Initial Feasibility of the "Families Moving Forward Connect" Mobile Health Intervention for Caregivers of Children With Fetal Alcohol Spectrum Disorders: Mixed Method Evaluation Within a Systematic User-Centered Design Approach.
Initial Feasibility of the "Families Moving Forward Connect" Mobile Health Intervention for Caregivers of Children With Fetal Alcohol Spectrum Disorders: Mixed Method Evaluation Within a Systematic User-Centered Design Approach.
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DOI：
10.2196/29687
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发表时间：
2021-12-02
影响因子：
2.2
通讯作者：
Olson HC
中科院分区：
文献类型：
--
作者：
Petrenko CLM;Kautz-Turnbull CC;Roth AR;Parr JE;Tapparello C;Demir U;Olson HC
胎儿酒精谱系障碍 (FASD) 是常见的神经发育疾病。严重的障碍阻碍了家庭获得 FASD 知情护理。为了提高可及性，正在为 FASD 儿童的护理人员开发可扩展的移动健康干预措施。该应用程序名为 Families Moving Forward (FMF) Connect，源自 FMF 计划，这是一项专为 FASD 量身定制的育儿干预措施。 FMF Connect 有 5 个组件：学习模块、家庭论坛、图书馆、笔记本和仪表板。本研究评估了 FMF Connect 干预原型的可行性。这包括检查应用程序使用数据并评估用户体验以指导进一步的改进。作为 FMF Connect 开发和评估系统方法的一部分，进行了两轮 Beta 测试：(1) 第一轮（2019 年 4 月至 5 月），iOS 原型由 20 名 FASD 儿童（3-17 岁）的看护者和 17 名提供者进行了测试；(2) 第二轮（11 月至 12 月），iOS 和 Android 原型由 25 名看护者和 1 名提供者进行了测试2019）。每 6 周试验结束后，完成焦点小组或个人访谈。使用情况分析和主题分析用于解决可行性目标。在 Beta 测试中，84% (38/45) 的护理人员和 94% (17/18) 的提供者安装了 FMF Connect 应用程序。实时跟踪技术问题并进行更新以解决问题并扩展应用程序功能。在使用日，护理人员平均使用该应用程序的时间为 20 分钟；大部分时间都花在观看学习模块中的视频上。护理人员对学习模块的参与度在 5 个使用模式级别中有所不同。总体而言，67% (30/45) 的护理人员至少在家庭论坛中发帖一次。 26 名护理人员和 16 名提供者完成了访谈。应用程序评估通常不会根据使用模式层或人口统计特征而有所不同。在全球范围内，应用程序用户的态度非常积极，参与者中积极编码的细分是消极编码细分的 2.5 倍。积极的评价强调了该应用程序可获取信息和实用性的好处。信息和视频内容被认为对护理人员特别有价值。该应用程序的许多情感和社会效益已被确定，与护理人员声称的使用应用程序的动机非常吻合。对用户体验的负面评价通常强调技术和导航方面。我们根据第一次 Beta 测试期间的反馈进行了改进，这些反馈在第二轮测试中得到了积极的反馈。参与者为持续改进应用程序提供了许多有价值的建议，这对于改善用户体验非常有用。结果表明，FMF Connect 干预对于抚养 FASD 儿童的护理人员来说是可以接受且可行的。他们将在大规模随机测试之前指导后续的应用程序改进。本研究采用系统的、以用户为中心的设计方法来进行应用程序开发和评估。这里使用的方法可能说明了一个模型，可以广泛地为移动健康和数字育儿干预措施的发展提供信息。
Fetal alcohol spectrum disorders (FASD) are prevalent neurodevelopmental conditions. Significant barriers prevent family access to FASD-informed care. To improve accessibility, a scalable mobile health intervention for caregivers of children with FASD is under development. The app, called Families Moving Forward (FMF) Connect, is derived from the FMF Program, a parenting intervention tailored for FASD. FMF Connect has 5 components: Learning Modules, Family Forum, Library, Notebook, and Dashboard. This study assesses the feasibility of FMF Connect intervention prototypes. This includes examining app usage data and evaluating user experience to guide further refinements. Two rounds of beta-testing were conducted as part of a systematic approach to the development and evaluation of FMF Connect: (1) an iOS prototype was tested with 20 caregivers of children (aged 3-17 years) with FASD and 17 providers for the first round (April-May 2019) and (2) iOS and Android prototypes were tested with 25 caregivers and 1 provider for the second round (November-December 2019). After each 6-week trial, focus groups or individual interviews were completed. Usage analytics and thematic analysis were used to address feasibility objectives. Across beta-test trials, 84% (38/45) of caregivers and 94% (17/18) of providers installed the FMF Connect app. Technological issues were tracked in real time with updates to address problems and expand app functionalities. On use days, caregivers averaged 20 minutes using the app; most of the time was spent watching videos in Learning Modules. Caregiver engagement with the Learning Modules varied across 5 usage pattern tiers. Overall, 67% (30/45) of caregivers posted at least once in the Family Forum. Interviews were completed by 26 caregivers and 16 providers. App evaluations generally did not differ according to usage pattern tier or demographic characteristics. Globally, app users were very positive, with 2.5 times more positive- than negative-coded segments across participants. Positive evaluations emphasized the benefits of accessible information and practical utility of the app. Informational and video content were described as especially valuable to caregivers. A number of affective and social benefits of the app were identified, aligning well with the caregivers’ stated motivators for app use. Negative evaluations of user experience generally emphasized technical and navigational aspects. Refinements were made on the basis of feedback during the first beta test, which were positively received during the second round. Participants offered many valuable recommendations for continuing app refinement, which is useful in improving user experience. The results demonstrate that the FMF Connect intervention is acceptable and feasible for caregivers raising children with FASD. They will guide subsequent app refinement before large-scale randomized testing. This study used a systematic, user-centered design approach for app development and evaluation. The approach used here may illustrate a model that can broadly inform the development of mobile health and digital parenting interventions.