JMIR Publications

ABSTRACT

Background:

Occupational therapy has highlighted the necessity for planning and executing interventions in collaboration with clients, families, and caregivers to facilitate their progress. Thus, in pediatric occupational therapy, it is essential to position the family as a primary client and to actively involve them in the intervention process. These interventions often incorporate tools that facilitate parental engagement in home-based activities. However, no tools have been specifically designed to support parents comprehensively in achieving their parenting goals in everyday situations. To address this gap, we developed a mobile application called the Children’s Occupation Support Mobile System (COSMO) to support occupational therapists, children, and parents in a collaborative manner to achieve intervention goals in daily life.

Objective:

To develop the COSMO and validate its content in terms of legibility, visibility, and accessibility.

Methods:

This study was conducted in two stages: (1) designing a prototype of COSMO and (2) validating its content using the Delphi method. This study included 10 Japanese pediatric occupational therapists, who were selected using convenience sampling to ensure diversity and heterogeneity in attributes, such as age, clinical experience, educational background, and employment status. The Delphi survey was conducted entirely through a web-based questionnaire (Google Forms) emailed to the experts. Participants rated their agreement with each item on a five-point Likert scale (1 = strongly disagree, 5 = strongly agree). A mean score of 3.75 (75%) or higher indicated consensus on an item.

Results:

The prototype was designed through a series of 13 one-hour meetings held monthly. The functional framework of COSMO was structured into four core components based on previous research: (1) collaborative goal setting; (2) home strategy; (3) self-reflection; and (4) progress reports. For validating the content, the two Delphi rounds resulted in a total mean score of 4.44 for legibility, 4.86 for visibility, and 4.84 for accessibility. In the free text responses, there were references to improvements in the wording and to the burden of writing the reflections. Therefore, the wording was revised to avoid jargon and to use plain language. The burden of COSMO use was reduced by simplifying the usage process by incorporating optional inputs for some of its function.

Conclusions:

COSMO was developed as a support tool to integrate the functions of collaborative goal setting, home strategy, self-reflection and progress reports, while aiming to reduce the burden on parents. This may reduce resistance to the use of this application and make it easier for more parents to utilize it. Ultimately, COSMO has the potential to enhance parental participation in achieving children’s goals and to contribute to more effective occupational-therapy interventions. Clinical Trial: Our protocol was registered with the University Medical Information Network (UMIN) Center (000057084).