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将移动支持干预措施转化和扩展:来自活动性肺结核治疗个体的焦点小组和现场测试结果。

Converting and expanding a mobile support intervention: Focus group and field-testing findings from individuals in active tuberculosis treatment.

机构信息

Biobehavioral Nursing and Health Informatics, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA.

University of Washington, School of Nursing, 1959 NE Pacific Street, Seattle, WA, 98195, USA.

出版信息

Int J Med Inform. 2020 Apr;136:104057. doi: 10.1016/j.ijmedinf.2019.104057. Epub 2020 Jan 7.

Abstract

BACKGROUND

Non-adherence to tuberculosis (TB) treatment jeopardizes the individual's health and contributes to disease transmission and drug resistance. New patient-centered strategies are needed to improve TB treatment outcomes.

PURPOSE

To convert and expand a texting-based intervention into a mobile optimized application (app), evaluate the feasibility of an added self-administered paper-based drug metabolite test, and identify needs and preferences to inform their iterative design.

METHODS

Qualitative methods using focus groups and field testing with patients in active TB treatment were used to gather initial input on the converted intervention design, content and issues using at home test strips to report medication adherence. Seven participants were recruited from an outpatient clinic within a regional public reference hospital specialized in respiratory diseases in Argentina. Thematic analyses were conducted on the transcripts and session notes.

RESULTS

Participants considered interactive communication, access to answers to frequently asked questions, and tracking of progress in treatment as important. Participants reported having many questions and uncertainties at initiation of treatment and emphasized a need for reliable information, assurance and support from both providers and peers. Other suggestions included streamlining the graphical user interface for easier and shorter data entry times and usability.

CONCLUSIONS

Overall feedback from the participants regarding the intervention was positive, reporting that it was useful and relevant, and they were eager to contribute their ideas for improvement and additional functionality. Valuable feedback to improve functionality and meet the needs of end-users were obtained to inform the generation of new design ideas for refinement and testing in a pilot study.

摘要

背景

结核病(TB)治疗不依从会危及个人健康,并导致疾病传播和耐药性的产生。需要新的以患者为中心的策略来改善结核病治疗结果。

目的

将基于短信的干预措施转换和扩展为移动优化应用程序(app),评估添加自我管理药物代谢物测试的可行性,并确定需求和偏好,以为其迭代设计提供信息。

方法

采用定性方法,通过在阿根廷一家专门治疗呼吸系统疾病的地区参考医院的门诊诊所对正在接受结核病治疗的患者进行焦点小组和现场测试,以获得对转换后的干预设计、内容和问题的初步意见,使用家庭测试条报告药物依从性。从七名参与者中招募。对转录本和会议记录进行主题分析。

结果

参与者认为交互沟通、获取常见问题解答、以及跟踪治疗进展很重要。参与者报告说,在开始治疗时会有很多问题和不确定因素,他们强调需要来自提供者和同行的可靠信息、保证和支持。其他建议包括简化图形用户界面,以便更轻松、更短的数据输入时间和更好的可用性。

结论

参与者对干预措施的总体反馈是积极的,报告称它是有用和相关的,他们渴望为改进和添加额外功能贡献自己的想法。获得了有价值的反馈,以改善功能并满足最终用户的需求,以便在试点研究中生成新的设计理念进行改进和测试。

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