Accepted for/Published in: JMIR Formative Research
Date Submitted: Oct 15, 2022
Date Accepted: Dec 31, 2022
A digital health intervention for concussion: development and clinical feasibility study
ABSTRACT
Background:
Concussion is a common condition that can lead to a constellation of symptoms which impact on quality of life, social integration and return to work. There are several evidence-based behavioural and psychological interventions which have been found to improve post-concussion symptom burden. However, these are not routinely delivered, and individuals get limited support during their concussion recovery.
Objective:
Develop and test the feasibility of digital health intervention using a systematic evidence-, theory- and person-based approach.
Methods:
This was a mixed methodology study involving a scoping review (n=21), behavioural analysis and logic model to inform the intervention design and content. During development, the intervention was optimised with feedback from individuals who had experienced concussion (n=12) and healthcare providers (n=11). The intervention was then offered to patients presenting to the emergency department with a concussion (n=50). Participants used the intervention freely and inputted symptom data as part of the program. A number of outcome measures were captured including participant engagement with the intervention, post-concussion symptom burden and attitudes towards the intervention. A selection of participants (n=15) undertook in-depth qualitative interviews to understand their attitudes towards the intervention and how to improve it.
Results:
Metrics indicated high levels of early engagement which tailed off through the course of the intervention. A quarter of study participants were classified as ‘high engagers’ who interacted with all the functionality within the intervention. Quantitative and qualitative feedback indicated a high level of usability and positive perception towards the intervention. Daily symptom diaries (n=494) demonstrated a wide variation in individual participant symptom burden but a decline in average burdens over time. Insights from the interviews were then fed back into development to optimise the intervention and facilitate engagement.
Conclusions:
Using this systematic approach, we have developed a digital health intervention for individuals who have experienced a concussion that is designed to facilitate positive behaviour change. Symptom data inputted as part of the intervention provide insights into post-concussion symptom burden and recovery trajectories. Clinical Trial: Clinicaltrials.gov NCT05069948
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