Content analysis of qualitative interviews for user-centered design of a prototype mobile health app for direct support professionals' resilience

BACKGROUND

Direct support professionals support people with intellectual and developmental disabilities with essential health and community living needs. Despite an unrelenting workforce shortage crisis, limited evidence-based resources exist for their support. Resilience, or the ability to thrive in the face of challenges, is a target for health care professional wellbeing initiatives. As an "invisible" workforce interspersed throughout various community-based settings, direct support professionals may benefit from resources provided via mobile health apps.

OBJECTIVES

To assess direct support professionals' acceptability of and preferences for the design of a mobile health app prototype to support their resilience, DSP Thrive.

METHOD

This concept generation and prototype design study employed a two-phase qualitative-descriptive design. Phase 1 assessed direct support professionals' acceptability of and preferences for a mobile health app for direct support professional resilience. Phase 2 elicited feedback on mock-up images of an initial prototype. Data were collected via qualitative interviews (n = 13), and transcripts were analyzed using content analysis.

RESULTS

Phase 1: Direct support professionals identified three primary opportunities for an app to support their resilience: learning via educational resources, practicing resilience strategies, and cultivating a peer support network. Based on these findings, the DSP Thrive app prototype was designed with Learn, Practice, and Connect functions. Phase 2: User feedback on walk-throughs of mock-up images indicated initial acceptability of the prototype design with considerations for further development identified.

CONCLUSIONS

Engaging direct support professionals in user-centered design of mobile health apps may help to bridge the gap to resilience resources for this essential workforce population.

Using a mobile health app in a weight management program for overweight and obese adolescents and young adults with spina bifida

CONTEXT

Adolescents and young adults (AYA) with spina bifida (SB) are more susceptible to obesity due to impaired mobility. There is limited access to physical activity for this population.

OBJECTIVE

The primary aim of this study was to evaluate the feasibility of a mobile health app in a weight management program for AYA with SB. This was determined by measuring program adherence, active use of the app (defined as ≥3 uses per week), and user rating of the Pt Pal™ mobile app. Secondary outcomes were changes in BMI, quality of life, and health behavior, and the number of active participants over time.

METHODS

Patients from the SB Clinic of a large metropolitan hospital between the ages of 11-21 years and overweight were invited to participate. The program consisted of group nutrition sessions and an individualized exercise plan using a mobile app with coaching. Outcome measures were program adherence, changes in BMI, and validated survey responses. Descriptive statistical analysis was performed.

RESULTS

Fifteen participants enrolled, and ten participants completed the program. Five of the ten participants attended the nutrition sessions. The number of active app users declined after the first week. Seventy percent of participants decreased their BMI. Most participants reported the program improved their ability to exercise regularly, eat a healthier diet and feel more self-confident. Peds QL™ psychosocial health domains increased postintervention. The YRBS showed increased physical activity and less sedentary time postintervention.

CONCLUSIONS

This mobile app-based weight management program with coaching implemented may not be feasible for adoption in the general population of AYA with SB; however, it was well received by some, and further testing is needed to determine how to improve feasibility. This study provides useful information to guide future programs utilizing digital health and coaching.

Remote Follow-up with a Mobile Application Is Equal to Traditional Outpatient Follow-up After Bariatric Surgery: the BELLA Pilot Trial

PURPOSE

Medical follow-up after bariatric surgery is recommended. However, the compliance was poor. This study aimed to evaluate the feasibility of a smartphone-based fully remote follow-up (FU) program for patients after bariatric surgery.

METHODS

In the interventional group, patients were followed up using a smartphone application (app), through which questionnaires were sent regularly. Participants in the control group underwent standard FU at the outpatient clinic every three months. After 12 months, all the participants were evaluated at an outpatient clinic.

RESULTS

Between August 2020 and March 2021, 44 and 43 patients in the interventional and control groups, respectively, were included in the analysis after three patients were lost to FU, and three withdrew their informed consent because they wished for more personal contact with medical caregivers. After 12 months, total weight loss (TWL), %TWL, and percentage of excess weight loss (%EWL) did not differ between groups. There were no significant differences in the complication rates, including surgical complications, malnutrition, and micronutrition deficiency. The parameters of bioelectrical impedance analysis and quality of life did not differ between the groups. Vitamins and minerals in serum were similar in both groups except for calcium, which was significantly higher in the interventional group (2.52 mmol/L vs. 2.35 mmol/L, p = 0.038).

CONCLUSION

Fully remote FU with a smartphone application is at least as effective as traditional in-person FU in an outpatient clinic after bariatric surgery. Through remote FU, patients can save time and medical professionals may have more resources for patients with more severe problems.

Reviewing and Content Analysis of Persian Language Mobile Health Apps for COVID-19 Management

The present study aimed to systematically search in app stores and intended to carry out content analysis of free Persian mobile health apps in the management of COVID-19 and, ultimately determine the relationship between the popularity and quality of these apps. According to a researcher-made checklist including five axes of ease of use, privacy, data sharing, education, and monitoring, four app markets such as Myket, Bazzar, Google Play and App Store were searched from May 2021 up to now. The findings showed that all selected apps performed well in terms of ease of use and privacy but they needed to be improved in terms of education, monitoring, and data sharing. Also, there was no significant relationship between the popularity and quality of these apps. Owing to the high penetration rate of smartphones in Iran and the low popularity of COVID-19 apps, government, developers, and investors are required to improve the quality of apps and their marketing.

Protocol for the Pilot Study of Group Video Yogic Breathing App in Breast Cancer Survivors

INTRODUCTION

Breast cancer remains a leading cause of cancer deaths; however, recent improvements in treatment have improved survivorship. As a result of this improvement, more individuals are living with the long-term side effects of cancer treatment. Therefore, methods that incorporate lifestyle and mind-body approaches are becoming increasingly used in the patient treatment pathway.

METHODS

In this study, PranaScience Institute will develop and test a group video mobile application for Yogic Breathing (YB). YB is shown to reduce symptomatic conditions associated with several conditions including breast cancer. For this initial feasibility study, PranaScience will collaborate with the Medical University of South Carolina to implement the study app-based program in breast cancer survivors. This research is aimed to understand if the YB could be delivered via an app, if participants are able to practice it satisfactorily, and if there is any symptom relief by the YB practice. In the control group, participants will be directed to the Attention Control (AC) feature of the app, which guides users to focus on a mindfulness activity not involving YB. Participants will be randomly assigned to the YB or AC study plan (N = 20 per group). Breast cancer survivors who have completed radiation therapy within last 2 months will be recruited for this study and provided access to the app for a 12-weeks program. The study app will record total practice times. Virtual visits by a study yoga instructor during group video sessions will measure participant compliance with proper technique. Feasibility will be examined by evaluating intervention delivery factors and resource needs. Acceptability of using the mobile study app to support symptom management will be evaluated using a satisfaction and system usability scale. Behavioral survey measures will help guide effect sizes and power calculations for the next larger-scale study. Biomarkers in the saliva (tumor suppressors, cytokines), and fingernails (cortisol, differential proteomics) will be measured at baseline and end of study at 12 weeks.

DISCUSSION

All findings from this pilot study will be synthesized to refine the mobile study app in preparation for large-scale evaluation in Phase II involving all-study site participants with cancer. ClinicalTrials.gov Identifier NCT05161260.