Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jan 29, 2020
Date Accepted: Apr 19, 2020
Co-designing a self-management app prototype to support persons with spinal cord injury in the prevention of pressure injuries: A mixed methods study
ABSTRACT
Background:
Spinal cord injury is a complex chronic health condition that requires individuals to actively self-manage. This study aimed to develop an evidence-based, self-management app to support individuals with spinal cord injury in the prevention of pressure injuries.
Objective:
The main objectives of this paper were to 1) detail the co-design approach we used to develop a high-fidelity prototype, 2) present the prototype that resulted from this process, and 3) report on the findings of a first usability assessment.
Methods:
We adopted a co-design approach to develop an evidence-based app-prototype. Starting from a preliminary content model (clinical guidelines for the prevention of pressure injuries) and three research-based user personas, we conducted an ideation workshop involving persons with spinal cord injury and healthcare professionals. The ideation workshop formed the basis for two consecutive design sprints. The result of this co-design phase was an interactive app-prototype. The prototype was evaluated in two rounds of usability-testing (N=4; N=15), using a combination of qualitative and quantitative methods.
Results:
The co-design process resulted in a high-fidelity prototype with two key components: a self-management component and a communication component. The final prototype included a combination of features to support individuals in the prevention of pressure injuries, namely: a smart camera, a pressure injury diary, an expert consultation, reminders, and a knowledge repository. Findings of the usability testing showed that most participants navigated the app fluently with little back and forth navigation and were able to complete the 11 tasks. These positive results are supported by the average system usability score achieved (78.5/100; min.47.5, max.95) and our qualitative analysis of the semi-structured interviews. Despite an overall positive evaluation, some challenges remained.
Conclusions:
Persons with spinal cord injury often need to navigate competing interests and priorities, paired with uncertainty about the accuracy and relevance of clinical recommendations. Understanding what matters to persons with SCI can help to design behavioral interventions that are useful and acceptable to persons with SCI in their daily lives. This study shows that involving individuals with spinal cord injury and healthcare professionals in co-designing a self-management app can foster knowledge co-creation at the intersection of lived experience, medical expertise, and technical solutions.
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Copyright
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