Background and Purpose: Mobile health (mHealth) apps hold potential to transform healthcare, but their adoption in clinical settings takes time and how providers and families use them is unknown. Three clinics at Riley Hospital for Children are preparing to implement BabyNoggin, an app that collects developmental screening tools typically collected via paper forms. The purpose of this study was two-fold: 1) to understand pre-implementation processes and provider perspectives of integrating BabyNoggin into clinic workflow; and 2) to examine parental attitudes towards the use of apps for child development.
Project Methods: Pre-implementation clinical observations of workflow were performed in participating clinics. Semi-structured interviews informed by the Consolidated Framework for Implementation Research (CFIR) were conducted with each clinical team to understand perceived implementation facilitators and barriers. Lastly, parents with children aged 0-5 were recruited from study clinics and social media to participate in a 26-item survey to gauge their attitudes towards using apps in place of paper screening forms and for tracking their child’s development.
Results: Implementation workflows were co-created with each clinical team that should not increase visit length. Five CFIR interviews highlighted facilitators and barriers towards implementation of BabyNoggin to be considered during implementation. Out of 199 parents who completed the survey, 72.9% (n=145) reported a higher likelihood of downloading a child health app that was recommended by their pediatrician.
Conclusion and Future Steps: This study constituted the pre-implementation phase of a larger project involving the implementation of BabyNoggin. Future research will use these findings as a guide during implementation.
Background: Clinical care guidelines for universal developmental screening are meant to identify at-risk children as early as possible so that early intervention can be initiated. However, despite years of initiatives, developmental screening rates remain less than ideal. Recent innovations in mHealth apps that integrate developmental screening may offer an alternate way to optimize screening rates if it can encourage co-use and seamless integration into clinical workflow.Objective: Prior to the planned deployment of a clinic-based mHealth developmental screening app, the research team sought to identify and characterize opportunities and challenges to implementation, focusing on clinic workflow and multi-stakeholder engagement with providers and parents.Methods: Three clinic settings were recruited to participate from one children's hospital in Indianapolis, Indiana. Preimplementation clinical observations of workflow and team dynamics were performed. Potential adoption barriers and facilitators were explored through interviews with health care teams guided by the Consolidated Framework for Implementation Research (CFIR). Parents with children aged 0-5 were recruited from study clinics and social media to complete a 26-item survey to gauge their attitudes towards using apps in place of paper screening forms and for tracking their child's development.Results: Proposed implementation workflows were co-created with each clinical team so to not increase overall visit length, which was the main concern for health care providers. Providers had enthusiasm for use of mHealth tools; however, concerns were expressed about potential technology failures, data security and HIPAA and the workflow impacts. Two hundred fifty parents responded to the social media survey. The top reason for downloading child health apps were for a convenient way to track development (62.6%). Two-thirds of respondents expressed interest in an app that included developmental screening forms. Most parents prefer to complete screening tools on the day of the clinic visit (47.7%) or electronically prior to the visit (44.8%). Seventy-four percent of parents expressed a higher likelihood of using an app if recommended by the pediatrician.
Conclusions:Parents and providers are interested and open to mHealth apps for child developmental screening. Provider buy-in and involvement in implementation planning is critical, both to integrating apps into clinic workflows and to encouraging parents to use the app.
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