JMIR Publications

ABSTRACT

Background:

Adherence to orthosis use remains a key challenge in nonsurgical scoliosis treatment. Smart monitoring uses technology that can quantify wear time and skin-to-orthosis pressure to support treatment adherence. Gaps remain in how Norwegian adolescent patients and their parents perceive such technologies or how they envision supportive monitoring systems integrated into daily life. This underscores the need to understand adolescent patient expectations in order to design future digital solutions together with participants, considering smart monitoring features that they perceive as meaningful, acceptable, and supportive of adhering to clinical prescriptions.

Objective:

The participatory design study was conducted in two sequential phases to identify user driven design requirements for a future smart orthosis monitoring solution in Norway involving adolescent scoliosis patients and their parents.

Methods:

This participatory design study was conducted in two sequential phases. Phase 1 involved qualitative focus group interviews with adolescents with scoliosis experience using orthoses, analyzed using directed content analysis. Phase 2 involved anonymous Mentimeter polling with adolescents and parents, analyzed using descriptive statistics. Illustrative sketches were used as supportive material for interpretation.

Results:

Phase 1 qualitative data were analyzed using the lens of Ajzen’s Theory of Planned Behavior (TPB), which yielded five main categories: Patient Behavior, Impact of environment, Patient belief, Smart Orthosis Ecosystem and User‑Informed Design Concepts. The downloadable Excel file from Mentimeter was analyzed using descriptive statistics. The convergence of themes such as daily challenges, preferences for supportive smart‑monitoring features, and perceptions of smart monitoring was consistent across discussions and quantitative poll results.

Conclusions:

Norwegian adolescent patients preferred feedback that was encouraging, easy to interpret, stress-free, and positive feedback. Adolescent patients and their parents living in Norway prefer smart monitoring using sensors placed on the orthosis that communicate to the user through a gamified solution on a mobile device that supports autonomy, gives meaningful alerts, rewards patient efforts, and avoids feelings of surveillance. Parents emerged as the adolescent patient’s direct support and expressed willingness to share orthosis‑related data with parents. Adolescent patients expressed a preference for feedback that was encouraging.