JMIR Publications

ABSTRACT

Background:

Post-fracture acute pain is often inadequately managed in older adults. Mobile health (mHealth) technologies can offer opportunities for self-management of pain; however, insufficient applications exist for acute pain management after a fracture, and none are designed for an older adult population.

Objective:

The purpose of this study was to design, develop, and evaluate a mHealth application prototype using a human-centered design approach to support older adults in the self-management of post-fracture acute pain.

Methods:

The study employed a multidisciplinary and user-centered design approach. Overall, 7 stakeholders (i.e., 1 internal medicine specialized clinician-researcher, 2 user experience designers, 1 computer science researcher, 1 clinical research assistant researcher, and 2 pharmacists) from the project team, together with 355 external stakeholders were involved throughout the 3 phases of our user-centered development process that included surveys, requirement elicitation, participatory design workshops, mobile app design and development, mobile app content development, and usability testing. We completed this study in three phases. (i) We analyzed data from prior surveys administered to 305 members of the virtual Canadian Osteoporosis Patient Network of Osteoporosis and 34 healthcare professionals to identify requirements for designing a low-fidelity prototype. (ii) Next, we facilitated four participatory design workshops with 6 participants for feedback on content, presentation, and interaction with our proposed low-fidelity prototype. After analyzing collected data using thematic analysis, we designed a medium-fidelity prototype. (iii) Lastly, to evaluate our medium-fidelity prototype, we conducted usability tests with 10 participants. The results informed the design of our high-fidelity prototype. Throughout all phases of this development study, we incorporated input from health professionals to ensure the accuracy and validity of the medical content in our prototypes.

Results:

We identified 3 categories of functionalities necessary to include in the design of our initial low-fidelity prototype: the need for support resources, diary entries and access to educational materials. We then conducted a thematic analysis of the data collected in the design workshops, which revealed four themes: (1) feedback on the user interface design and usability, (2) requests for additional functionalities, (3) feedback on medical guides and educational materials and (4) suggestions for additional medical content. Based on these results, we designed a medium-fidelity prototype. All participants in the usability evaluation tests found the medium-fidelity prototype useful and easy to use. Based on feedback and difficulties experienced by participants, we adjusted our prototype in preparation for deployment.

Conclusions:

We designed, developed, and evaluated a mHealth application to support older adults in the self-management of pain after a fracture. Participants found our proposed prototype useful for managing acute pain, easy to interact with and navigate. Assessment of the clinical outcomes and long-term impacts of our proposed mHealth application will be evaluated in the future.