Willemsen Romy Fleur, Meijer Eline, van den Berg Liselot Nicoline, van der Burg Luuk, Chavannes Niels Henrik, Aardoom Jiska Joelle
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.
National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands.
JMIR Form Res. 2023 Sep 29;7:e49473. doi: 10.2196/49473.
eHealth has the potential to improve health outcomes. However, this potential is largely untapped. Individuals face an overload of apps and have difficulties choosing suitable apps for themselves. In the FitKnip experiment, individuals were given access to a health app platform, where they could purchase reliable preselected health apps with a personal budget of €100 (US $107.35). By conducting a prospective study, we aimed to scientifically evaluate the FitKnip experiment as an innovative way to improve population health.
The aim of the experiment was to scientifically evaluate the FitKnip experiment as an innovative way to improve population health. More specifically, we conducted an in-depth qualitative evaluation of the concept and acceptability of FitKnip, its perceived impact on health empowerment, as well as the roles of stakeholders for the future implementation of a health app platform through focus group interviews.
This study followed a phenomenological research design and included 7 focus group interviews with end users and 1 with stakeholders, held between July and December 2020. End users were recruited through various institutions in the Netherlands, for example, insurance companies and local governments. All focus groups were semistructured using interview guides and were held via videoconferencing due to the COVID-19 pandemic measures. Each participant received access to a health app platform where they were enabled to purchase reliable, preselected health apps with a budget of €100 (US $107.35). The budget was valid for the entire research period. The health app platform offered 38 apps. A third party, a health care coalition, selected the apps to be included in FitKnip. The analyses were conducted according to the principles of the Framework Method.
A priori formulated themes were concept, acceptability, health empowerment, and outcomes, and the roles of stakeholders for the future implementation of a health app platform. Both end users (n=31) and stakeholders (n=5) were enthusiastic about the concept of a health app platform. End users indicated missing apps regarding physical health and lifestyle and needing more guidance toward suitable apps. End users saw health empowerment as a precondition to using a health app platform and achieving health outcomes depending on the purchased mobile apps. End users and stakeholders identified potential providers and financing parties of FitKnip. Stakeholders recommended the establishment of a reputable national or international quality guidelines or certification for health and wellbeing apps, that can demonstrate the quality and reliability of mobile health applications.
This study showed the need for a personalized and flexible platform. Next to this, a deeper understanding of the roles of stakeholders in such initiatives is needed especially on financing and reimbursement of health promotion and digital health services. A personalized, flexible health app platform is a promising initiative to support individuals in their health.
电子健康有改善健康结果的潜力。然而，这一潜力在很大程度上尚未得到挖掘。个人面临着应用程序过载的问题，难以自行选择合适的应用程序。在FitKnip实验中，参与者可以访问一个健康应用程序平台，他们可以用100欧元（107.35美元）的个人预算购买经过预先筛选的可靠健康应用程序。通过开展一项前瞻性研究，我们旨在科学评估FitKnip实验作为改善人群健康的创新方式。
该实验的目的是科学评估FitKnip实验作为改善人群健康的创新方式。更具体地说，我们通过焦点小组访谈对FitKnip的概念和可接受性、其对健康赋权的感知影响以及利益相关者在未来实施健康应用程序平台中的作用进行了深入的定性评估。
本研究采用现象学研究设计，在2020年7月至12月期间进行了7次与最终用户的焦点小组访谈和1次与利益相关者的访谈。最终用户通过荷兰的各种机构招募，例如保险公司和地方政府。由于COVID-19大流行措施，所有焦点小组均使用访谈指南进行半结构化，并通过视频会议进行。每位参与者都可以访问一个健康应用程序平台，在那里他们可以用100欧元（107.35美元）的预算购买可靠的、预先筛选的健康应用程序。该预算在整个研究期间有效。健康应用程序平台提供了38个应用程序。第三方，一个医疗保健联盟，选择了要纳入FitKnip的应用程序。分析是根据框架方法的原则进行的。
预先制定的主题是概念、可接受性、健康赋权和结果，以及利益相关者在未来实施健康应用程序平台中的作用。最终用户（n=31）和利益相关者（n=5）都对健康应用程序平台的概念充满热情。最终用户表示缺少关于身体健康和生活方式的应用程序，并且需要更多关于选择合适应用程序的指导。最终用户将健康赋权视为使用健康应用程序平台并根据购买的移动应用程序实现健康结果的前提条件。最终用户和利益相关者确定了FitKnip的潜在提供商和融资方。利益相关者建议为健康和福祉应用程序建立一个知名的国家或国际质量指南或认证，以证明移动健康应用程序的质量和可靠性。
本研究表明需要一个个性化且灵活的平台。除此之外，尤其需要更深入地了解利益相关者在此类举措中的作用，特别是在健康促进和数字健康服务的融资和报销方面。一个个性化、灵活的健康应用程序平台是支持个人健康的一项有前途的举措。
