Informing evaluation of a smartphone application for people with acquired brain injury: a stakeholder engagement study

Kettlewell, Jade; Phillips, Julie; Radford, Kathryn A.; das Nair, Roshan

Abstract

Background

Brain in Hand is a smartphone application (app) that allows users to create structured diaries with problems and solutions, attach reminders, record task completion and has a symptom monitoring system. Brain in Hand was designed to support people with psychological problems, and encourage behaviour monitoring and change. The aim of this paper is to describe the process of exploring the barriers and enablers for the uptake and use of Brain in Hand in clinical practice, identify potential adaptations of the app for use with people with acquired brain injury (ABI), and determine whether the behaviour change wheel can be used as a model for engagement.

Methods

We identified stakeholders: ABI survivors and carers, National Health Service and private healthcare professionals, and engaged with them via focus groups, conference presentations, small group discussions, and through questionnaires. The results were evaluated using the behaviour change wheel and descriptive statistics of questionnaire responses.

Results

We engaged with 20 ABI survivors, 5 carers, 25 professionals, 41 questionnaires were completed by stakeholders. Comments made during group discussions were supported by questionnaire results. Enablers included smartphone competency (capability), personalisation of app (opportunity), and identifying perceived need (motivation). Barriers included a physical and cognitive inability to use smartphone (capability), potential cost and reliability of technology (opportunity), and no desire to use technology or change from existing strategies (motivation). The stakeholders identified potential uses and changes to the app, which were not easily mapped onto the behaviour change wheel, e.g. monitoring fatigue levels, method of logging task completion, and editing the diary on their smartphone.

Conclusions

The study identified that both ABI survivors and therapists could see a use for Brain in Hand, but wanted users to be able to personalise it themselves to address individual user needs, e.g. monitoring activity levels. The behaviour change wheel is a useful tool when designing and evaluating engagement activities as it addresses most aspects of implementation, however additional categories may be needed to explore the specific features of assistive technology interventions, e.g. technical functions.

Citation

Kettlewell, J., Phillips, J., Radford, K. A., & das Nair, R. (2018). Informing evaluation of a smartphone application for people with acquired brain injury: a stakeholder engagement study. BMC Medical Informatics and Decision Making, 18(1), Article 33. https://doi.org/10.1186/s12911-018-0611-0

• Journal Article Type: Article
• Acceptance Date: May 4, 2018
• Online Publication Date: May 30, 2018
• Publication Date: 2018-12
• Deposit Date: Jun 5, 2018
• Publicly Available Date: Jun 5, 2018
• Journal: BMC Medical Informatics and Decision Making
• Electronic ISSN: 1472-6947
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 18
• Issue: 1
• Article Number: 33
• DOI: https://doi.org/10.1186/s12911-018-0611-0
• Keywords: Brain injuries; Technology; Smartphone application; mHealth; Self-monitoring; Engagement study; Behaviour change
• Public URL: https://nottingham-repository.worktribe.com/output/934645
• Publisher URL: https://doi.org/10.1186/s12911-018-0611-0
• Contract Date: Jun 5, 2018