Exploring the Specific Needs of Persons with Multiple Sclerosis for mHealth Solutions for Physical Activity: Mixed-Methods Study

Abstract

BackgroundMultiple sclerosis (MS) is one of the world’s most common neurologic disorders, with symptoms such as fatigue, cognitive problems, and issues with mobility. Evidence suggests that physical activity (PA) helps people with MS reduce fatigue and improve quality of life. The use of mobile technologies for health has grown in recent years with little involvement from relevant stakeholders. User-centered design (UCD) is a design philosophy with the goal of creating solutions specific to the needs and tasks of the intended users. UCD involves stakeholders early and often in the design process. In a preliminary study, we assessed the landscape of commercially available MS mobile health (mHealth) apps; to our knowledge, no study has explored what persons with MS and their formal care providers think of mHealth solutions for PA.ObjectiveThe aim of this study was to (1) explore MS-specific needs for MS mHealth solutions for PA, (2) detect perceived obstacles and facilitators for mHealth solutions from persons with MS and health care professionals, and (3) understand the motivational aspects behind adoption of mHealth solutions for MS.MethodsA mixed-methods design study was conducted in Kliniken Valens, Switzerland, a clinic specializing in neurological rehabilitation. We explored persons with MS and health care professionals who work with them separately. The study had a qualitative part comprising focus groups and interviews, and a quantitative part with standardized tools such as satisfaction with life scale and electronic health (eHealth) literacy.ResultsA total of 12 persons with relapsing-remitting MS and 12 health care professionals from different backgrounds participated in the study. Participants were well-educated with an even distribution between genders. Themes identified during analysis were MS-related barriers and facilitators, mHealth design considerations, and general motivational aspects. The insights generated were used to create MS personas for design purposes. Desired mHealth features were as follows: (1) activity tracking, (2) incentives for completing tasks and objectives, (3) customizable goal setting, (4) optional sociability, and (5) game-like attitude among others. Potential barriers to mHealth apps adoption were as follows: (1) rough on-boarding experiences, (2) lack of clear use benefits, and (3) disruption of the health care provider-patient relationship. Potential facilitators were identified: (1) endorsements from experts, (2) playfulness, and (3) tailored to specific persons with MS needs. A total of 4 MS personas were developed to provide designers and computer scientists means to help in the creation of future mHealth solutions for MS.ConclusionsmHealth solutions for increasing PA in persons with MS hold promise. Allowing for realistic goal setting and positive feedback, while minimizing usability burdens, seems to be critical for the adoption of such apps. Fatigue management is especially important in this population; more attention should be brought to this area.

Mobile Applications for Multiple Sclerosis: a Focus on Self-Management

“…Results of studies that explore needs of persons with MS can provide invaluable information for designers and developers of mobile health solutions for multiple sclerosis. For example, some of the evidence-based features that have been suggested for physical activity in MS are as follows: customizable goal settings, energy profiles, and fatigue management, patient education, data visualization, positive feedback system, activity tracking, an exercise library, and game-like attitude (38). Such information can provide an evidence- based content required for MS M-health solutions.…”

“…However, some other needs have not been addressed enough by the existing apps. People with MS need an application that helps them to manage the fatigue while the majority of existing apps focused only on recording the fatigue levels without providing an effective mechanism for its management by the patients (38). Fatigue management is one of the basic needs of people with MS.…”

Toward Digital Self-monitoring of Multiple Sclerosis

“…Some studies have inquired into the attitudes of people with MS toward using smartphone apps, including the importance of clear use benefits and of tailoring apps to the specific patient. 10,11 However, these studies were not focused on self-monitoring and did not deal with patients' actual experiences. Ayobi et al 12 conducted interviews with patients with MS who engaged in selfmonitoring, including using smartphones and activity trackers.…”

“…6 Furthermore, in a study on the attitudes of patients with MS and health care providers toward smartphone apps for monitoring physical activity, customization was mentioned as a facilitator for the adoption of such apps. 11 This finding suggests that to increase usefulness and user friendliness, digital self-monitoring tools for MS should be adaptable to the patient's person-Furthermore, some remarks are required regarding the study design. First, the interviews were conducted by telephone rather than face-to-face.…”

3MD for Chronic Conditions, a Model for Motivational mHealth Design: Embedded Case Study

“…To see how UCD could be applied to the design of behavioral change mHealth solutions, we conducted a mixed methods design study with qualitative and quantitative components to explore the views of chronic patients and the health care professionals who work with them [103]. …”