BackgroundCare coordination can be highly challenging to carry out. When care is fragmented across health systems and providers, there is an increased likelihood of hospital readmissions and wasteful health care spending. During and after care transitions, smartphones have the potential to bolster information transfer and care coordination. However, little research has examined patients’ perceptions of using smartphones to coordinate care.ObjectiveThis study’s primary objective was to explore patient acceptability of a smartphone app that could facilitate care coordination in a safety net setting. Our secondary objective was to identify how clinicians and other members of primary care teams could use this app to coordinate care.MethodsThis qualitative study was conducted at a federally qualified health center in metropolitan Chicago, IL. We conducted four focus groups (two in English, two in Spanish) with high-risk adults who owned a smartphone and received services from an organizational care management program. We also conducted structured interviews with clinicians and a group interview with care managers. Focus groups elicited patients’ perceptions of a smartphone app designed to: (1) identify emergency department (ED) visits and inpatient stays using real-time location data; (2) send automated notifications (ie, alerts) to users’ phones, asking whether they were a patient in the hospital; and (3) send automated messages to primary care teams to notify them about patients’ confirmed ED visits and inpatient stays. Focus group transcripts were coded based on emergent themes. Clinicians and care managers were asked about messages they would like to receive from the app.ResultsFive main themes emerged in patient focus group discussions. First, participants expressed a high degree of willingness to use the proposed app during inpatient stays. Second, participants expressed varying degrees of willingness to use the app during ED visits, particularly for low acuity ED visits. Third, participants stated their willingness to have their location tracked by the proposed app due to its perceived benefits. Fourth, the most frequently mentioned barriers to acceptability were inconveniences such as “false alarm” notifications and smartphone battery drainage. Finally, there was some tension between how to maximize usability without unnecessarily increasing user burden. Both clinicians and care managers expressed interest in receiving messages from the app at the time of hospital arrival and at discharge. Clinicians were particularly interested in conducting outreach during ED visits and inpatient stays, while care managers expressed more interest in coordinating postdischarge care.ConclusionsHigh-risk primary care patients in a safety net setting reported a willingness to utilize smartphone location tracking technology to facilitate care coordination. Further research is needed on the development and implementation of new smartphone-based approaches to care coordination.

Background Atopic dermatitis is a pruritic chronic condition associated with significant sleep disturbance, inattention, and sometimes behavioral problems. Enhancing resiliency in children with atopic dermatitis may promote coping strategies to improve quality of life. Positive psychology is one strategy that can be used to strengthen resiliency. Objective Our objective was to identify positive psychology concepts mentioned by children with atopic dermatitis and their parent to inform strategies to strengthen resiliency in children with atopic dermatitis. Methods A total of 20 patient-parent dyads were interviewed to share their experience with atopic dermatitis to help develop a novel psychologic intervention for atopic dermatitis. Patients were 8 to 17 years old and diagnosed with atopic dermatitis. Trained coders analyzed transcripts using a coding dictionary developed based on Seligman’s PERMA (positive emotion, engagement, relationships, meaning, and accomplishment) model of positive psychology. The frequency of unprompted mentions of PERMA themes and relevant quotations was captured. Transcripts were also separately coded for resiliency, which is the ultimate goal of PERMA. Results Positive psychology concepts were mentioned by 100% (20/20) of children and 95% (19/20) of parents. Engagement and relationships, both negative and positive aspects, were the most common unprompted PERMA themes mentioned by children (14/20, 70%) and parents (13/20, 65%). Emotion elicited the most negative comments from children (19/20, 95%) and parents (17/20, 85%). When analyzed for resiliency, 8 participants were identified with at least one resiliency code. On average, participants with a resiliency code mentioned PERMA concepts 9.1 (SD 4.7) times compared to those who mentioned none (mean 5.9, SD 4.6) (P=.14). When participants were stratified by disease severity, on average, more positive psychology concepts were mentioned by patients with mild atopic dermatitis (mean 13, SD 3.0) than those with moderate symptoms (mean 6.2, SD 4.9) or severe symptoms (mean 6.1, SD 4.0) (P=.03). Conclusions Among PERMA themes, engagement and relationships are the two most commonly mentioned categories for children with atopic dermatitis. Strategies targeting PERMA such as affirmations and positive reframing may improve psychosocial well-being and resiliency in pediatric atopic dermatitis. Future directions will look at incorporating “positive medicine” into atopic dermatitis treatment to not only relieve symptoms but also strengthen positive aspects of life.

BACKGROUND Atopic dermatitis (AD) is a pruritic chronic condition associated with significant sleep disturbance, inattention, and sometimes behavioral problems. Enhancing resiliency in children with AD may promote coping strategies to improve quality of life. One strategy for strengthening resiliency is via positive psychology. OBJECTIVE Our objective was to identify positive psychology concepts mentioned by children with AD and their parent to inform strategies to strengthen resiliency in children with AD. METHODS Twenty patient-parent dyads were interviewed to provide feedback on a novel brief Cognitive Behavioral Therapy (CBT) intervention for itch rumination. Patients were 8-17 years-old and diagnosed with AD. Trained coders analyzed transcripts using a coding dictionary developed based on Seligman’s PERMA (Positive emotion, Engagement, Relationships, Meaning, Achievement) model of positive psychology. The frequency of unprompted mentions of PERMA themes and relevant quotations were captured. Transcripts were also separately coded for resiliency, the ultimate goal of PERMA. RESULTS Positive psychology concepts were mentioned by 100% of children and 95% of parents. Engagement and relationships, both negative and positive aspects, were the most common unprompted PERMA themes mentioned by children (70%) and parents (65%). Emotion elicited the most negative comments from children (95%) and parents (85%). When analyzed for resiliency, 8 participants were identified with at least one resiliency code. On average, participants with a resiliency code versus none mentioned PERMA concepts 9.1±4.7 times versus 5.9±4.6 (p = 0.14). When participants were stratified by disease severity, positive psychology concepts were mentioned more by mild patients vs moderate patients vs severe patients, 13±3.0 vs 6.2±4.9 vs 6.13±4.0, respectively (p = 0.034). CONCLUSIONS Among PERMA themes, engagement and relationships are the two most commonly mentioned categories for children with AD. Strategies targeting PERMA such as affirmations and positive reframing may improve psychosocial wellbeing and resiliency in pediatric AD. Future directions will look at incorporating “positive medicine” in AD treatment to not only relieve symptoms but also strengthen positive aspects of life.

Background: Care coordination can be highly challenging to carry out. When care is