Jasper Vanhoof 1, MScN, PhD student

Transcription

1 Applying a human-centered design process to increase acceptance of interactive health technology to support solid organ transplant patients medication adherence, physical activity and weight control: the PICASSO-Tx project. Jasper Vanhoof 1, MScN, PhD student Bert Vandenberghe 2, Pieter Philippaerts 3, David Geerts 2, Patrick De Mazière 3, Sabina De Geest 1,4, Fabienne Dobbels 1,4, on behalf of the PICASSO-Tx consortium 1 Academic Centre for Nursing and Midwifery, KU Leuven, Belgium 2 Mintlab, KU Leuven / imec, Belgium 3 ITech, UC Leuven-Limburg, Belgium 4 Institute of Nursing Science, University of Basel, Switzerland

2 Dew, et al. Transplantation. 2007; 83: High nonadherence in transplantation (Tx) Behavior Point estimate Immunosuppressive medication Tobacco use Alcohol use Illicit drug use Attending appointments Exercise Following diet Blood work and tests Monitoring vital signs Global nonadherence Cases per 100 patients per year

3 1. Murray, et al. Cochr Datab Syst Rev. 2005, 4; 2. de Jongh, et al. Cochr Datab Syst Rev. 2012,12 3. Dew, et al. J Heart Lung Transplant, 2004;23:745 58; 4. DeVito Dabbs, et al. Am J of Transplant. 2016, 16: Opportunities for Interactive Health Technology (IHT) = Use of technology to transmit health information and to receive guidance or support Meta-analysis on 24 RCT s including 3739 chronically ill patients 1 : Outcome N studies N patients Standard mean difference 95% CI Knowledge [0.22; 0.69] Social support [0.18; 0.52] Self-efficacy [0.00; 0.48] Behavioral outcomes [0.01; 0.41] Clinical outcomes [0.01; 0.35] Large differences in sample size, design and methodological quality 1,2

4 1. Or, et al. J Am Med Inform Assoc. 2009;16(4): ; 2. van Gemert-Pijnen, et al. J Med Internet Res. 2011; 13(4):e111 ; 3. Gould JD, Commun ACM. 1985;28(3): Importance of taking into account patient perspective when developing IHT Low acceptance rate of patients towards new technologies, e.g. they did not need it, poor device usability, lack of skills or low self-efficacy 1 Active involvement of the end-users in the development and testing of the IHT is crucial to address their true needs and increase eventual acceptance 2,3 To develop and test the efficacy of a preference-based self-management intervention with interactive health technology option after heart, lung, liver and kidney transplantation on medication adherence, physical activity levels and weight control

5 van Gemert-Pijnen, et al. J Med Internet Res. 2011; 13(4):e111 Development and testing of IHT based on Human-Centered Design Process Empathize Aim 1 Define Aim 2 Aim Test 4, 5 Human-Centered Design Process Ideate Aim 2 Prototype Aim 3, 4

6 1. Venkatesh, et al. MIS Quarterly. 2003; 27(3): Aim 1: To select a technology platform and assess attitudes towards IHT Cross-sectional descriptive study Convenience sample of 122 heart, lung, liver and kidney Tx patients Structured interview, based on technology acceptance variables and UTAUT Possession and use of technology by Tx patients Own (%) Use (%) Importance of IHT development for own support

7 Aim 2: To observe Tx patients selfmanagement and identify IHT-opportunities Contextual inquiry study Purposive sample of 19 heart, lung, liver and kidney Tx patients Two home visits: 1) diary for one week; 2) interview and observe patients Example medication taking: I forgot to take my medication, but they say it s okay to take them up to 4 hours after my normal hour of intake Provide electronic medication monitoring system Automatic data transfer to IHT-platform Receive correct instructions Enable delivery of behavioural change techniques, e.g. o Self-monitoring o Tailored feedback o Goal setting

8 Aim 3: To develop and test the IHT-prototype empirically and iteratively Prospective, iterative laboratory study Purposive sample of 12 Tx patients (4 per round; total of 3 rounds) Perform tasks Think aloud Incorporate feedback in new IHT prototype Paper sketch in round 1 Result after round 3

9 Hedonic Quality 1. Technology acceptance questionnaire; 2. ATTRAKDIFF; 3. Post-study system usability questionnaire Aim 4: To test the IHT-prototype in Tx patients home environment Mixed method study, Quan-Qual design Purposive sample of 19 heart, lung, liver and kidney Tx patients Two home visits: 1) Installation, usability test and questionnaire 2) After 2 weeks: usability interview and 2 questionnaires Too selforiented Selforiented Desired P Usefulness Ease of use Taskoriented Superfluous Neutral Too taskoriented Pragmatic Quality -3 Initial usefulness and ease of use 1 Usability and design of the website 2 User satisfaction 3

10 Conclusion A website-based interactive health technology was developed that patients liked, found useful and easy to use The application of a human-centered design process and smooth interdisciplinary teamwork proved to be of great importance and should not be underestimated The IHT is currently being finalized based on patients concluding remarks, after which its efficacy and cost-effectiveness will be further tested in a randomized controlled trial (Aim 5)

11 Thank you for your attention!