Date Presented 04/04/19
The 5Minutes4Myself companion mobile app aims to improve wellness for caregivers of children with autism. It provides efficient access to an occupation-based wellness program that includes habit-building features and mindfulness podcasts. We examined usability of the 5Minutes4Myself app via the Modified System Usability Scale, usage data, and focus groups. The app had above-average usability, suggesting it can be a practical tool for stress reduction in populations with elevated stress levels.
Primary Author and Speaker: Jenna Sherman
Additional Authors and Speakers: Elizabeth Larson, John Newlon, McKenzie Rowley
PURPOSE: Wellness promotion programs are desperately needed for caregivers of children with autism spectrum disorder (ASD), who are among the most stressed caregivers. Occupational therapists need to consider the caregivers’ capacity to manage family life and ability to foster their child’s participation. Developed with and for caregivers, the 5Minutes4Myself program is an occupation-based wellness program tailored to caregivers’ lifestyles and constraints with features to support effective behavior change. Together, we designed a user-friendly supporting app with habit-building features, and mini-mindfulness podcasts. The app seamlessly collects user data for program evaluation. The purpose of this feasibility study was to evaluate the quality and functionality of the 5Minutes4Myself companion app.
DESIGN: A quasi-experimental study examined the usability of the 5Minutes4Myself wellness companion app. Fifteen participants who were the primary caregiver for a child with ASD between 8-21 years old and were willing to participate in a wellness program were recruited in three cohorts through a convenience sample. Caregivers participated in a workshop where they were trained on the app and completed surveys (including MSUS). Next, coaches used an activity card sort and motivational interviewing approach to evoke caregiver’s goals and a plan for lifestyle change. Goals were programmed into the app with individually tailored reminders and weekly check-ins. Coaches checked in monthly on each caregiver’s progress. App usage data was gathered electronically. After 4 months, in a 2nd workshop caregivers completed post-intervention surveys. After one cohort completed the program, we revised the app based on their feedback.
METHOD: App quality and functionality and usage was assessed after the 4-month intervention via 1) the Modified System Usability Scale (MSUS) with success being > 65 (above average usability), 2) a focus group, and 3) frequency of usage of the podcasts with success being 75% of caregivers using the mindfulness podcasts 2x per week for 12 of 16 weeks.
RESULTS: The mean caregiver MSUS rating of the app was 76.7 (> 65 is above & > 80 is top 10% of all products tested using SUS). Usability ratings improved from the first version (M =70) to the second version (M = 84). In focus groups, caregivers did report finding the app easy to use although they requested some modifications. Only one caregiver listened at least 2 days in 12 out of 16 weeks. (A 2nd participant listened at least 2 days in 11 out of 16 weeks, but the remaining subjects only met this criterion in 5 or less than 5 out of 16 weeks.) Participants on average listened 10.9 minutes per week.
CONCLUSION: Study participants viewed the 5Minutes4Myself companion app as user-friendly. This app shows promise as an effective support to a wellness intervention for caregivers of children with ASD as well as other groups experiencing elevated stress levels. While the usability was ranked well, participants’ frequency of use was lower than expected. This suggests additional improvements are needed to accommodate the unpredictable lives of caregivers of children with ASD and promote their success in the program.
IMPACT STATEMENT: The use of companion apps to extend occupational therapy interventions beyond the clinic has great potential to foster lifestyle change for our clients. The 5Minutes4Myself program introduces a quick and user-friendly way for caregivers of children with ASD, who are known to experience lower levels of wellbeing and higher levels of stress, to have access to effective interventions that fit into their lives.
References
Brooke, J. (1996). SUS: A 'quick and dirty" usability scale. In P.W. Jordan, B. Thomas, B.A. Weerdmeester, & I.L. McClelland (Eds.), Usability evaluation in industry (pp. 189-194). London: Taylor & Francis.
Coulon, S.M., Monroe, C.M., & West, D.S. (2016). A systematic, multi-domain review of mobile smartphone apps for evidence-baed stress management. American Journal of Preventative Medicine, 51(1), 95-105. https://doi.org/10.1016/j.amepre.2016.01.026
Hayes, S.A., & Watson, S.L. (2013) The impact of parenting stress: A meta-analysis of studies comparing the experience of parenting stress in parents of children with and without autism spectrum disorder. Journal of Autism and Developmental Disorders, 43, 629-642.
