M-ACZiE project 21/02/2018

Transcription

1 User-centered development of an mhealth intervention to enhance self-management of exacerbations in patients with Chronic Obstructive Pulmonary Disease (COPD). M-ACZiE project Yvonne Korpershoek RN, MSc, PhD candidate Teacher bachelor of nursing JCA Trappenburg, PhD; MJ Schuurmans, RN, PhD, Professor in Nursing. Faculty of Health Care - University of Applied Sciences Utrecht / NL. University Medical Center Utrecht Utrecht / NL. 21/02/2018

2 Rationale Hospital admissions Mortality > Increased health care use Lung function Quality of life

3 Aim To develop a tailored mhealth intervention to decrease the impact of exacerbations by enhancing exacerbation-related selfmanagement in COPD patients.

4 User-centered development design (based on: Johnston, 2009; Van Meijel, 2004; Graig, 2008)

5 1A + 1B Theory identification Literature review Aims: 1) To specify different symptom fluctuation phases. 2) To identify potential relevant self-management behaviors. Outcome Conceptual exacerbation model. Overview of potential behavioral targets. (Korpershoek et al., 2017)

6 1C Problem analysis (1) Expert perspective International Delphi study Aim: To provide insight into expert opinion on relevance and feasibility of identified self-management behaviors. Design: Two-round Delphi study with international expert panel (n=19). Outcome Consensus on relevant and feasible target behaviors for each phase of the conceptual model. (Korpershoek et al., 2017)

7 1C Problem analysis (2) Patient perspective Qualitative study Aim: To provide insight into patients perceptions, capabilities and needs with regard to exacerbation-related self-management. Design: Grounded Theory approach. Semi-structured interviews (n=15). Outcome Conceptual model factors influencing exacerbation-related selfmanagement. (Korpershoek et al., 2016)

8 1D Needs analysis Qualitative study Aim: To explore perceptions of COPD patients and their HCPs towards using mhealth for exacerbation-related self-management. Design: Focus group interviews (Patients: n=13; HCPs: n=6). Thematic analysis. Outcome Overview of potential benefits and barriers regarding mhealth use. Overview of ideas for the mhealth intervention.

9 1E Current pratice analysis Aims: 1) To provide insight into current self-management support. 2) To explore how the mhealth intervention can be delivered to COPD patients by bringing it to the market. Design: 1) Literature review & interviews with HCPs (n=10). 2) Business modelling Outcome Overview of provided care by healthcare professionals. A business model for the mhealth intervention.

10 1F Intervention design Aim: To develop a proto-type of the mhealth intervention. Steps: 1)Develop logic model. 2)Select final target behaviors, perform COM-B analysis and select behavior change techniques. 3)Organise pressure-cooker session with creative designers. 4)Reach consensus on first prototype with designers, health care professionals and patients.

11 Target behaviors Self-monitoring/exacerbation detection & management

12 Take home messages For academia/researchers: To increase the likelihood that mhealth interventions are effective and used, researchers should: 1) underpin the potential workingmechanism; and 2) explore the market potential during the development phase. For industry/practice: To increase the likelihood that mhealth interventions change health behaviors, target behaviours should be identifed by scientific evidence. Behavior change techniques should be selected based on a thorough behavioral analysis. 22/02/ /02/2018

13 Questions? Thank you for your attention!

14 References Craig P, Dieppe P, Macintyre S, et al. Developing and evaluating complex interventions: The new medical research council guidance. BMJ. 2008;337:a1655. Johnston SK, Nguyen HQ, Wolpin S. Designing and testing a web-based interface for self-monitoring of exercise and symptoms for older adults with chronic obstructive pulmonary disease. Comput Inform Nurs. 2009;27(3): van Meijel B, Gamel C, van Swieten-Duijfjes B, Grypdonck MH. The development of evidence-based nursing interventions: Methodological considerations. J Adv Nurs. 2004;48(1): Korpershoek YJG et al. Factors influencing exacerbation-related self-management in patients with COPD: a qualitative studie. Int J Chron Obstruct Pulmon Dis Nov 28;11: Korpershoek YJG et al. Self-management behaviors to reduce exacerbation impact in COPD patients: a Delphi study. Int J Chron Obstruct Pulmon Dis Sep;