Development of a comprehensive mobile assessment of pressure (CMAP) system for pressure injury prevention for veterans with spinal cord injury

Abstract

Objective: This paper reports the iterative redesign, feasibility and usability of the Comprehensive Mobile Assessment of Pressure (CMAP) system's mobile app used by Veterans with SCI. Design: This three-year, multi-staged study used a mixed-methods approach.

Mobile Health Self-management Support for Spinal Cord Injury: Systematic Literature Review

“…The 24 included publications comprised 20 (83%) studies [ 36 , 37 , 40 , 42 - 57 , 59 ], 3 (12%) reports [ 38 , 39 , 58 ], and 1 (4%) protocol paper [ 41 ] (Table S1 Multimedia Appendix 3 ). The included publications primarily aimed to describe and develop mHealth tools (10/24, 42%) [ 38 , 39 , 43 , 45 , 46 , 48 , 54 , 56 - 58 ], evaluate implementation factors (9/24, 38%) [ 37 , 40 , 45 , 46 , 49 , 50 , 54 , 55 , 57 ], evaluate usability and user experience (7/24, 29%) [ 45 - 48 , 52 - 54 ] and effectiveness (6/24, 25%) [ 36 , 41 , 42 , 44 , 51 , 54 ], and describe stakeholder perspectives (1/24, 4%). The included publications were published between 2015 and 2022, and most (18/24, 75%) were published from 2018 onward [ 41 - 57 , 59 ].…”

“…Of the 20 included studies, 7 (35%) were quasi-experimental [ 37 , 42 , 43 , 50 , 51 , 53 , 57 ], 5 (25%) were mixed methods [ 46 - 48 , 54 ], 4 (20%) were qualitative [ 49 , 52 , 56 , 59 ], 2 (10%) were observational [ 45 , 55 ], and 2 (10%) were experimental [ 36 , 44 ]. The risk of bias was deemed low in just over half (11/20, 55%) of the included studies [ 44 , 45 , 47 , 49 , 51 , 52 , 55 - 57 , 59 ] ( Multimedia Appendix 4 [ 36 - 59 ]).…”

“…In total, 4 tools were unnamed (4/24, 17%) [ 38 , 40 , 43 , 48 , 49 ]. The included publications documented mHealth tools mainly at their testing stage (10/19, 53%) [ 36 , 40 , 43 - 45 , 47 , 50 - 52 , 54 , 55 , 58 ], followed by the developmental (6/19, 32%) [ 38 , 39 , 41 , 46 , 48 , 56 , 59 ], proof-of-concept (3/19, 16%) [ 37 , 42 , 49 ], proposal (1/19, 5%) [ 57 ], and launch (1/19, 5%) [ 53 ] stages.…”

eHealth interventions for the prevention of pressure injuries: a scoping review protocol

“…There are a range of interventions available; however, these have varying degrees of effectiveness and there is a lack of cohesiveness in their implementation 16 . eHealth interventions are increasingly being utilised in PI prevention through modalities such as mobile phone applications that enable timely access to education, remote consultation with health professionals, and social and emotional support from other peers [17][18][19][20][21] . In community settings, where there is less opportunity for healthcare professionals to view the skin, and where clients may be reluctant to share signs and symptoms of PI online due to modesty issues, supporting client and carers to express care needs early is essential [22][23][24][25] .…”

“…Conversely, abandonment of eHealth interventions is described in the literature; the need for user-centred design has been identified as a way to support the implementation of eHealth interventions and reduce the likelihood of its abandonment 38,39 . Thus, it is also necessary to broaden and focus our understanding of the barriers to implementation and best approaches to incorporate eHealth into PI prevention by learning from those at the forefront of research in this field [17][18][19][20][21]40 . Some well-documented challenges in the use of eHealth interventions include non-adoption and subsequent abandonment by clients and clinicians, as well as potential failures to become part of mainstream practice and sustain such interventions within and across services 37 .…”