JMIR Publications

ABSTRACT

Background:

Persistent or chronic pain is a common health problem among adolescents. Thus, it is important that they receive evidence-based strategies for symptom management. iCanCope with PainTM is a smartphone application (app) designed to help adolescents cope with chronic pain. The app comprises five evidence- and theory-based features: (I) symptom trackers for pain, sleep, mood, physical function, and social function; (II) goalsetting to improve pain and function; (III) a coping toolbox of pain self-management strategies; (IV) social support; and (V) age-appropriate pain education. The iCanCope with PainTM app is based on theory, identified health care needs, and current best practices for pain self-management.

Objective:

Describe the translation and cultural adaptation of the app into the Norwegian context, and evaluate the app’s usability using a phased approach.

Methods:

Phase 1 included translation and cultural adaptation of the app into the Norwegian context. This process used an expert panel of researchers and target group representatives, who were responsible for linguistic quality assurance and assessment. In phases 2 and 3 the app’s usability was tested. For phase 2, assessments of usability and user experiences included observation, the think aloud method, audiovisual recordings, questionnaires, and individual end-user interviews in a laboratory setting. For phase 3, assessment of usability and user experience over a two-week home-based test included questionnaires and individual end-user interviews. Overall, app usability was determined based on ease of use, efficiency, and user satisfaction. Qualitative data were analyzed using deductive content analysis. Descriptive statistics were calculated for quantitative data.

Results:

End users did not report any misunderstandings or discrepancies with the words or phrasing of the translated and culturally adapted app. Participants in both the laboratory- and home-based usability tests found the app self-explanatory and reported that all five of its features were easy to use. One home-based user commented that the app served as a reminder of their pain. All tasks were completed within the allocated timeframe (i.e., efficiency), with few errors. Overall System Usability Scale scores were high, with average scores of 82 and 89 out of 100 from laboratory- and field-based tests, respectively. Participants liked the idea of a social support function (feature IV), although qualitative and Internet server data revealed that this feature was rarely used.

Conclusions:

This study described the cultural and linguistic adaptation, and usability testing, of the Norwegian version of the iCanCope with PainTM app. High user satisfaction, ease of use, efficiency, and only minor errors cumulatively indicated that no changes to the app were needed, with the exception of facilitating user interaction within the social support feature. The app will be used in an upcoming randomized controlled trial with a larger sample. Clinical Trial: ClinicalTrials.gov ID NCT03551977