIran
- Health Care Governance, Erasmus School of Health Policy and ManagementErasmus University RotterdamRotterdamThe Netherlands
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Harahap NC, Handayani PW, Hidayanto AN. Integrated Personal Health Record in Indonesia: Design Science Research Study. JMIR Med Inform 2023; 11:e44784. [PMID: 36917168 PMCID: PMC10131695 DOI: 10.2196/44784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Personal health records (PHRs) are consumer-centric tools designed to facilitate the tracking, management, and sharing of personal health information. PHR research has mainly been conducted in high-income countries rather than in low- and middle-income countries. Moreover, previous studies that proposed PHR design in low- and middle-income countries did not describe integration with other systems, or there was no stakeholder involvement in exploring PHR requirements. OBJECTIVE This study developed an integrated PHR architecture and prototype in Indonesia using design science research. We conducted the research in Indonesia, a low- to middle-income country with the largest population in Southeast Asia and a tiered health system. METHODS This study followed the design science research guidelines. The requirements were identified through interviews with 37 respondents from health organizations and a questionnaire with 1012 patients. Afterward, the proposed architecture and prototype were evaluated via interviews with 6 IT or eHealth experts. RESULTS The architecture design refers to The Open Group Architecture Framework version 9.2 and comprises 5 components: architecture vision, business architecture, application architecture, data architecture, and technology architecture. We developed a high-fidelity prototype for patients and physicians. In the evaluation, improvements were made to add the stakeholders and the required functionality to the PHR and add the necessary information to the functions that were developed in the prototype. CONCLUSIONS We used design science to illustrate PHR integration in Indonesia, which involves related stakeholders in requirement gathering and evaluation. We developed architecture and application prototypes based on health systems in Indonesia, which comprise routine health services, including disease treatment and health examinations, as well as promotive and preventive health efforts.
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Brenner M, Weir A, McCann M, Doyle C, Hughes M, Moen A, Ingvar M, Nauwelaerts K, Turk E, McCabe C. Development of the key performance indicators for digital health interventions: A scoping review. Digit Health 2023; 9:20552076231152160. [PMID: 36714542 PMCID: PMC9880566 DOI: 10.1177/20552076231152160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 01/03/2023] [Indexed: 01/25/2023] Open
Abstract
Background Digital health interventions offer new methods for delivering healthcare, with the potential to innovate healthcare services. Key performance indicators play a role in the evaluation, measurement, and improvement in healthcare quality and service performance. The aim of this scoping review was to identify current knowledge and evidence surrounding the development of key performance indicators for digital health interventions. Methods A literature search was conducted across ten key databases: AMED - The Allied and Complementary Medicine Database, CINAHL - Complete, Health Source: Nursing/Academic Edition, MEDLINE, APA PsycINFO, EMBASE, EBM Reviews - Cochrane Database of Systematic Reviews, EBM Reviews - Database of Abstracts of Reviews of Effects, EBM Reviews - Health Technology Assessment, and IEEE Xplore. Results Five references were eligible for the review. Two were articles on original research studies of a specific digital health intervention, and two were overviews of methods for developing digital health interventions (not specific to a single digital health intervention). All the included reports discussed the involvement of stakeholders in developing key performance indicators for digital health interventions. The step of identifying and defining the key performance indicators was completed using various methodologies, but all centred on a form of stakeholder involvement. Potential options for stakeholder involvement for key performance indicator identification include the use of an elicitation framework, a factorial survey approach, or a Delphi study. Conclusions Few articles were identified, highlighting a significant gap in evidence-based knowledge in this domain. All the included articles discussed the involvement of stakeholders in developing key performance indicators for digital health interventions, which were performed using various methodologies. The articles acknowledged a lack of literature related to key performance indicator development for digital health interventions. To allow comparability between key performance indicator initiatives and facilitate work in the field, further research would be beneficial to develop a common methodology for key performance indicators development for digital health interventions.
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Affiliation(s)
- Maria Brenner
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Arielle Weir
- HIQA, George's Court, Smithfield, Dublin, Ireland
| | - Margaret McCann
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Carmel Doyle
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Mary Hughes
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Anne Moen
- Institute for Health and Society, Faculty of Medicine, University of
Oslo, Oslo, Norway
| | - Martin Ingvar
- Integrative Medicine, Karolinska Institute, Stockholm, Sweden
| | | | - Eva Turk
- Institute for Health and Society, Faculty of Medicine, University of
Oslo, Oslo, Norway
| | - Catherine McCabe
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland,Catherine McCabe, School of Nursing and
Midwifery, Trinity College Dublin, Dublin, Ireland.
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Sun K, Goodfellow H, Konstantara E, Hill A, Lennard D, Lloyd-Dehler E, Mughal M, Pritchard-Jones K, Robson C, Murray E. The multidisciplinary, theory-based co-design of a new digital health intervention supporting the care of oesophageal cancer patients. Digit Health 2021; 7:20552076211038410. [PMID: 34873450 PMCID: PMC8642779 DOI: 10.1177/20552076211038410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 07/19/2021] [Indexed: 11/17/2022] Open
Abstract
Objective Oesophageal cancer patients have complex care needs. Cancer clinical nurse
specialists play a key role in coordinating their care but often have heavy
workloads. Digital health interventions can improve patient care but there
are few examples for oesophageal cancer. This paper aims to describe the
multidisciplinary co-design process of a digital health intervention to
improve the experience of care and reduce unmet needs among patients with
oesophageal cancer. Methods A theory-based, multi-disciplinary, co-design approach was used to inform the
developmental process of the digital health intervention. Key user needs
were elicited using mixed methodology from systematic reviews, focus groups
and interviews and holistic need assessments. Overarching decisions were
discussed among a core team of patients, carers, health care professionals
including oncologists and cancer clinical nurse specialists, researchers and
digital health providers. A series of workshops incorporating a summary of
findings of key user needs resulted in the development of a minimum viable
product. This was further refined after a pilot study based on feedback from
end users. Results The final digital health intervention consists of a mobile app feature for
patients and carers connected to a dashboard with supporting additional
features for clinical nurse specialist. It contains a one-way messaging
function for clinical nurse specialists to communicate with patients,
functions for patients to record weight and holistic need assessment results
which could be viewed by their clinical nurse specialists as well as a
library of informative articles. Conclusions The multidisciplinary co-design of a digital health intervention providing
support for oesophageal cancer patients and health care professionals has
been described. Future studies to establish its impact on patient outcomes
are planned.
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Affiliation(s)
- Kristi Sun
- Research Department of Primary Care and Population Health, University College London, UK
| | - Henry Goodfellow
- Research Department of Primary Care and Population Health, University College London, UK
| | - Emmanouela Konstantara
- Research Department of Primary Care and Population Health, University College London, UK
| | | | - Debby Lennard
- Research Department of Primary Care and Population Health, University College London, UK
| | - Elizabeth Lloyd-Dehler
- Research Department of Primary Care and Population Health, University College London, UK
| | | | - Kathy Pritchard-Jones
- North Central and East London Cancer Alliance, University College London Hospitals NHS Foundation Trust, UK
| | - Chris Robson
- Research Department of Primary Care and Population Health, University College London, UK
| | - Elizabeth Murray
- Research Department of Primary Care and Population Health, University College London, UK
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Göttgens I, Oertelt-Prigione S. The Application of Human-Centered Design Approaches in Health Research and Innovation: A Narrative Review of Current Practices. JMIR Mhealth Uhealth 2021; 9:e28102. [PMID: 34874893 PMCID: PMC8691403 DOI: 10.2196/28102] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 07/16/2021] [Accepted: 10/21/2021] [Indexed: 12/14/2022] Open
Abstract
Background Human-centered design (HCD) approaches to health care strive to support the development of innovative, effective, and person-centered solutions for health care. Although their use is increasing, there is no integral overview describing the details of HCD methods in health innovations. Objective This review aims to explore the current practices of HCD approaches for the development of health innovations, with the aim of providing an overview of the applied methods for participatory and HCD processes and highlighting their shortcomings for further research. Methods A narrative review of health research was conducted based on systematic electronic searches in the PubMed, CINAHL, Embase, Cochrane Library, Web of Science, PsycINFO, and Sociological Abstracts (2000-2020) databases using keywords related to human-centered design, design thinking (DT), and user-centered design (UCD). Abstracts and full-text articles were screened by 2 reviewers independently based on predefined inclusion criteria. Data extraction focused on the methodology used throughout the research process, the choice of methods in different phases of the innovation cycle, and the level of engagement of end users. Results This review summarizes the application of HCD practices across various areas of health innovation. All approaches prioritized the user’s needs and the participatory and iterative nature of the design process. The design processes comprised several design cycles during which multiple qualitative and quantitative methods were used in combination with specific design methods. HCD- and DT-based research primarily targeted understanding the research context and defining the problem, whereas UCD-based work focused mainly on the direct generation of solutions. Although UCD approaches involved end users primarily as testers and informants, HCD and DT approaches involved end users most often as design partners. Conclusions We have provided an overview of the currently applied methodologies and HCD guidelines to assist health care professionals and design researchers in their methodological choices. HCD-based techniques are challenging to evaluate using traditional biomedical research methods. Previously proposed reporting guidelines are a step forward but would require a level of detail that is incompatible with the current publishing landscape. Hence, further development is needed in this area. Special focus should be placed on the congruence between the chosen methods, design strategy, and achievable outcomes. Furthermore, power dimensions, agency, and intersectionality need to be considered in co-design sessions with multiple stakeholders, especially when including vulnerable groups.
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Affiliation(s)
- Irene Göttgens
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands
| | - Sabine Oertelt-Prigione
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands
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Park HS, Kim KI, Chung HY, Jeong S, Soh JY, Hyun YH, Kim HS. A Worker-Centered Personal Health Record App for Workplace Health Promotion Using National Health Care Data Sets: Design and Development Study. JMIR Med Inform 2021; 9:e29184. [PMID: 34346894 PMCID: PMC8374662 DOI: 10.2196/29184] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/09/2021] [Accepted: 06/23/2021] [Indexed: 12/15/2022] Open
Abstract
Background Personal health record (PHR) technology can be used to support workplace health promotion, and prevent social and economic losses related to workers’ health management. PHR services can not only ensure interoperability, security, privacy, and data quality, but also consider the user’s perspective in their design. Objective Using Fast Healthcare Interoperability Resources (FHIR) and national health care data sets, this study aimed to design and develop an app for providing worker-centered, interconnected PHR services. Methods This study considered the user’s perspective, using the human-centered design (HCD) methodology, to develop a PHR app suitable for occupational health. We developed a prototype after analyzing quantitative and qualitative data collected from workers and a health care professional group, after which we performed a usability evaluation. We structured workers’ PHR items based on the analyzed data, and ensured structural and semantic interoperability using FHIR, Systematized Nomenclature of Medicine–Clinical Terms (SNOMED-CT), and Logical Observation Identifiers Names and Codes (LOINC). This study integrated workers’ health information scattered across different Korean institutions through an interface method, and workers’ PHRs were managed through a cloud server, using Azure API for FHIR. Results In total, 562 workers from industrial parks participated in the quantitative study. The preferred data items for PHR were medication, number of steps walked, diet, blood pressure, weight, and blood glucose. The preferred features were ability to access medical checkup results, health information content provision, consultation record inquiry, and teleconsultation. The worker-centered PHR app collected data on, among others, life logs, vital signs, and medical checkup results; offered health care services such as reservation and teleconsultation; and provided occupational safety and health information through material safety data sheet search and health questionnaires. The app reflected improvements in user convenience and app usability proposed by 19 participants (7 health care professionals and 12 end users) in the usability evaluation. The After-Scenario Questionnaire (ASQ) was evaluated with a mean score of 5.90 (SD 0.34) out of 7, and the System Usability Scale (SUS) was evaluated a mean score of 88.7 (SD 4.83) out of 100. Conclusions The worker-centered PHR app integrates workers’ health information from different institutions and provides a variety of health care services from linked institutions through workers’ shared PHR. This app is expected to increase workers’ autonomy over their health information and support medical personnel’s decision making regarding workers’ health in the workplace. Particularly, the app will provide solutions for current major PHR challenges, and its design, which considers the user’s perspective, satisfies the prerequisites for its utilization in occupational health.
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Affiliation(s)
- Hyun Sang Park
- Digital Healthcare Department, BIT Computer Co. Ltd., Seoul, Republic of Korea.,Department of Medical Informatics, Kyungpook National University, Daegu, Republic of Korea
| | - Kwang Il Kim
- Finance Programs Department, Korea Occupational Safety and Health Agency, Ulsan, Republic of Korea
| | - Ho-Young Chung
- Department of Medical Informatics, Kyungpook National University, Daegu, Republic of Korea
| | - Sungmoon Jeong
- Department of Medical Informatics, Kyungpook National University, Daegu, Republic of Korea
| | - Jae Young Soh
- Digital Healthcare Department, BIT Computer Co. Ltd., Seoul, Republic of Korea
| | - Young Ho Hyun
- Digital Healthcare Department, BIT Computer Co. Ltd., Seoul, Republic of Korea
| | - Hwa Sun Kim
- Elecmarvels Co. Ltd., Daegu, Republic of Korea
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Harahap NC, Handayani PW, Hidayanto AN. Functionalities and Issues in the Implementation of Personal Health Records: Systematic Review. J Med Internet Res 2021; 23:e26236. [PMID: 34287210 PMCID: PMC8339989 DOI: 10.2196/26236] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/07/2021] [Accepted: 05/24/2021] [Indexed: 12/28/2022] Open
Abstract
Background Functionalities of personal health record (PHR) are evolving, and continued discussions about PHR functionalities need to be performed to keep it up-to-date. Technological issues such as nonfunctional requirements should also be discussed in the implementation of PHR. Objective This study systematically reviewed the main functionalities and issues in implementing the PHR. Methods This systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The search is performed using the online databases Scopus, ScienceDirect, IEEE, MEDLINE, CINAHL, and PubMed for English journal articles and conference proceedings published between 2015 and 2020. Results A total of 105 articles were selected in the review. Seven function categories were identified in this review, which is grouped into basic and advanced functions. Health records and administrative records were grouped into basic functions. Medication management, communication, appointment management, education, and self-health monitoring were grouped into advanced functions. The issues found in this study include interoperability, security and privacy, usability, data quality, and personalization. Conclusions In addition to PHR basic and advanced functions, other supporting functionalities may also need to be developed based on the issues identified in this study. This paper provides an integrated PHR architectural model that describes the functional requirements and data sources of PHRs.
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Aslani N, Ahmadi M, Samadbeik M. A systematic review of the attributes of electronic personal health Records for Patients with multiple sclerosis. HEALTH AND TECHNOLOGY 2019. [DOI: 10.1007/s12553-019-00387-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Alwashmi MF, Hawboldt J, Davis E, Fetters MD. The Iterative Convergent Design for Mobile Health Usability Testing: Mixed Methods Approach. JMIR Mhealth Uhealth 2019; 7:e11656. [PMID: 31025951 PMCID: PMC6658163 DOI: 10.2196/11656] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 11/05/2018] [Accepted: 03/24/2019] [Indexed: 01/12/2023] Open
Abstract
Although patients express an interest in using mobile health (mHealth) interventions to manage their health and chronic conditions, many current mHealth interventions are difficult to use. Usability testing is critical for the success of novel mHealth interventions. Researchers recognize the utility of using qualitative and quantitative approaches for usability testing, but many mHealth researchers lack the awareness of integration approaches from advances in mixed methods research that can add value to mHealth technology. As efficient usability testing proceeds iteratively, we introduce a novel mixed methods design developed specifically for mHealth researchers. The iterative convergent mixed methods design involves simultaneous qualitative and quantitative data collection and analysis that continues cyclically through multiple rounds of mixed methods data collection and analysis until the mHealth technology under evaluation is found to work to the satisfaction of the researcher. In cyclical iterations, early development is more qualitatively driven but progressively becomes more quantitatively driven. Using this design, mHealth researchers can leverage mixed methods integration procedures in the research question, data collection, data analysis, interpretation, and dissemination dimensions. This study demonstrates how the iterative convergent mixed methods design provides a novel framework for generating unique insights into multifaceted phenomena impacting mHealth usability. Understanding these practices can help developers and researchers leverage the strengths of an integrated mixed methods design.
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Affiliation(s)
| | | | - Erin Davis
- Memorial University, St John's, NL, Canada
| | - Michael D Fetters
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
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Moraes Carrilho J, Oliveira IJR, Santos D, Osanan GC, Cruz-Correia RJ, Reis ZSN. Pregnant Users' Perceptions of the Birth Plan Interface in the "My Prenatal Care" App: Observational Validation Study. JMIR Form Res 2019; 3:e11374. [PMID: 30920372 PMCID: PMC6458531 DOI: 10.2196/11374] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 11/28/2018] [Accepted: 12/30/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Birth plans are meant to be a declaration of the expectations and preferences of pregnant woman regarding childbirth. The My Prenatal Care app engages pregnant women in an educational intervention for a healthy pregnancy. We hypothesized that users' positive perception of an in-app birth plan is a relevant step for establishing direct communication between pregnant women and the health care team, based on an online report available on the app. OBJECTIVE This study aimed to evaluate pregnant women's perception about the communicability of birth-plan preparation using a mobile app. METHODS This was an observational, exploratory, descriptive study. The methodology was user centered, and both qualitative and quantitative approaches were employed. The tools of the communicability evaluation method were applied. Overall, 11 pregnant women evaluated their experience of using a birth-plan prototype interface. The evaluation was performed in a controlled environment, with authorized video recording. There were 8 task-oriented interactions proposed to evaluate interface communicability with users when using the Birth Plan menu. For evaluating perceptions and experiences, a survey with structured and open-ended questions in addition to the free expression of participants was conducted. The primary outcomes assessed were interface communicability and user's perception of the Birth Plan prototype interface in the My Prenatal Care mobile app. Secondarily, we involved users in the prototyping phase of the interface to identify bottlenecks for making improvements in the app. RESULTS Regarding users' performance in accomplishing previously prepared tasks, we found that 10 of 11 (91%) women were capable of completing at least 6 of 8 (75%) tasks. A positive relationship was found between the number of communicability problems and the success of completing the tasks. An analysis of the records revealed three communicability breakdowns related to the data entry, save, and scrollbar functions. The participants freely expressed suggestions for improvements such as for the save function and the process of sharing the birth-plan form upon completion. CONCLUSIONS Users had a positive perception of the Birth Plan menu of the My Prenatal Care app. This user-centered validation enabled the identification of solutions for problems, resulting in improvements in the app.
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Affiliation(s)
- Juliana Moraes Carrilho
- Informatics Center in Health, Universidade Federal de Minas Gerais, Faculty of Medicine, Belo Horizonte, Brazil
| | - Isaias José Ramos Oliveira
- Informatics Center in Health, Universidade Federal de Minas Gerais, Faculty of Medicine, Belo Horizonte, Brazil
| | - Dimitri Santos
- Informatics Center in Health, Universidade Federal de Minas Gerais, Faculty of Medicine, Belo Horizonte, Brazil
| | - Gabriel Costa Osanan
- Informatics Center in Health, Universidade Federal de Minas Gerais, Faculty of Medicine, Belo Horizonte, Brazil.,Obstetrics and Gynecology Department, Universidade Federal de Minas Gerais, Faculty of Medicine, Belo Horizonte, Brazil
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