Department of Neurology, SUNY Downstate Health Sciences University, Brooklyn, NY.
Department of Neurology, SUNY Downstate Health Sciences University, Brooklyn, NY.
Arch Phys Med Rehabil. 2023 Oct;104(10):1573-1579. doi: 10.1016/j.apmr.2023.05.009. Epub 2023 Jun 8.
OBJECTIVE: Investigate stroke survivors' (SS) preferences for a hypothetical mHealth app for post-stroke care and to study the influence of demographic variables on these preferences. DESIGN: Mixed-methods, sequential, observational study. SETTING: Focus groups (phase 1) were conducted to identify SS perceptions and knowledge of mHealth applications (apps). Using grounded theory approach, recurring themes were identified. A multiple-choice questionnaire of 5 desired app features was generated using these themes and mailed to SS (national survey, phase 2). SS' demographics and perceived usefulness (yes/no) for each feature were recorded. In-person usability testing (phase 3) was conducted to identify areas of improvement in user interfaces of existing apps. Summative telephone interviews (phase 4) were conducted for final impressions supplementary to national survey. PARTICIPANTS: SS aged >18 years recruited from study hospital, national stroke association database, stroke support and advocacy groups. Non-English speakers and those unable to communicate were excluded. INTERVENTIONS: None. MAIN OUTCOME MEASURES: (1) Percentage of SS (phase 2) identifying proposed app features to be useful. (2) Influence of age, sex, race, education, and time since stroke on perceived usefulness. RESULTS: Ninety-six SS participated in focus groups. High cost, complexity, and lack of technical support were identified as barriers to adoption of mHealth apps. In the national survey (n=1194), ability to track fitness and diet (84%) and communication (70%) were the most and least useful features, respectively. Perceived usefulness was higher among younger SS (P<.001 to .006) and SS of color (African American and Hispanic) (ORs 1.73-4.41). Simple design and accommodation for neurologic deficits were main recommendations from usability testing. CONCLUSIONS: SS are willing to adopt mHealth apps that are free of cost and provide technical support. Apps for SS should perform multiple tasks and be of simple design. Greater interest for the app's features among SS of color may provide opportunities to address health inequities.
目的：调查中风幸存者（SS）对假设的中风后护理移动健康应用程序（mHealth app）的偏好，并研究人口统计学变量对这些偏好的影响。
设计：混合方法、顺序、观察性研究。
地点：在焦点小组（第 1 阶段）中，确定 SS 对移动健康应用程序（app）的认知和知识。使用扎根理论方法，确定了反复出现的主题。使用这些主题生成了一个包含 5 个所需应用程序功能的多项选择问卷，并邮寄给 SS（全国调查，第 2 阶段）。记录 SS 的人口统计学数据和对每个功能的感知有用性（是/否）。进行了用户界面可用性测试（第 3 阶段），以确定现有应用程序的用户界面改进领域。进行了总结性电话访谈（第 4 阶段），以补充全国调查的最终印象。
参与者：从研究医院、国家中风协会数据库、中风支持和宣传团体中招募年龄>18 岁的 SS。不包括不会说英语或无法交流的人。
干预措施：无。
主要观察结果：（1）确定提出的应用程序功能有用的 SS 百分比（第 2 阶段）。（2）年龄、性别、种族、教育程度和中风后时间对感知有用性的影响。
结果：96 名 SS 参加了焦点小组。采用移动健康应用程序的障碍包括高成本、复杂性和缺乏技术支持。在全国调查（n=1194）中，能够跟踪健身和饮食（84%）和沟通（70%）是最有用和最无用的功能，分别。感知有用性在年轻 SS 中更高（P<.001 至<.006）和有色人种 SS（非裔美国人和西班牙裔）（ORs 1.73-4.41）。从可用性测试中主要提出了简单的设计和适应神经缺陷的建议。
结论：SS 愿意采用免费提供技术支持的移动健康应用程序。SS 的应用程序应执行多项任务，设计简单。有色人种 SS 对应用程序功能更感兴趣，这可能为解决健康不平等问题提供机会。
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