From "Step Away" to "Stand Down": Tailoring a Smartphone App for Self-Management of Hazardous Drinking for Veterans.


Journal

JMIR mHealth and uHealth
ISSN: 2291-5222
Titre abrégé: JMIR Mhealth Uhealth
Pays: Canada
ID NLM: 101624439

Informations de publication

Date de publication:
13 02 2020
Historique:
received: 29 08 2019
accepted: 14 11 2019
revised: 11 11 2019
entrez: 14 2 2020
pubmed: 14 2 2020
medline: 1 4 2021
Statut: epublish

Résumé

US military veterans who screen positive for hazardous drinking during primary care visits may benefit from a mobile app. Step Away is an evidence-based mobile intervention system for the self-management of hazardous drinking. However, Step Away was not designed for veterans, and differences between veterans and civilians could limit the reach and effectiveness of the app with this population. The primary objective of this study was to repurpose Step Away to address the needs and preferences of the veteran primary care population. The Method for Program Adaptation through Community Engagement (M-PACE) model was used to guide the adaptation process. This model can serve as a generalizable approach that other researchers and intervention developers can follow to systematically tailor mobile health tools for a new population. Veteran patients who screened positive for hazardous drinking during a primary care visit (n=12) and peer providers employed by the US Veterans Health Administration (n=11) were recruited to systematically review Step Away and provide feedback on its content and presentation via Web-based surveys and a semistructured interview. Participant feedback was reviewed through an iterative process by key stakeholders who adjudicated which suggested modifications to the app could enhance engagement and effectiveness with veterans while maintaining program integrity. Usability ratings of the individual modules of Step Away were uniformly positive across patients and peers, as was the perceived utility of the app overall. Personalized feedback on the health consequences and costs of drinking, options for customization, and the measurement-based care capabilities of the app were viewed as facilitators of engagement. Conversely, lengthy text, small font, and a lack of interactive features were viewed as potential barriers with the older primary care population. Modifications to create a veteran version of the app (Stand Down: Think Before You Drink) included altering the appearance of the app to incorporate more veteran-centric content, adding links and options for resources and activities for veterans, and reducing the amount of text and adding veteran-specific references and common concerns and triggers for drinking in this population. The M-PACE model provided a systematic approach to repurpose Step Away to fit the needs and preferences of veteran primary care patients who engage in hazardous drinking. Stand Down may serve as an innovative, low-cost means of expanding access to care for veterans who engage in hazardous drinking.

Sections du résumé

BACKGROUND
US military veterans who screen positive for hazardous drinking during primary care visits may benefit from a mobile app. Step Away is an evidence-based mobile intervention system for the self-management of hazardous drinking. However, Step Away was not designed for veterans, and differences between veterans and civilians could limit the reach and effectiveness of the app with this population.
OBJECTIVE
The primary objective of this study was to repurpose Step Away to address the needs and preferences of the veteran primary care population. The Method for Program Adaptation through Community Engagement (M-PACE) model was used to guide the adaptation process. This model can serve as a generalizable approach that other researchers and intervention developers can follow to systematically tailor mobile health tools for a new population.
METHODS
Veteran patients who screened positive for hazardous drinking during a primary care visit (n=12) and peer providers employed by the US Veterans Health Administration (n=11) were recruited to systematically review Step Away and provide feedback on its content and presentation via Web-based surveys and a semistructured interview. Participant feedback was reviewed through an iterative process by key stakeholders who adjudicated which suggested modifications to the app could enhance engagement and effectiveness with veterans while maintaining program integrity.
RESULTS
Usability ratings of the individual modules of Step Away were uniformly positive across patients and peers, as was the perceived utility of the app overall. Personalized feedback on the health consequences and costs of drinking, options for customization, and the measurement-based care capabilities of the app were viewed as facilitators of engagement. Conversely, lengthy text, small font, and a lack of interactive features were viewed as potential barriers with the older primary care population. Modifications to create a veteran version of the app (Stand Down: Think Before You Drink) included altering the appearance of the app to incorporate more veteran-centric content, adding links and options for resources and activities for veterans, and reducing the amount of text and adding veteran-specific references and common concerns and triggers for drinking in this population.
CONCLUSIONS
The M-PACE model provided a systematic approach to repurpose Step Away to fit the needs and preferences of veteran primary care patients who engage in hazardous drinking. Stand Down may serve as an innovative, low-cost means of expanding access to care for veterans who engage in hazardous drinking.

Identifiants

pubmed: 32053118
pii: v8i2e16062
doi: 10.2196/16062
pmc: PMC7055774
doi:

Types de publication

Journal Article Research Support, U.S. Gov't, Non-P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

e16062

Subventions

Organisme : HSRD VA
ID : RCS 00-001
Pays : United States

Informations de copyright

©Daniel Blonigen, Brooke Harris-Olenak, Eric Kuhn, Keith Humphreys, Christine Timko, Patrick Dulin. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 13.02.2020.

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Auteurs

Daniel Blonigen (D)

Department of Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, United States.

Brooke Harris-Olenak (B)

Department of Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, United States.

Eric Kuhn (E)

Department of Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, United States.

Keith Humphreys (K)

Department of Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, United States.

Christine Timko (C)

Department of Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, United States.

Patrick Dulin (P)

University of Alaska-Anchorage, Anchorage, AK, United States.

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