Kerstiens Savanna, Bender Edward M, Rizzo Michael G, Landi Andrea, Gleason Lauren J, Huisingh-Scheetz Megan, Rubin Daniel, Ferguson Mark, Madariaga Maria Lucia L
Department of Surgery, University of Chicago Medicine, Chicago, IL, USA.
Department of Cardiothoracic Surgery, Stanford University Medicine, Stanford, CA, USA.
Digit Health. 2023 Sep 26;9:20552076231203957. doi: 10.1177/20552076231203957. eCollection 2023 Jan-Dec.
Increasing the physical activity of frail, older patients before surgery through prehabilitation (prehab) can hasten return to autonomy and reduce complications postoperatively. However, prehab participation is low in the clinical setting. In this study, we re-design an existing prehab smartphone application (BeFitMe™) using a novel standalone Apple Watch platform to increase accessibility and usability for vulnerable patients.
Design Science Research Methodology was used to (1) develop an approach to clinical research using standalone Apple Watches, (2) re-design BeFitMe™ for the Apple Watch platform, and (3) incorporate user feedback into app design. In phase 3, beta and user testers gave feedback via a follow-up phone call. Exercise data was extracted from the watch after testing. Descriptive statistics were used to summarize accessibility and usability.
BeFitMe™ was redesigned for the Apple Watch with full functionality without requiring patients to have an iPhone or internet connectivity and the ability to passively collect exercise data without patient interaction. Three study staff participated in beta testing over 3 weeks. Six randomly chosen thoracic surgery patients participated in user testing over 12 weeks. Feedback from beta and user testers was addressed with updated software (versions 1.0-1.10), improved interface and notification schemes, and the development of educational materials used during enrollment. The majority of users (5/6, 83%) participated by responding to at least one notification and data was able to be collected for 54/82 (68%) of the days users had the watches. The amount of data collected in BeFitMe™ Watch app increased from 2/11 (16%) days with the first patient tester to 13/13 (100%) days with the final patient tester.
The BeFitMe™ Watch app is accessible and usable. The BeFitMe™ Watch app may help older patients, particularly those from vulnerable backgrounds with fewer resources, participate in prehab prior to surgery.
通过术前康复（预康复）增加体弱老年患者术前的身体活动，可加速其恢复自主能力并减少术后并发症。然而，在临床环境中，预康复的参与率较低。在本研究中，我们使用全新的独立苹果手表平台重新设计了现有的预康复智能手机应用程序（BeFitMe™），以提高其对脆弱患者的可及性和易用性。
采用设计科学研究方法来（1）开发一种使用独立苹果手表进行临床研究的方法，（2）为苹果手表平台重新设计BeFitMe™，以及（3）将用户反馈纳入应用程序设计。在第3阶段，测试版用户和用户测试者通过后续电话提供反馈。测试后从手表中提取运动数据。使用描述性统计来总结可及性和易用性。
BeFitMe™已针对苹果手表进行了重新设计，具备完整功能，无需患者拥有iPhone或网络连接，并且能够在无需患者交互的情况下被动收集运动数据。三名研究人员参与了为期3周的测试版测试。六名随机挑选的胸外科患者参与了为期12周的用户测试。测试版用户和用户测试者的反馈通过更新软件（版本1.0 - 1.10）、改进界面和通知方案以及开发注册期间使用的教育材料来解决。大多数用户（5/6，83%）通过回应至少一条通知参与其中，并且在用户佩戴手表的82天中，有54天（68%）能够收集到数据。BeFitMe™手表应用程序收集的数据量从第一名患者测试者的2/11天（16%）增加到最后一名患者测试者的13/13天（100%）。
BeFitMe™手表应用程序具有可及性和易用性。BeFitMe™手表应用程序可能有助于老年患者，特别是那些资源较少的弱势群体，在手术前参与预康复。
