Testing a Digital Health App for Patients With Alcohol-Associated Liver Disease: Mixed Methods Usability Study.
ALD
AUD
alcohol cessation
alcohol use disorder
alcohol-associated liver disease
digital tools
mHealth
mobile health
mobile phone
usability test
Journal
JMIR formative research
ISSN: 2561-326X
Titre abrégé: JMIR Form Res
Pays: Canada
ID NLM: 101726394
Informations de publication
Date de publication:
15 Nov 2023
15 Nov 2023
Historique:
received:
19
03
2023
accepted:
27
09
2023
revised:
25
09
2023
medline:
15
11
2023
pubmed:
15
11
2023
entrez:
15
11
2023
Statut:
epublish
Résumé
Alcohol-associated liver disease (ALD) is increasingly common and associated with serious and costly health consequences. Cessation of drinking can improve ALD morbidity and mortality; however, support for cessation is not routinely offered to those diagnosed with ALD, and continued drinking or resumption of drinking after diagnosis is common. Mobile health (mHealth) has the potential to offer convenient and scalable support for alcohol cessation to those diagnosed with ALD, but mHealth interventions for alcohol cessation have not been designed for or evaluated in a population with ALD. This study aims to understand how individuals with ALD would perceive and use an mHealth tool for alcohol cessation and to gather their perspectives on potential refinements to the tool that would allow it to better meet their needs. We interviewed 11 individuals who attended clinic visits related to their ALD to elicit their needs related to support for alcohol cessation and views on how mHealth could be applied. After completing initial interviews (pre), participants were provided with access to an mHealth app designed for alcohol cessation, which they used for 1 month. Afterward, they were interviewed again (post) to give feedback on their experiences, including aspects of the app that met their needs and potential refinements. We applied a mixed methods approach, including a qualitative analysis to identify major themes from the interview transcripts and descriptive analyses of use of the app over 1 month. First, we found that a diagnosis of ALD is perceived as a motivator to quit drinking but that patients had difficulty processing the overwhelming amount of information about ALD they received and finding resources for cessation of alcohol use. Second, we found that the app was perceived as usable and useful for supporting drinking recovery, with patients responding favorably to the self-tracking and motivational components of the app. Finally, patients identified areas in which the app could be adapted to meet the needs of patients with ALD, such as providing information on the medical implications of an ALD diagnosis and how to care for their liver as well as connecting individuals with ALD to one another via a peer-to-peer support forum. Rates of app use were high and sustained across the entire study, with participants using the app a little more than half the days during the study on average and with 100% (11/11) of participants logging in each week. Our results highlight the need for convenient access to resources for alcohol cessation after ALD diagnosis and support the potential of an mHealth approach to integrate recovery support into care for ALD. Our findings also highlight the ways the alcohol cessation app should be modified to address ALD-specific concerns.
Sections du résumé
BACKGROUND
BACKGROUND
Alcohol-associated liver disease (ALD) is increasingly common and associated with serious and costly health consequences. Cessation of drinking can improve ALD morbidity and mortality; however, support for cessation is not routinely offered to those diagnosed with ALD, and continued drinking or resumption of drinking after diagnosis is common. Mobile health (mHealth) has the potential to offer convenient and scalable support for alcohol cessation to those diagnosed with ALD, but mHealth interventions for alcohol cessation have not been designed for or evaluated in a population with ALD.
OBJECTIVE
OBJECTIVE
This study aims to understand how individuals with ALD would perceive and use an mHealth tool for alcohol cessation and to gather their perspectives on potential refinements to the tool that would allow it to better meet their needs.
METHODS
METHODS
We interviewed 11 individuals who attended clinic visits related to their ALD to elicit their needs related to support for alcohol cessation and views on how mHealth could be applied. After completing initial interviews (pre), participants were provided with access to an mHealth app designed for alcohol cessation, which they used for 1 month. Afterward, they were interviewed again (post) to give feedback on their experiences, including aspects of the app that met their needs and potential refinements. We applied a mixed methods approach, including a qualitative analysis to identify major themes from the interview transcripts and descriptive analyses of use of the app over 1 month.
RESULTS
RESULTS
First, we found that a diagnosis of ALD is perceived as a motivator to quit drinking but that patients had difficulty processing the overwhelming amount of information about ALD they received and finding resources for cessation of alcohol use. Second, we found that the app was perceived as usable and useful for supporting drinking recovery, with patients responding favorably to the self-tracking and motivational components of the app. Finally, patients identified areas in which the app could be adapted to meet the needs of patients with ALD, such as providing information on the medical implications of an ALD diagnosis and how to care for their liver as well as connecting individuals with ALD to one another via a peer-to-peer support forum. Rates of app use were high and sustained across the entire study, with participants using the app a little more than half the days during the study on average and with 100% (11/11) of participants logging in each week.
CONCLUSIONS
CONCLUSIONS
Our results highlight the need for convenient access to resources for alcohol cessation after ALD diagnosis and support the potential of an mHealth approach to integrate recovery support into care for ALD. Our findings also highlight the ways the alcohol cessation app should be modified to address ALD-specific concerns.
Identifiants
pubmed: 37966869
pii: v7i1e47404
doi: 10.2196/47404
pmc: PMC10687677
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e47404Informations de copyright
©Linda S Park, Rachel Kornfield, Mihret Yezihalem, Andrew Quanbeck, Jessica Mellinger, Margarita German. Originally published in JMIR Formative Research (https://formative.jmir.org), 15.11.2023.
Références
J Clin Exp Hepatol. 2022 Nov-Dec;12(6):1514-1526
pubmed: 36340303
Alcohol Res. 2022 Nov 10;42(1):13
pubmed: 36420303
JMIR Mhealth Uhealth. 2021 Jan 15;9(1):e24424
pubmed: 33448931
Addiction. 2022 Feb;117(2):331-340
pubmed: 34159674
Nat Rev Gastroenterol Hepatol. 2022 Jan;19(1):45-59
pubmed: 34725498
Patient Educ Couns. 2017 Jun;100(6):1073-1082
pubmed: 28174067
World J Hepatol. 2022 Oct 27;14(10):1875-1883
pubmed: 36340751
Qual Quant. 2018;52(4):1893-1907
pubmed: 29937585
J Med Internet Res. 2018 Jan 30;20(1):e37
pubmed: 29382624
J Biomed Inform. 2010 Feb;43(1):159-72
pubmed: 19615467
Subst Abuse. 2019 Jul 08;13:1178221819861377
pubmed: 31312084
PLoS One. 2021 Jul 27;16(7):e0255349
pubmed: 34314445
Clin Gastroenterol Hepatol. 2021 Nov;19(11):2407-2416.e8
pubmed: 33069880
J Stud Alcohol. 2001 Sep;62(5):637-45
pubmed: 11702803
Am J Prev Med. 2010 Jan;38(1):103-9
pubmed: 20117565
Hepatology. 2017 Nov;66(5):1464-1473
pubmed: 28459138
Psychosomatics. 2020 May - Jun;61(3):238-253
pubmed: 32033835
J Dual Diagn. 2017 Oct-Dec;13(4):280-290
pubmed: 28692420
J Subst Abuse Treat. 2021 Nov;130:108396
pubmed: 34118717
J Subst Abuse Treat. 2018 Aug;91:20-27
pubmed: 29910011
JMIR Mhealth Uhealth. 2018 Dec 13;6(12):e11692
pubmed: 30545806
Liver Transpl. 2020 Jan;26(1):14-16
pubmed: 31299131
Digit Health. 2018 Jul 16;4:2055207618785841
pubmed: 31463077
Proc ACM Hum Comput Interact. 2019 Nov;3(CSCW):
pubmed: 33585802
Clin Gastroenterol Hepatol. 2016 Feb;14(2):191-202.e1-4; quiz e20
pubmed: 26256464
World J Gastroenterol. 2015 Oct 21;21(39):11027-33
pubmed: 26494959
Drug Alcohol Depend. 2020 Oct 1;215:108201
pubmed: 32777691
Am J Med. 2017 Feb;130(2):124-134
pubmed: 27984008
Alcohol Clin Exp Res. 2018 Apr;42(4):761-769
pubmed: 29498753
CNS Drugs. 2013 Apr;27(4):287-99
pubmed: 23456576
Subst Abuse. 2016 Feb 14;10:1-7
pubmed: 26917964
JAMA Psychiatry. 2014 May;71(5):566-72
pubmed: 24671165
Health Serv Res. 2022 Jun;57 Suppl 1:53-65
pubmed: 35243621
Curr Psychiatry Rep. 2021 May 7;23(7):38
pubmed: 33961135
Transplant Direct. 2016 Sep 07;2(10):e104
pubmed: 27795986
J Subst Abuse Treat. 2021 Jan;120:108152
pubmed: 33129636
JMIR Res Protoc. 2022 Feb 18;11(2):e31109
pubmed: 35179502
J Hepatol. 2016 Sep;65(3):618-30
pubmed: 27155530
Clin Liver Dis (Hoboken). 2019 May 31;13(5):136-139
pubmed: 31236261
Drug Alcohol Depend. 2022 Oct 1;239:109597
pubmed: 35963209
Int J Med Inform. 2002 Nov 12;65(3):169-77
pubmed: 12414016
Am Psychol. 2000 Jan;55(1):68-78
pubmed: 11392867
Int J Environ Res Public Health. 2020 Sep 15;17(18):
pubmed: 32942763
Arch Intern Med. 1998 Jan 26;158(2):166-72
pubmed: 9448555
J Med Internet Res. 2020 Nov 24;22(11):e17156
pubmed: 33231555
Addiction. 2012 Aug;107(8):1431-40
pubmed: 22340523
Clin Gastroenterol Hepatol. 2023 Nov;21(12):3173-3175.e1
pubmed: 36436769
Nephrol Dial Transplant. 2018 Sep 1;33(9):1545-1558
pubmed: 29165627
Addict Behav. 2016 Nov;62:25-34
pubmed: 27310031
Psychol Addict Behav. 2014 Sep;28(3):928-34
pubmed: 24274437
Alcohol Clin Exp Res. 2018 Jul;42(7):1160-1165
pubmed: 29750368
Hepatology. 2020 Sep;72(3):1102-1108
pubmed: 32369624