JMIR Publications

ABSTRACT

Background:

Functional abdominal pain disorders (FAPDs) are highly prevalent and are associated with significant morbidity. Guided imagery therapy (GIT) is an efficacious treatment, but systemic barriers often impede access to this care. Therefore, we developed a GIT mobile application prototype (GIT App) as a novel delivery platform.

Objective:

Guided by the user-centered design approach, this study captured children's and caregivers' critiques of the GIT App to inform its future refinement.

Methods:

7- to 12-year-old children with Rome IV-defined FAPDs and their caregivers were enrolled. Participants completed a software evaluation to assess how well users executed specific App tasks: open the App, log in, initiate a GIT session, set the reminder notification time, and exit the App. Difficulties completing these tasks were tallied. Afterward, participants independently completed the System Usability Scale (SUS) survey. Lastly, participants were separately interviewed to capture their thoughts about the App. Using a semi-structured thematic analytic approach, two independent coders coded interview transcripts using a shared codebook. Data integration occurred after qualitative and quantitative data were analyzed, and their collective results were summarized.

Results:

We enrolled 16 dyads. The average child age was 9.0 ± 1.6 years old, and 69% were female. SUS average scores were above-average at 78.2 ± 12.6 and 78.0 ± 13.5 for the children and caregivers, respectively. The software evaluation revealed favorable usability with most tasks, but 12 (75%) children and 11 (69%) caregivers had difficulty setting the reminder notification. Analysis of the interview data confirmed the App's overall usability as favorable but noted difficulty locating the reminder notification. Children recommended adding exciting scenery and animations to the session screen. Their preferred topics were those related to animals, beaches, swimming, and forests. Children also recommended adding soft sounds related to the session topic. They also thought App gamification enhancements using tangible and virtual rewards for listening to sessions would promote regular use. Caregivers also assessed the App's usability as favorable but verified difficulty locating the reminder notification. A beach was their preferred session setting, and theme-related music and nature sounds were recommended to augment the session narration. App interface suggestions included increasing the font and image sizes. Caregivers also thought the App's ability to relieve gastrointestinal symptoms and gamification enhancements using tangible and virtual incentives would positively influence the children's motivation to use the App regularly. Data integration revealed that the GIT App had above-average usability. The challenges included difficulty locating the reminder notification feature and various aesthetic criticisms affecting its usability.

Conclusions:

Children and their caregivers rated our GIT App's usability favorably, offered suggestions to improve its appearance and session content, and recommended rewards to promote regular use. Their feedback will guide future App refinement to tailor to end-user preferences for sustained use.