A Mobile Health Platform for Self-Management of Pediatric Cystic Fibrosis: Qualitative Study of Adaptation to Stakeholder Needs and Integration in Clinical Settings.

cystic fibrosis mHealth

Journal

JMIR formative research
ISSN: 2561-326X
Titre abrégé: JMIR Form Res
Pays: Canada
ID NLM: 101726394

Informations de publication

Date de publication:
26 Jan 2021
Historique:
received: 16 04 2020
accepted: 17 12 2020
revised: 03 07 2020
entrez: 26 1 2021
pubmed: 27 1 2021
medline: 27 1 2021
Statut: epublish

Résumé

Cystic fibrosis (CF) is an inherited chronic condition that requires extensive daily care and quarterly clinic visits with a multidisciplinary care team. The limited exchange of information outside of the quarterly clinic visits impedes optimal disease self-management, patient engagement, and shared decision making. The aim of this study is to adapt a mobile health (mHealth) app originally developed in Sweden to the needs of patients, families, and health care providers in a CF center in the United States and to test it as a platform for sharing patient-generated health data with the CF health care team. Focus groups with health care providers of patients with CF, adolescents with CF, and caregivers of children with CF were conducted to determine what modifications were necessary. Focus group data were analyzed using a thematic analysis, and emergent themes were ranked according to desirability and technical feasibility. The mHealth platform was then modified to meet the identified needs and preferences, and the flow of patient-generated health data to a secure Research Electronic Data Capture database was tested. Protocols for data management and clinical follow-up were also developed. A total of 5 focus groups with 21 participants were conducted. Recommended modifications pertained to all functionalities of the mHealth platform, including tracking of symptoms, treatments, and activities of daily care; creating and organizing medication lists and setting up reminders; generating reports for the health care team; language and presentation; sharing and privacy; and settings and accounts. Overall, health care providers recommended changes to align the mHealth platform with US standards of care, people with CF and their caregivers requested more tracking functionalities, and both groups suggested the inclusion of a mental health tracker as well as more detailed response options and precise language. Beta testers of the modified platform reported issues related to translatability to US environment and various bugs. This study demonstrated the importance of identifying the needs and preferences of target users and stakeholders before adopting existing mHealth solutions. All relevant perspectives, including those of clinicians, patients, and caregivers, should be thoroughly considered to meet both end users' needs and evidence-based practice recommendations.

Sections du résumé

BACKGROUND BACKGROUND
Cystic fibrosis (CF) is an inherited chronic condition that requires extensive daily care and quarterly clinic visits with a multidisciplinary care team. The limited exchange of information outside of the quarterly clinic visits impedes optimal disease self-management, patient engagement, and shared decision making.
OBJECTIVE OBJECTIVE
The aim of this study is to adapt a mobile health (mHealth) app originally developed in Sweden to the needs of patients, families, and health care providers in a CF center in the United States and to test it as a platform for sharing patient-generated health data with the CF health care team.
METHODS METHODS
Focus groups with health care providers of patients with CF, adolescents with CF, and caregivers of children with CF were conducted to determine what modifications were necessary. Focus group data were analyzed using a thematic analysis, and emergent themes were ranked according to desirability and technical feasibility. The mHealth platform was then modified to meet the identified needs and preferences, and the flow of patient-generated health data to a secure Research Electronic Data Capture database was tested. Protocols for data management and clinical follow-up were also developed.
RESULTS RESULTS
A total of 5 focus groups with 21 participants were conducted. Recommended modifications pertained to all functionalities of the mHealth platform, including tracking of symptoms, treatments, and activities of daily care; creating and organizing medication lists and setting up reminders; generating reports for the health care team; language and presentation; sharing and privacy; and settings and accounts. Overall, health care providers recommended changes to align the mHealth platform with US standards of care, people with CF and their caregivers requested more tracking functionalities, and both groups suggested the inclusion of a mental health tracker as well as more detailed response options and precise language. Beta testers of the modified platform reported issues related to translatability to US environment and various bugs.
CONCLUSIONS CONCLUSIONS
This study demonstrated the importance of identifying the needs and preferences of target users and stakeholders before adopting existing mHealth solutions. All relevant perspectives, including those of clinicians, patients, and caregivers, should be thoroughly considered to meet both end users' needs and evidence-based practice recommendations.

Identifiants

pubmed: 33496667
pii: v5i1e19413
doi: 10.2196/19413
pmc: PMC7872830
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e19413

Subventions

Organisme : NIDDK NIH HHS
ID : P30 DK072482
Pays : United States

Informations de copyright

©Sarah B Rutland, Rikard Palmer Bergquist, Andreas Hager, Robin Geurs, Cathy Mims, Hector H Gutierrez, Gabriela R Oates. Originally published in JMIR Formative Research (http://formative.jmir.org), 26.01.2021.

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Auteurs

Sarah B Rutland (SB)

Pediatric Pulmonary and Sleep Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States.

Rikard Palmer Bergquist (RP)

Motivo Management LLC, Reno, NV, United States.

Andreas Hager (A)

Upstream Dream AB, Stockholm, Sweden.

Robin Geurs (R)

Pediatric Pulmonary and Sleep Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States.

Cathy Mims (C)

Children's of Alabama, Birmingham, AL, United States.

Hector H Gutierrez (HH)

Pediatric Pulmonary and Sleep Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States.

Gabriela R Oates (GR)

Pediatric Pulmonary and Sleep Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States.

Classifications MeSH