Feasibility, Usability, and Acceptability of an Adaptive Mobile Health Medication Adherence Intervention for Youth: Iterative Mixed Methods Human-Centered Design Study (Preprint)
Notice bibliographique
Résumé
Background: Adolescents and young adults with chronic health conditions often struggle to adhere to their daily oral medications. Transdiagnostic mobile health (mHealth) interventions have the potential to promote medication adherence by reaching youth at a large scale. Objective: This study aimed at designing an adaptive medication adherence mHealth intervention (Adaptive Cell Phone Support), guided by iterative feasibility, usability, and acceptability feedback. A secondary objective was to explore changes in self-reported medication adherence during a field trial. Methods: Using human-centered design methods, researchers collaborated with a community advisory board of young adult patients to conduct 3 cycles of iterative design and usability testing. Adolescents and young adults aged 15-20 years (N=22) were recruited from a large pediatric hospital to user-test the intervention. Data collection included self-report questionnaires, think-aloud usability testing, semistructured interviews, and a 3-week field trial. Quantitative measures included the mHealth App Usability Questionnaire Ease of Use and Usefulness subscales, the Theoretical Framework of Acceptability Questionnaire, and visual analogue scales assessing medication adherence, as well as enrollment and engagement metrics. Qualitative data were analyzed using rapid assessment methods to identify actionable design insights, while quantitative data were analyzed using descriptive statistics and paired-samples t tests with a Holm-Bonferroni correction. Results: Enrollment was 63% and participants completed a mean of 67.2% (SD 23.5) of automated check-ins. Usability and acceptability ratings were relatively high across prototypes (eg, mHealth App Usability Questionnaire Ease of Use was mean 6.40, SD 0.64 for the initial prototype and mean 6.31, SD 0.61 for the third prototype, on a 7-point scale; Theoretical Framework of Acceptability was mean 4.33, SD 0.52 for the initial prototype and mean 4.50, SD 0.53 for the third prototype, on a 5-point scale). Qualitative data emphasized that the intervention was simple, easy to use, convenient, appropriate, and helpful for staying accountable for medication adherence, while also highlighting areas for improvement. Uncontrolled, 2-tailed, pre-post t tests estimated medium-sized improvements in self-reported medication adherence. However, only the percentage of time taking medications over the past month significantly increased (t21=3.26, d=0.70, 95% CI 0.22-1.16; P=.004). Conclusions: Integrated qualitative and quantitative results still suggest that more refinement is needed to optimize the intervention. Partnering with community members early in the development of an intervention may improve the ultimate feasibility, usability, and acceptability of digital health tools. Human-centered design offers a rapid, practical, and creative framework for identifying what works and what needs to be improved early in the lifecycle of a new intervention.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,030 | 0,035 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».