JMIR Publications

ABSTRACT

Background:

Mobile health applications can offer tailored self-management support to individuals living with chronic health conditions. Yet, there are several challenges to the adoption of these technologies in practice. Co-design is a promising approach to overcoming some of these challenges by enabling the development of solutions that meet the actual needs and preferences of the relevant stakeholder groups.

Objective:

Taking spinal cord injury as a case in point, the overall objectives of this study were to identify the perceived benefits of a co-designed self-management app that could promote its uptake and to explore the factors that may impede adoption.

Methods:

We adopted a qualitative research approach guided by the Technology Acceptance Model. Data were collected through semi-structured interviews with individuals with spinal cord injury (N=15) and two focus groups with healthcare professionals specialized in spinal cord injury (N=7, N=5). Prior to the interview and focus group, study participants were given time to explore the app prototype. All interviews were transcribed verbatim and analyzed using inductive thematic analysis.

Results:

Findings of our analysis indicate that study participants perceived the app prototype as potentially useful to support individuals with spinal cord injury in preventing pressure injuries. In particular, we identified three concrete use cases highlighting the benefits of the app for different audiences: 1) companion for newly injured individuals, 2) an emergency kit and motivational support for experienced wheelchair users, and 3) guide for informal caregivers and family members. We also uncovered several challenges that might impede the adoption of the self-management app in practice, including 1) challenges to motivate individuals to use the app, 2) concerns about the misuse and abuse of the app, and 3) organizational and maintenance challenges.

Conclusions:

This study adds to a growing body of research that investigates individuals’ adoption and non-adoption behavior of mobile health solutions. Building on earlier work, we make recommendations on how to address the barriers to the adoption of mobile health solutions identified by this study. In particular, there is a need to foster trust in mobile health among prospective users, including both patients and healthcare professionals. Moreover, increasing personal relevance of mHealth solutions through personalization may be a promising approach to promote uptake. Last but not least, also organizational support plays an instrumental role in mobile health adoption. We conclude that even though co-design is promoted as a promising approach to develop self-management tools, co-design does not guarantee adoption. More research is needed to identify the most promising strategies to promote the adoption of evidence-based mobile health solutions in practice.