Currently submitted to: JMIR Formative Research
Date Submitted: Jul 14, 2019
(currently open for review)
Understanding end-user perspectives of mobile pulmonary rehabilitation (mPR): Formative studies
Pulmonary rehabilitation (PR) is an effective intervention for the management of people with chronic respiratory diseases but uptake of and adherence to PR programs is low. There is potential for mobile health (mHealth) to provide an alternative modality for the delivery of PR, overcoming many of the barriers contributing to poor attendance to current services.
This study aims to understand the needs, preferences and priorities of end-users for the development of an adaptive mHealth PR support intervention.
A mixed methods (qualitative and quantitative) approach was used to assess the needs, preferences and priorities of end users (i.e. patients with chronic respiratory disorders) and key stakeholders (i.e. clinicians working with patients with chronic respiratory disorders and running PR). The formative studies included: (1) A survey to understand the preferences and priorities of patients for PR and how mobile technology can be used to provide PR support, (2) Ethnographic semi-structured interviews with patients with chronic respiratory disorders to gain perspectives on their understanding of their health and potential features that could be included in a mobile PR intervention and (3) Key informant interviews with healthcare providers to understand the needs, preferences and priorities for the development of an mHealth PR support intervention.
Across all formative studies (patient survey (n=30), patient interviews (n=8) and key stakeholder interviews (n=8)) participants were positive about the idea of a mobile PR program but raised concerns related to digital literacy and confidence in using technology, access to technology, as well as loss of social support currently gained from traditional programs. Key stakeholders highlighted the need for patient safety to be maintained and ensuring appropriate programs for different groups within the population. Finding a balance between ensuring safety and maximizing access was seen to be essential in the success of a mobile PR program.
These formative studies found high interest in mHealth based PR intervention and detailed the potential for a mobile PR program to overcome current barriers to accessing traditional PR programs. Key considerations and features were identified including the importance of technology access and digital literacy being considered in utilizing technology with this population.
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