Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jul 11, 2019
Date Accepted: Jun 16, 2020
Usability and Acceptability of Smartphone Applications to Support Falls Rehabilitation Exercise: Participatory Evaluation
ABSTRACT
Background:
Falls have implications for older adults’ health and well-being. Evidence shows that strength and balance interventions significantly reduce risk/rate of falls. However, patients do not always carry-out the required unsupervised home-exercise needed for adequate dose of strength and balance for falls reduction. Smartphone technology could support patients to maintain an adequate dose of exercise.
Objective:
1. Develop motivational smartphone applications (apps) designed to support patients to carry-out evidence-based exercise, co-designed with healthcare professionals/older adults. 2. Explore the apps usability/acceptability with healthcare professionals/patients.
Methods:
We followed three phases of app development. Analysis. We examined the literature to establish key components of the app. We then carried out consultation with 12 older adults attending a strength and balance class, exercise instructors and three falls services. Design. We created prototype apps and carried-out two Patient and Public Involvement (PPI) workshops, one with five healthcare professionals, the second with eight older adults from an exercise group. We revised the apps based on the feedback. Implementation. We tested them with one falls service and their patients for three weeks. We used participatory evaluation through testing, semi-structured interviews and focus groups to explore acceptability and usability. Focus groups were carried-out with the service who tested the apps and two other services. Qualitative data were analysed using the framework approach.
Results:
Analysis. Based on findings from the literature and consultation we selected Behaviour Change Techniques; goal-setting, action planning and feedback on behaviour to be key parts of the app. We developed goals for patients to select and added the self-reporting of exercise using familiar icons. We decided to develop two apps, one for patients (My Activity Programme) and one for healthcare professionals (Motivate Me). This enabled healthcare professionals to guide patients through the goal-setting process, making it more accessible to non-technology users. Design. Storyboards were created leading to prototypes of Motivate Me and My Activity Programme. Key changes from the workshops included being able to add more details about the patients’ exercise programme within Motivate Me and adding a wider selection of goals. The overall design of the apps were acceptable to healthcare professionals/older adults. Implementation. Seven patients and three health professionals took part in the participatory evaluation/testing, with interviews carried out with six patients and focus groups with three teams (11 healthcare professionals). Barriers, facilitators and further functionality were identified for both apps, with two cross-cutting themes around phone usability and confidence.
Conclusions:
The motivational apps were found mostly acceptable to older adults taking part in the design stage and patients and healthcare professionals testing the apps in a clinical setting. User-led design is important to ensure the apps are usable/acceptable. The apps require further development before being tested as part of a feasibility trial.
Citation
Per the author's request the PDF is not available.
Copyright
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