JMIR Publications

ABSTRACT

Background:

Little is known about women’s decisions around toileting for urination and how those decisions influence moment-to-moment behaviors to manage bladder needs. The new smartphone application Where I Go captures such nuanced and granular data in real-world environments.

Objective:

Describe participant engagement with Where I Go, variation in novel parameters collected, and readiness for the data collection tool’s use in population-based studies.

Methods:

Where I Go has three components: a) real-time, b) short look-back periods (3-4 hours), and c) event location (GPS recorded at each interaction). Sample size was forty-four women. Recording of real-time toileting events and responding to look-back questions was measured over 2-days of data collection. The participant’s self-entered location descriptions and the automatic GPS recordings were compared.

Results:

Forty-four women with an average age of 44 years interacted with the application.: Real-time reporting of at least one toileting event per day was high (38/44 [86%] day 1, 40/44 [91%] day 2) with median of 5 toileting events recorded each day. Toileting most commonly occurred at home (85/140 [61%] day 1, 129/171 [75%] day 2) due to a need to go (114/140 [66%] day 1, 153/171 [74%] day 2). The most common reasons for delaying toileting were “work duties” (33/140 [21%] day 1, 21/171 [11%] day 2) and “errands or traveling” (19/140 [12%] day 1, 19/171 [10%] day 2). Response to at least one look-back notification was similarly high (41/44 [93%] day 1, 42/44 [95%] day 2), with number of responses higher on average on day 2 compared to day 1 (mean day 1=3.2, mean day 2=4.3, P<.001). Median additional toileting events reported on the look-back survey was one and two on days 1 and 2, respectively. Overall concordance between self-reported location recording and GPS was 76% (188/247). Participants reported lower urge ratings when at home versus away when reporting real time toileting (median rating 61 vs. 72), and daily fluid intake showed small to medium positive correlation with toileting frequency (day 1 r=0.3, day 2 r=0.24). Toileting frequency reported in Where I Go showed small positive correlation with the frequency item from the International Consultation on Incontinence Questionnaire (ICIQ) (r=0.31 with day 1 toileting frequency and r=0.21 with day 2 toileting frequency).

Conclusions:

Where I Go has potential to increase understanding of factors that affect women’s toileting decisions and potentially long-term bladder health. We anticipate its use as a data collection tool in population-based studies. Clinical Trial: Not applicable.