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评估世界卫生组织的 SkinNTDs 应用程序作为加纳和肯尼亚皮肤忽视性热带病培训工具的效果:横断面研究。

Evaluating the World Health Organization's SkinNTDs App as a Training Tool for Skin Neglected Tropical Diseases in Ghana and Kenya: Cross-Sectional Study.

机构信息

eHealth Lab Research Group, eHealth Center, School of Health Sciences, Universitat de Catalunya, Barcelona, Spain.

Innovation, Digital Transformation and Health Economics Research Group, Research Institut Germans Trias i Pujol, Badalona, Spain.

出版信息

J Med Internet Res. 2024 Apr 30;26:e51628. doi: 10.2196/51628.

Abstract

BACKGROUND

Neglected tropical diseases (NTDs) affect over 1.5 billion people worldwide, primarily impoverished populations in low- and middle-income countries. Skin NTDs, a significant subgroup, manifest primarily as skin lesions and require extensive diagnosis and treatment resources, including trained personnel and financial backing. The World Health Organization has introduced the SkinNTDs app, a mobile health tool designed to train and be used as a decision support tool for frontline health care workers. As most digital health guidelines prioritize the thorough evaluation of mobile health interventions, it is essential to conduct a rigorous and validated assessment of this app.

OBJECTIVE

This study aims to assess the usability and user experience of World Health Organization SkinNTDs app (version 3) as a capacity-building tool and decision-support tool for frontline health care workers.

METHODS

A cross-sectional study was conducted in Ghana and Kenya. Frontline health care workers dealing with skin NTDs were recruited through snowball sampling. They used the SkinNTDs app for at least 5 days before completing a web-based survey containing demographic variables and the user version of the Mobile Application Rating Scale (uMARS), a validated scale for assessing health apps. A smaller group of participants took part in semistructured interviews and one focus group. Quantitative data were analyzed using SPSS with a 95% CI and P≤.05 for statistical significance and qualitative data using ATLAS.ti to identify attributes, cluster themes, and code various dimensions that were explored.

RESULTS

Overall, 60 participants participated in the quantitative phase and 17 in the qualitative phase. The SkinNTDs app scored highly on the uMARS questionnaire, with an app quality mean score of 4.02 (SD 0.47) of 5, a subjective quality score of 3.82 (SD 0.61) of 5, and a perceived impact of 4.47 (SD 0.56) of 5. There was no significant association between the app quality mean score and any of the categorical variables examined, according to Pearson correlation analysis; app quality mean score vs age (P=.37), sex (P=.70), type of health worker (P=.35), country (P=.94), work context (P=.17), frequency of dealing with skin NTDs (P=.09), and dermatology experience (P=.63). Qualitative results echoed the quantitative outcomes, highlighting the ease of use, the offline functionality, and the potential utility for frontline health care workers in remote and resource-constrained settings. Areas for improvement were identified, such as enhancing the signs and symptoms section.

CONCLUSIONS

The SkinNTDs app demonstrates notable usability and user-friendliness. The results indicate that the app could play a crucial role in improving capacity building of frontline health care workers dealing with skin NTDs. It could be improved in the future by including new features such as epidemiological context and direct contact with experts. The possibility of using the app as a diagnostic tool should be considered.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/39393.

摘要

背景

被忽视的热带病(NTDs)影响着全球超过 15 亿人,主要是中低收入国家的贫困人群。皮肤 NTDs 是一个重要的亚组,主要表现为皮肤损伤,需要大量的诊断和治疗资源,包括训练有素的人员和财政支持。世界卫生组织(WHO)推出了 SkinNTDs 应用程序,这是一款移动健康工具,旨在培训和作为一线卫生保健工作者的决策支持工具。由于大多数数字健康指南都优先对移动健康干预措施进行全面评估,因此对该应用程序进行严格和验证的评估至关重要。

目的

本研究旨在评估世界卫生组织 SkinNTDs 应用程序(第 3 版)作为一线卫生保健工作者能力建设和决策支持工具的可用性和用户体验。

方法

在加纳和肯尼亚进行了一项横断面研究。通过滚雪球抽样招募处理皮肤 NTD 的一线卫生保健工作者。他们在使用 SkinNTDs 应用程序至少 5 天后,完成了一项基于网络的调查,其中包含人口统计学变量和用户版本的移动应用程序评级量表(uMARS),这是一种用于评估健康应用程序的经过验证的量表。一小部分参与者参加了半结构化访谈和一个焦点小组。使用 SPSS 对定量数据进行分析,置信区间为 95%,P≤.05 为统计学意义,使用 ATLAS.ti 对定性数据进行分析,以确定属性、聚类主题,并对各种维度进行编码,这些维度都进行了探索。

结果

共有 60 名参与者参加了定量阶段,17 名参与者参加了定性阶段。SkinNTDs 应用程序在 uMARS 问卷中得分很高,应用程序质量平均得分为 4.02(SD 0.47),主观质量得分为 3.82(SD 0.61),感知影响得分为 4.47(SD 0.56)。根据 Pearson 相关分析,应用程序质量平均得分与任何检查的分类变量之间均无显著关联;应用程序质量平均得分与年龄(P=.37)、性别(P=.70)、卫生工作者类型(P=.35)、国家(P=.94)、工作环境(P=.17)、处理皮肤 NTDs 的频率(P=.09)和皮肤科经验(P=.63)。定性结果与定量结果相呼应,强调了易用性、离线功能以及在远程和资源受限环境中对一线卫生保健工作者的潜在效用。确定了需要改进的领域,例如增强体征和症状部分。

结论

SkinNTDs 应用程序具有显著的可用性和用户友好性。结果表明,该应用程序可以在提高处理皮肤 NTDs 的一线卫生保健工作者的能力建设方面发挥关键作用。未来可以通过增加新功能,如流行病学背景和与专家的直接联系来改进该应用程序。还应考虑将该应用程序用作诊断工具的可能性。

国际注册报告标识符(IRRID):RR2-10.2196/39393。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/47ce/11094592/1f41f1dfbf4f/jmir_v26i1e51628_fig1.jpg

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