Now showing 1 - 6 of 6
  • Publication
    Human-centred recommendations to maximise the potential for digital health in the management of chronic obstructive pulmonary disease
    (University College Dublin. School of Public Health, Physiotherapy and Sports Science, 2020)
    Chronic obstructive pulmonary disease (COPD) negatively impacts the quality of life and mortality of patients and is very costly for healthcare systems to manage. Digital health (DH) has been proposed as a novel solution to support self-management, reduce exacerbations and decrease hospitalisations. However, despite the promises, evidence demonstrating significant outcomes for patients, or for the management of the disease, are limited and unconvincing. To smooth adoption and mitigate sustained engagement challenges, human-centred design (HCD) approaches are recommended when designing digital health interventions (DHI) as they emphasise the importance of situating user experiences, needs and preferences as the driver of the intervention design. However, recent research has identified there is an absence of a core principle in HCD, user-involvement, in the development of DHIs in COPD with user-experience issues commonly cited as reasons for poor levels of adoption for both HCPs and patients. To address these shortcomings and to contribute new insights to an area lacking in empirical research, this thesis explored the perceptions of HCPs and patients regarding the potential for DH in the management of COPD. The thesis employed a qualitative study design, namely semi-structured interviewing. The sample consisted of n=30 patients and n=32 HCPs. Thematic analysis was conducted on the data using NVivo 12 software. The research also involved conducting a systematic review that explored the use of HCD principles in the design of DHIs in COPD randomised controlled trials (RCT). The findings identified there is an absence of user-involvement in the design of COPD DHIs, and that the needs of patients and HCPs are rarely the foundation or driver of the design process. The findings also offer previously unexplored insights regarding the potential for DH to address the needs of COPD patients and HCPs. The findings show there are several opportunities for DH to enhance patient self-management practices such as symptom management, improving patient self-efficacy and engagement, and increasing the delivery of preventative and personalised care which to date, have not been researched elsewhere. Furthermore, the findings provide new insights regarding the barriers and facilitators patients and HCPs perceive facing the adoption and implementation of DHIs. The findings highlight substantial individual, structural and social barriers to overcome before DH can be realised as a routinely prescribed intervention in COPD. Patient and HCP digital literacy for example represents a significant individual level barrier, as does the patient’s perception of their illness. Structural barriers however, such as an absence of an evidence-base, or clinical guidelines, for the use of DHIs in COPD represent salient obstacles to overcome. Several facilitators to support the implementation and adoption of DHIs were identified. The facilitators focus largely on education and training, but the participants also placed significant weight on the importance of being aware of patient’s needs as a means to ease the adoption of DHIs. Such facilitators have not been published in the COPD context until now. This thesis offers a comprehensive list of human-centred recommendations for future DHI design in COPD. They propose a number of potential new research trajectories and provide new insights regarding the adoption needs of this cohort which can inform the development of implementation strategies for future DHIs in COPD. Importantly, these recommendations are generated from an empirical exploration of the needs and experiences of the patients and HCPs which has not been conducted thoroughly to date.
  • Publication
    Clinician perceptions of a prototype wearable exercise biofeedback system for orthopaedic rehabilitation: a qualitative exploration
    Objectives: This study explores the opinions of orthopaedic healthcare professionals regarding the opportunities and challenges of using wearable technology in rehabilitation. It continues to assess the perceived impact of an exemplar exercise biofeedback system that incorporates wearable sensing, involving the clinician in the user-centred design process, a valuable step in ensuring ease of implementation, sustained engagement and clinical relevance. Design: This is a qualitative study consisting of one-to-one semi-structured interviews, including a demonstration of a prototype wearable exercise biofeedback system. Interviews were audio-recorded and transcribed, with thematic analysis conducted of all transcripts. Setting: The study was conducted in the orthopaedic department of an acute private hospital. Participants Ten clinicians from a multidisciplinary team of healthcare professionals involved in the orthopaedic rehabilitation pathway participated in the study. Results: Participants reported that there is currently a challenge in gathering timely and objective data for the monitoring of patients in orthopaedic rehabilitation. While there are challenges in ensuring reliability and engagement of biofeedback systems, clinicians perceive significant value in the use of wearable biofeedback systems such as the exemplar demonstrated for use following total knee replacement. Conclusions: Clinicians see an opportunity for wearable technology to continuously track data in real-time, and feel that feedback provided to users regarding exercise technique and adherence can further support the patient at home, although there are clear design and implementation challenges relating to ensuring technical accuracy and tailoring rehabilitation to the individual. There was perceived value in the prototype system demonstrated to participants which supports the ongoing development of such exercise biofeedback platforms.
      328Scopus© Citations 15
  • Publication
    A Wearable Sensor-Based Exercise Biofeedback System: Mixed Methods Evaluation of Formulift
    Background: Formulift is a newly developed mobile health (mHealth) app that connects to a single inertial measurement unit (IMU) worn on the left thigh. The IMU captures users movements as they exercise, and the app analyzes the data to count repetitions in real time and classify users exercise technique. The app also offers feedback and guidance to users on exercising safely and effectively. Objective: The aim of this study was to assess the Formulift system with three different and realistic types of potential users (beginner gym-goers, experienced gym-goers, and qualified strength and conditioning [S&C] coaches) under a number of categories: (1) usability, (2) functionality, (3) the perceived impact of the system, and (4) the subjective quality of the system. It was also desired to discover suggestions for future improvements to the system. Methods: A total of 15 healthy volunteers participated (12 males; 3 females; age: 23.8 years [SD 1.80]; height: 1.79 m [SD0.07], body mass: 78.4 kg [SD 9.6]). Five participants were beginner gym-goers, 5 were experienced gym-goers, and 5 were qualified and practicing S&C coaches. IMU data were first collected from each participant to create individualized exercise classifiers for them. They then completed a number of non exercise-related tasks with the app. Following this, a workout was completed using the system, involving squats, dead lifts, lunges, and single-leg squats. Participants were then interviewed about their user experience and completed the System Usability Scale (SUS) and the user version of the Mobile Application Rating Scale (uMARS). Thematic analysis was completed on all interview transcripts, and survey results were analyzed. Results: Qualitative and quantitative analysis found the system has good to excellent usability. The system achieved a mean (SD) SUS usability score of 79.2 (8.8). Functionality was also deemed to be good, with many users reporting positively on the systems repetition counting, technique classification, and feedback. A number of bugs were found, and other suggested changes to the system were also made. The overall subjective quality of the app was good, with a median star rating of 4 out of 5 (interquartile range, IQR: 3-5). Participants also reported that the system would aid their technique, provide motivation, reassure them, and help them avoid injury. Conclusions: This study demonstrated an overall positive evaluation of Formulift in the categories of usability, functionality, perceived impact, and subjective quality. Users also suggested a number of changes for future iterations of the system. These findings are the first of their kind and show great promise for wearable sensor-based exercise biofeedback systems.
      303Scopus© Citations 14
  • Publication
    A qualitative study of chronic obstructive pulmonary disease patient perceptions of the barriers and facilitators to adopting digital health technology
    Objective Non-adherence to self-management plans in chronic obstructive pulmonary disease (COPD) results in poorer outcomes for patients. Digital health technology (DHT) promises to support self-management by enhancing the sense of control patients possess over their disease. COPD digital health studies have yet to show significant evidence of improved outcomes for patients, with many user-adoption issues still present in the literature. To help better address the adoption needs of COPD patients, this paper explores their perceived barriers and facilitators to the adoption of DHT. Methods A sample of convenience was chosen and patients (n = 30) were recruited from two Dublin university hospitals. Each patient completed a qualitative semi-structured interview. Thematic analysis of the data was performed using NVivo 12 software. Results Barrier sub-themes included lack of perceived usefulness, digital literacy, illness perception, and social context; facilitator sub-themes included existing digital self-efficacy, personalised education, and community-based support. Conclusion The findings represent a set of key considerations for researchers and clinicians to inform the design of patient-centred study protocols that aim to account for the needs and preferences of patients in the development of implementation and adoption strategies for DHT in COPD.
      301Scopus© Citations 21
  • Publication
    Exploring the Use of Mobile Athlete Self-report Measures in Elite Gaelic Games: A Qualitative Approach
    Athlete self-report measures (ASRMs) are used in research and practice as an accurate, practical, and accessible method of athlete monitoring. Mobile adaptations of constructs from validated ASRM have increasingly been used for athlete monitoring in various sports settings; however, insights on the user experience and perceived value of these systems in the applied team sport setting have been limited. This study aimed to portray the experiences of stakeholders using a pre-existing mobile ASRM (M-ASRM) in elite Gaelic games. Twenty-one stakeholders in elite Gaelic games were recruited for this study (players n = 10, coaches and support staff n = 11). Subjects completed a semistructured interview with the lead researcher regarding their experience of using an M-ASRM in practice. Thematic analysis of the transcripts was conducted using NVivo 12 software. Results were defined under the themes of positive and negative user experience. Positive user experience was portrayed through M-ASRM uses and perceived value: communication and information disclosure, remote player monitoring, decision making and advanced planning, and player education and self-management. Negative user experience was portrayed through M-ASRM challenges: player adherence, player dishonesty, coach time and expertise requirements, and sociotechnical and system factors. Results outline the major uses of M-ASRM in elite Gaelic games and, importantly, highlight the key challenges experienced by stakeholders. These results can be applied by coaches, sports medicine professionals, and sports scientists using or intending to use an M-ASRM, providing key considerations to employ for effective use in team sport.
      340Scopus© Citations 3
  • Publication
    Not All Sensors are Created Equal: A Framework for Evaluating Human Performance Measurement technologies
    Recent years have witnessed an explosion in the number of wearable sensing devices and associated apps that target a wide range of biomedical metrics, from actigraphy to glucose monitoring to lung function. This offers big opportunities for achieving scale in the use of such devices in application contexts such as telehealth, human performance and behaviour research and digitally enabled clinical trials. However, this increased availability and choice of sensors also brings with it a great challenge in optimising the match between the sensor and a specific application context. There is a need for a structured approach to first refining the requirements for a specific application, and then evaluating the available devices against those requirements. In this paper we will outline the main features of such an evaluation framework that has been developed with input from stakeholders in academic, clinical and industry settings.
      257Scopus© Citations 15