Co-Design to Support the Development of Inclusive eHealth Tools for Caregivers of Functionally Dependent Older Persons: Social Justice Design

Latulippe, Karine; Hamel, Christine; Giroux, Dominique

doi:10.2196/18399

Cited by 21 publications

(29 citation statements)

References 33 publications

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“…To best meet the needs of older veterans, and older adults more generally, future research should utilize qualitative methods and co-design processes to ensure that interventions are solving mental health challenges in usable, meaningful, and engaging ways. Co-design can help address barriers that are specific to older adults (eg, [ 69 ]); ensure that the product is findable, accessible, usable, desirable, credible, useful, and valuable (eg, [ 70 ]); improve the overall quality of the product [ 71 ]; and promote equity and inclusion (eg, [ 72 , 73 ]). More research focused on effective dissemination and implementation strategies is also needed.…”

Section: Discussionmentioning

confidence: 99%

Predicting Uptake of the COVID Coach App Among US Military Veterans: Funnel Analysis Using a Probability-Based Panel

Jaworski¹,

Taylor²,

Ramsey³

et al. 2022

JMIR Ment Health

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Background Although the COVID-19 pandemic has not led to a uniform increase of mental health concerns among older adults, there is evidence to suggest that some older veterans did experience an exacerbation of preexisting mental health conditions, and that mental health difficulties were associated with a lack of social support and increasing numbers of pandemic-related stressors. Mobile mental health apps are scalable, may be a helpful resource for managing stress during the pandemic and beyond, and could potentially provide services that are not accessible due to the pandemic. However, overall comfort with mobile devices and factors influencing the uptake and usage of mobile apps during the pandemic among older veterans are not well known. COVID Coach is a free, evidence-informed mobile app designed for pandemic-related stress. Public usage data have been evaluated; however, the uptake and usage of the app among older veterans have not been explored. Objective The purpose of this study was to characterize smartphone ownership rates among US veterans, identify veteran characteristics associated with downloading and use of COVID Coach, and characterize key content usage within the app. Methods Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study (NHRVS), which surveyed a nationally representative, prospective cohort of 3078 US military veterans before and 1 year into the pandemic. The NHRVS sample was drawn from KnowledgePanel, a research panel of more than 50,000 households maintained by Ipsos, Inc. The median time to complete the survey was nearly 32 minutes. The research version of COVID Coach was offered to all veterans who completed the peripandemic follow-up assessment on a mobile device (n=814; weighted 34.2% of total sample). App usage data from all respondents who downloaded the app (n=34; weighted 3.3% of the mobile completers sample) were collected between November 14, 2020, and November 7, 2021. Results We found that most US veterans (81.5%) own smartphones, and that veterans with higher education, greater number of adverse childhood experiences, higher extraversion, and greater severity of pandemic-related posttraumatic stress disorder symptoms were more likely to download COVID Coach. Although uptake and usage of COVID Coach were relatively low (3.3% of eligible participants, n=34), 50% of the participants returned to the app for more than 1 day of use. The interactive tools for managing stress were used most frequently. Conclusions The COVID-19 pandemic has increased the need for and creation of digital mental health tools. However, these resources may require tailoring for older veteran populations. Future research is needed to better understand how to optimize digital mental health tools such as apps to ensure uptake and usage among older adults, particularly those who have experienced traumas across the lifespan.

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Section: Discussionmentioning

confidence: 99%

Predicting Uptake of the COVID Coach App Among US Military Veterans: Funnel Analysis Using a Probability-Based Panel

Jaworski¹,

Taylor²,

Ramsey³

et al. 2022

JMIR Ment Health

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“…Caregivers include professional as well as family and non-professional ones (Couture et al. , 2018; Latulippe et al. , 2020).…”

Section: Resultsmentioning

confidence: 99%

User innovation rings the bell for new horizons in e-health: a bibliometric analysis

Ghasemzadeh

Escobar

Yordanova

et al. 2022

EJIM

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PurposeThe study examines the amplifying role of users in the e-healthcare sector and holistically show its current state and potential. The paper aims at contributing to the scientific literature with a comprehensive review of the current state of the art on the application of user innovation (UI) in the e-healthcare sector, as a solid step for discussing the potential, trends, managerial gaps and future research avenues in this field. Despite the crucial importance of the topic and increasing attention toward it in the last few years, there is a lack of comprehensive scrutiny on different angles of involving users in health technology innovations so far.Design/methodology/approachThis study combines two methods of bibliometric analysis and extensive content analysis of 169 journal articles on Scopus and Web of Science to unfold five research questions regarding the mechanisms of involving users, innovations characteristics and the role of users throughout the innovation process.FindingsA clear result of the applied methodology is the profiling of users involved in e-health innovations in seven categories. The results of this study shed light on the current practice of not involving users in all the stages of the innovation process of m-health, telemedicine, self-managing technologies, which is contrary to the best practices of the UI application.Research limitations/implicationsCollection of relevant studies due to lack of comprehensibility of the keywords.Practical implicationsThe offered propositions can act as a roadmap to potential research opportunities as well as to organize such innovations from a managerial perspective in particular healthcare organization managers and the middle managers operating at R&D sectors and policymakers.Originality/valueThis study is the first of its kind that digs out the application of UI strategies such as user-centered design in the context of e-healthcare and provides a bibliometric and extensive content analysis of the studies conducted in this theme over the years.

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“…The participatory, co-design approach to this project ensured that the perspectives of key stakeholders such as primary caregivers of persons with dementia and the Alzheimer’s Society were incorporated into content and program development, which we consider a strength of our project. The value of co-designed programs has been amply demonstrated in the literature, notably in the field of technological support for chronic diseases and/or ailments, given the purposes of our research [ 48 , 49 ]. Despite some challenges that can stem from co-designed programs (eg, time issues can interfere with a fully democratic process [ 49 ]), they remain the gold standard for program development in the field of integrated care [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

“…The value of co-designed programs has been amply demonstrated in the literature, notably in the field of technological support for chronic diseases and/or ailments, given the purposes of our research [ 48 , 49 ]. Despite some challenges that can stem from co-designed programs (eg, time issues can interfere with a fully democratic process [ 49 ]), they remain the gold standard for program development in the field of integrated care [ 50 ]. The advantages of co-designed support apps such as ours include knowledge cocreation across technical solutions, lived experience, and medical expertise [ 48 ] and the reduction of social health inequalities [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

“…The advantages of co-designed support apps such as ours include knowledge cocreation across technical solutions, lived experience, and medical expertise [ 48 ] and the reduction of social health inequalities [ 50 ]. For caregivers of functionally dependent adults like many of the primary caregivers of persons with dementia in our research, co-designed support apps have shown value by enabling caregivers to identify their needs and tailoring the support program accordingly [ 49 ]. Moreover, inclusivity and feasibility are enhanced through co-designed programs because users and/or stakeholders can provide insight into important considerations, including appropriate digital literacy levels and respect for the help-seeking process of users [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

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An App-Based Mindfulness-Based Self-compassion Program to Support Caregivers of People With Dementia: Participatory Feasibility Study

Goodridge¹,

Reis²,

Neiser³

et al. 2021

JMIR Aging

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Background The number of persons with dementia is steadily growing, as is the number of individuals supporting persons with dementia. Primary caregivers of persons with dementia are most often family members or spouses of the persons with dementia, and they are more likely to experience increased stress and other negative effects than individuals who are not primary caregivers. Although in-person support groups have been shown to help buffer the negative impacts of caregiving, some caregivers live in isolated or rural communities and are unable to make the burdensome commitment of traveling to cities. Using an interdisciplinary approach, we developed a mobile smartphone support app designed for primary caregivers of persons with dementia, with the goal of reducing caregiver burden and easing stress. The app features a 12-week intervention, largely rooted in mindfulness-based self-compassion (MBSC), because MBSC has been linked to minimizing stress, depression, and anxiety. Objective The primary objectives of our program are twofold: to explore the feasibility of a 12-week mobile support program and to conduct an initial efficacy evaluation of changes in perceived caregiver burden, coping styles, and emotional well-being of caregivers before and after the program. Methods Our feasibility study used a 2-phase participatory pretest and posttest design, focusing on acceptability, demand, practicality, implementation, and efficacy. At phase I, we recruited 57 primary caregivers of persons with dementia (mean age 76.3, SD 12.9 years), comprising spouses (21/57, 37%), children (21/57, 37%), and friends or relatives (15/57, 26%) of persons with dementia, of whom 29 (51%) completed all measures at both pre- and postprogram. The content of the program featured a series of MBSC podcasts. Our primary outcome measure was caregiver burden, with secondary outcome measures including coping styles and emotional well-being. Daily ecological momentary assessments enabled us to ask participants, “How are you feeling today?” Phase II of our study involved semistructured follow-up interviews with most participants (n=21) who completed phase I. Results Our findings suggest that our app or program meets the feasibility criteria examined. Notably, participants generally accepted the program and believed it could be a useful resource. Emotional well-being increased significantly (P=.04), and emotion-based coping significantly decreased (P=.01). Participants generally considered the app or program to be a helpful resource. Conclusions Although there were no significant changes in caregiver burden, we were encouraged by the increased emotional well-being of our participants following the completion of our program. We also conclude that our app or program demonstrated feasibility (ie, acceptability, practicality, implementation, and efficacy) and can provide a much-needed resource for primary caregivers of persons with dementia. In the subsequent version of the program, we will respond to participant feedback by incorporating web-based weekly sessions and incorporating an outcome measure of self-compassion.

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Co-Design to Support the Development of Inclusive eHealth Tools for Caregivers of Functionally Dependent Older Persons: Social Justice Design

Cited by 21 publications

References 33 publications

Predicting Uptake of the COVID Coach App Among US Military Veterans: Funnel Analysis Using a Probability-Based Panel

Predicting Uptake of the COVID Coach App Among US Military Veterans: Funnel Analysis Using a Probability-Based Panel

User innovation rings the bell for new horizons in e-health: a bibliometric analysis

An App-Based Mindfulness-Based Self-compassion Program to Support Caregivers of People With Dementia: Participatory Feasibility Study

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