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一种用于慢性创伤性脑损伤记忆的生态瞬时评估与干预工具:记忆生态瞬时干预的开发与可用性

An Ecological Momentary Assessment and Intervention Tool for Memory in Chronic Traumatic Brain Injury: Development and Usability of Memory Ecological Momentary Intervention.

作者信息

Morrow Emily L, Nelson Lyndsay A, Duff Melissa C, Mayberry Lindsay S

机构信息

Department of Medicine, Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, 2525 West End Avenue, Nashville, TN, 37203, United States.

Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, United States.

出版信息

JMIR Rehabil Assist Technol. 2024 Nov 26;11:e59630. doi: 10.2196/59630.


DOI:10.2196/59630
PMID:39591513
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11612602/
Abstract

BACKGROUND: Memory and learning deficits are among the most impactful and longest-lasting symptoms experienced by people with chronic traumatic brain injury (TBI). Despite the persistence of post-TBI memory deficits and their implications for community reintegration, memory rehabilitation is restricted to short-term care within structured therapy sessions. Technology shows promise to extend memory rehabilitation into daily life and to increase the number and contextual diversity of learning opportunities. Ecological momentary assessment and intervention frameworks leverage mobile phone technology to assess and support individuals' behaviors across contexts and have shown benefits in other chronic conditions. However, few studies have used regular outreach via text messaging for adults with chronic TBI, and none have done so to assess and support memory. OBJECTIVE: This study aimed to develop and test the usability of memory ecological momentary intervention (MEMI), a text message-based assessment and intervention tool for memory in daily life. MEMI is designed to introduce new information, cue retrieval of the information, and assess learning across time and contexts. We tested MEMI via an iterative, user-centered design process to ready it for a future trial. METHODS: We developed MEMI by leveraging automated text messages for prompts using a REDCap (Research Electronic Data Capture)/Twilio interface linking to the Gorilla web-based behavioral experimental platform. We recruited 14 adults with chronic, moderate-severe TBI from the Vanderbilt Brain Injury Patient Registry to participate in 3 rounds of usability testing: one round of ThinkAloud sessions using the platform and providing real-time feedback to an experimenter (n=4) and 2 rounds of real-world usability testing in which participants used MEMI in their daily lives for a week and provided feedback (n=5/round). We analyzed engagement and quantitative and qualitative user feedback to assess MEMI's usability and acceptability. RESULTS: Participants were highly engaged with MEMI, completing an average of 11.8 out of 12 (98%) possible sessions. They rated MEMI as highly usable, with scores on the System Usability Scale across all rounds equivalent to an A+ on a standardized scale. In semistructured interviews, they stated that MEMI was simple and easy to use, that daily retrieval sessions were not burdensome, and that they perceived MEMI as helpful for memory. We identified a few small issues (eg, instruction wording) and made improvements between usability testing rounds. CONCLUSIONS: Testing MEMI with adults with chronic TBI revealed that this technology is highly usable and favorably rated for this population. We incorporated feedback regarding users' preferences and plan to test the efficacy of this tool in a future clinical trial.

摘要

背景:记忆和学习缺陷是慢性创伤性脑损伤(TBI)患者所经历的最具影响力且持续时间最长的症状之一。尽管TBI后的记忆缺陷持续存在及其对重返社区的影响,但记忆康复仅限于结构化治疗课程中的短期护理。技术有望将记忆康复扩展到日常生活中,并增加学习机会的数量和情境多样性。生态瞬时评估和干预框架利用移动电话技术来评估和支持个体在不同情境下的行为,并且已在其他慢性疾病中显示出益处。然而,很少有研究通过短信对患有慢性TBI的成年人进行定期随访,而且没有一项研究这样做来评估和支持记忆。 目的:本研究旨在开发并测试记忆生态瞬时干预(MEMI)的可用性,这是一种基于短信的日常生活记忆评估和干预工具。MEMI旨在引入新信息、提示信息检索,并评估跨时间和情境的学习情况。我们通过迭代的、以用户为中心的设计过程对MEMI进行测试,为未来的试验做好准备。 方法:我们利用REDCap(研究电子数据采集)/Twilio接口链接到基于网络的大猩猩行为实验平台,通过自动短信提示来开发MEMI。我们从范德比尔特脑损伤患者登记处招募了14名患有慢性中度至重度TBI的成年人,参与3轮可用性测试:一轮使用该平台的出声思考会议,并向实验者提供实时反馈(n = 4),以及两轮现实世界可用性测试,参与者在日常生活中使用MEMI一周并提供反馈(每轮n = 5)。我们分析了参与度以及定量和定性的用户反馈,以评估MEMI的可用性和可接受性。 结果:参与者对MEMI的参与度很高,平均完成了12个可能会话中的11.8个(98%)。他们将MEMI评为高度可用,所有轮次的系统可用性量表得分在标准化量表上相当于A+。在半结构化访谈中,他们表示MEMI简单易用,日常检索会话不繁重,并且他们认为MEMI有助于记忆。我们发现了一些小问题(例如,说明措辞),并在可用性测试轮次之间进行了改进。 结论:对患有慢性TBI的成年人进行MEMI测试表明,该技术具有高度可用性,并且在该人群中获得了好评。我们纳入了有关用户偏好的反馈,并计划在未来临床研究中测试该工具的疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b2e/11612602/ab796ed6b45d/rehab-v11-e59630-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b2e/11612602/37ee735f8273/rehab-v11-e59630-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b2e/11612602/eda9616b2a15/rehab-v11-e59630-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b2e/11612602/ab796ed6b45d/rehab-v11-e59630-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b2e/11612602/37ee735f8273/rehab-v11-e59630-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b2e/11612602/eda9616b2a15/rehab-v11-e59630-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b2e/11612602/ab796ed6b45d/rehab-v11-e59630-g003.jpg

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本文引用的文献

[1]
Traumatic brain injury as a chronic disease: insights from the United States Traumatic Brain Injury Model Systems Research Program.

Lancet Neurol. 2023-6

[2]
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Neuropsychologia. 2023-6-6

[3]
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J Neurotrauma. 2023-8

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Am J Speech Lang Pathol. 2023-3-23

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Front Behav Neurosci. 2022-4-25

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JMIR Form Res. 2022-4-29

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BMC Med Res Methodol. 2022-4-22

[9]
Ecological momentary assessment of affect in context after traumatic brain injury.

Rehabil Psychol. 2021-11

[10]
Ecological momentary assessment for health behaviors and contextual factors in persons with diabetes: A systematic review.

Diabetes Res Clin Pract. 2021-4

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