Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
We developed a mobile app to facilitate self-management behaviour among individuals with spinal cord injury (SCI) to help them improve their management of secondary conditions. The purpose of this study was to explore user expectations of the mobile app intervention to inform its adoption. This presentation will inform practitioners about a technology-based approach to promoting self-care and the unique mobile self-management app expectations and needs of people living with SCI.
Primary Author and Speaker: W. Ben Mortenson
Contributing Authors: Gurkaran Singh, Ethan Simpson, Megan McGillivray, Jared Adams, and Bonita Sawatzky
PURPOSE: Self-management is important for individuals who have experienced spinal cord injury (SCI) to help manage and reduce the occurrence of secondary conditions. The continued growth of technology has resulted in mobile apps being increasingly used to promote independence and reduce burden on health services. We developed a mobile app to facilitate self-management behaviour among individuals living with SCI. Mobile health app users are often satisfied with app usability and performance, but their adherence remains a key issue (Adu et al., 2020). To facilitate mobile health app adherence, it is important to understand potential users' expectations and needs (Adu et al., 2019). According to the Unified Theory of Acceptance and Use of Technology model, key aspects for user adherence include ‘performance expectancy', ‘effort expectancy', ‘social influence', and ‘facilitating conditions' (Vankatesh et al., 2003). To facilitate our understanding of app adherence, the purpose of this study was to explore user expectations of a community-based mobile self-management app intervention designed to facilitate self-management behaviour among individuals with SCI. Understanding user expectations can enable app modifications to improve app adherence.
DESIGN: As part of a larger mixed-methods study, qualitative data were collected using qualitative descriptive methodology. Participants were recruited across Canada and the United States using a variety of recruitment sources including websites, social media, SCI support groups, and SCI newsletter advertisements. Participants needed to (1) have experienced an SCI, (2) be living in the community for at least one-year post-injury, and (3) have internet access to be eligible for participation. Participants were excluded if they had previously used an SCI related self-management app or had cognitive impairments that could inhibit their ability to reliably track behaviors using the app.
METHOD: Data were collected via one-on-one interviews from a sub-sample of 20 participants enrolled in the larger study. Most interviews were conducted over the phone; however 5 interviews were conducted in-person. A semi-structured interview guide was used to explore participants' expectations of the mobile self-management intervention. Analysis of the transcripts was undertaken using the six-phase process of thematic analysis outlined by Braun and Clarke (2006). We employed two main trustworthiness strategies including reflexivity and investigator triangulation.
RESULTS: We interviewed 20 participants, among which 70% were female and 65% experienced a traumatic SCI. Our analysis identified three major themes of user expectation from participating in the mobile app intervention. The first theme, desiring better health outcomes identified participants' expectation of being able to improve their psychological, behavioural and physical health outcomes, and associated secondary conditions. The second theme, wanting to learn about the mobile app's potential, identified participants' interest in exploring the functionality of the app and ability to promote new experiences in health management. The third theme, desiring greater personal and social autonomy, identified participants' desire to improve their understanding of their own health and expectation for the app to facilitate social engagement with others in the community.
CONCLUSION: This study identities the potential pitfalls and benefits of using mobile apps to facilitate self-management among community-dwelling individuals with SCI. This information will be helpful for clinicians who are considering using mobile self-management interventions with their clients as it identifies expectation that need to be addressed to promote long-term adherence.
References
Adu, M., Malabu, U., Malau-Aduli, A. & Malau-Aduli, B. (2019). Mobile application intervention to promote self-management in insulin-requiring type 1 and type 2 diabetes individuals: protocol for a mixed methods study and non-blinded randomized controlled trial. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 12, 789-800. https://doi.org/10.2147/DMSO.S208324
Adu, M., Malabu, U., Malau-Aduli, A. & Malau-Aduli, B. (2020). The development of My Care Hub mobile-phone app to support self-management in Australians with type 1 or type 2 diabetes. Scientific Reports, 10. https://doi.org/10.1038/s41598-019-56411-0
Braun, V. & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77-101. https://doi.org/10.1191/1478088706qp063oa
Vankatesh, V., Morris, M.G., Davis, G.B., & Davis, F.D. (2003). User acceptance of information technology: Toward a unified view. MIS Quarterly, 27(3), 425–478. https://doi.org/10.2307/30036540
