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Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Aug 25, 2025
Open Peer Review Period: Aug 27, 2025 - Oct 22, 2025
Date Accepted: Dec 24, 2025
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Changing Habits With the Happy Hands App: Qualitative Focus Group Study of a Hand Osteoarthritis Self-Management Intervention

Fjeldstad KA, Tveter AT, Rasmussen E, Olden L, Nyheim SB, Blanck T, Killingmo RM, Kjeken I

Changing Habits With the Happy Hands App: Qualitative Focus Group Study of a Hand Osteoarthritis Self-Management Intervention

J Med Internet Res 2026;28:e82773

DOI: 10.2196/82773

PMID: 41628446

PMCID: 12910265

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Changing habits with the Happy Hands app: A qualitative study of participants’ experiences with a hand osteoarthritis self-management intervention

  • Kristine Aasness Fjeldstad; 
  • Anne Therese Tveter; 
  • Eivor Rasmussen; 
  • Lena Olden; 
  • Sissel Bærø Nyheim; 
  • Thalita Blanck; 
  • Rikke Munk Killingmo; 
  • Ingvild Kjeken

ABSTRACT

Background:

People with hand osteoarthritis represent a large patient group with limited access to recommended treatment. In recent years, there has been a notable shift in healthcare delivery, with increased use of digital technologies. The Happy Hands app is a digital self-management intervention developed to provide evidence-based treatment for people with hand osteoarthritis, with the goal of empowering them to self-manage their disease. Participants’ experiences and perceptions of using this digital intervention remain unknown, and understanding these perspectives is crucial for the adoption and continued use of the Happy Hands app.

Objective:

The objective of this qualitative study is to explore how people with hand osteoarthritis experience using the Happy Hands app.

Methods:

The study is embedded within a randomized controlled trial (RCT). The participants were recruited from the intervention group in the RCT, and had completed a 12-week digital self-management intervention in the Happy Hands app. The self-management intervention included a hand exercise program and informational videos about hand osteoarthritis. Focus group were conducted across all four health regions in Norway. The focus groups were transcribed verbatim, coded and analysed inductively using reflexive thematic analysis.

Results:

A total of 26 participants, 18 women and 8 men, were recruited from both specialist- and primary healthcare. The median age was 67 years. Three themes were developed from the analysis. The first theme, “Being acknowledged,” highlights the essential role of recognition for people with hand osteoarthritis. It suggests that the Happy Hands app provided participants with a sense of validation and support. The second theme, “Changed perception of hand osteoarthritis,” indicates that participants gained insights and knowledge about their condition. This new understanding empowered them to make more informed decisions about their care, fostering a sense of hope and motivation by demonstrating that effective measures are available to manage the disease. The third theme “Changing habits with the Happy Hands app” describes how participants developed new habits after using the self-management intervention delivered through the app. The exercise program was experienced as motivating, flexible, well-structured and committing. Some challenges were reported, including experiencing pain during or after exercising. The new habits included performing hand exercises and implementing ergonomic working methods, which were tailored to meet the individual needs and integrated into the participants’ daily lives and routines.

Conclusions:

The findings suggest that the Happy Hands app is a valuable tool for supporting people with hand osteoarthritis in managing their disease by helping them integrate hand OA management into their daily lives. Clinical Trial: NCT05568875


 Citation

Please cite as:

Fjeldstad KA, Tveter AT, Rasmussen E, Olden L, Nyheim SB, Blanck T, Killingmo RM, Kjeken I

Changing Habits With the Happy Hands App: Qualitative Focus Group Study of a Hand Osteoarthritis Self-Management Intervention

J Med Internet Res 2026;28:e82773

DOI: 10.2196/82773

PMID: 41628446

PMCID: 12910265

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