Understanding End-User Perspectives of Mobile Pulmonary Rehabilitation (mPR): Cross-Sectional Survey and Interviews

Abstract

Background Pulmonary rehabilitation (PR) is an effective intervention for the management of people with chronic respiratory diseases, but the uptake of and adherence to PR programs is low. There is potential for mobile health (mHealth) to provide an alternative modality for the delivery of PR, overcoming many of the barriers contributing to poor attendance to current services. Objective The objective of this study was to understand the needs, preferences, and priorities of end users for the development of an adaptive mobile PR (mPR) support program. Methods A mixed methods (qualitative and quantitative) approach was used to assess the needs, preferences, and priorities of the end users (ie, patients with chronic respiratory disorders) and key stakeholders (ie, clinicians working with patients with chronic respiratory disorders and running PR). The formative studies included the following: (1) a survey to understand the preferences and priorities of patients for PR and how mobile technology could be used to provide PR support, (2) ethnographic semistructured interviews with patients with chronic respiratory disorders to gain perspectives on their understanding of their health and potential features that could be included in an mPR program, and (3) key informant interviews with health care providers to understand the needs, preferences, and priorities for the development of an mPR support program. Results Across all formative studies (patient survey, n=30; patient interviews, n=8; and key stakeholder interviews, n=8), the participants were positive about the idea of an mPR program but raised concerns related to digital literacy and confidence in using technology, access to technology, and loss of social support currently gained from traditional programs. Key stakeholders highlighted the need for patient safety to be maintained and ensuring appropriate programs for different groups within the population. Finding a balance between ensuring safety and maximizing access was seen to be essential in the success of an mPR program. Conclusions These formative studies found high interest in mHealth-based PR intervention and detailed the potential for an mPR program to overcome current barriers to accessing traditional PR programs. Key considerations and features were identified, including the importance of technology access and digital literacy being considered in utilizing technology with this population.

Development and Preliminary Evaluation of the Effects of an mHealth Web-Based Platform (HappyAir) on Adherence to a Maintenance Program After Pulmonary Rehabilitation in Patients With Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial

“…In any case, when developing mHealth tools, it is important to consider factors such as age, information technology experience, education level, and possible comorbidities. Engagement with patients in the design and testing is essential to make sure the intervention is easy for older people [ 38 - 40 ].…”

Mobile Pulmonary Rehabilitation: Feasibility of Delivery by a Mobile Phone-Based Program

“…The development of this program followed the mHealth Development and Evaluation framework (Whittaker et al, 2012), which provides a process to guide the development and testing of mHealth interventions with a focus on implementation, behavioral change theory, and involvement of the target population. The development of the content was informed by a review of current PR program content, literature, existing mHealth interventions, patient resources, and our formative research with the target audience (Dobson et al, 2019a). The program was informed by behavior change theories and incorporates behavior change techniques (BCTs) (Michie et al, 2013) including information about health consequences, social support, (practical) instructions on how to perform the behavior, and graded tasks.…”

“…This project aims to develop a mobile phone-based PR support program using the steps outlined in the mHealth Development and Evaluation Framework (Whittaker et al, 2012). Formative work undertaken for this project found high interest in mPR from both patients and healthcare professionals (Dobson et al, 2019a). Both patients and healthcare professionals identified potential for an mPR program to overcome current barriers to traditional PR programs but had concerns regarding technology and the lack of a group environment within a digital program.…”

Visual Design and Anthropomorphism in a Mobile Pulmonary Rehabilitation Support Intervention

“…A mixed-methods (survey and interview) study undertaken for this project found high interest in mPR from both patients and healthcare professionals [7]. While participants saw the potential to improve access to PR through technology, there was concern about access to technology and digital literacy, as well as patient safety and the lack of group environment (as compared to gold standard PR).…”