Development of an mHealth platform for HIV care

Gathering user perspectives through co-Design workshops and interviews

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background:

Despite advances in testing and treatment, HIV incidence rates within European countries are at best stable or else increasing. mHealth technology has been advocated to increase quality and cost-effectiveness of health services while dealing with growing patient numbers. However, studies suggested that mHealth applications are rarely adopted and often considered of low quality by users. Only a few studies (conducted in the US) have involved people living with HIV (PLWH) in the design of mHealth.

Objective:

The goal of this study was to facilitate a co-design process among PLWH and clinicians across five clinical sites in the European Union to inform the development of an mHealth platform to be integrated into clinical care pathways. We aimed to (1) elicit experiences of living with HIV and of working in HIV care, (2) identify mHealth functionalities that are considered useful for HIV care, and (3) identify potential benefits as well as concerns about mHealth.

Methods:

Between January and June 2016, 14 co-design workshops and 22 semi-structured interviews were conducted, involving 97 PLWH and 63 clinicians. Data were analysed thematically and iteratively, drawing on grounded theory techniques.

Results:

Findings were established into three thematic clusters: (1) ‘Approaching the mHealth platform’, (2) ‘Imagining the mHealth Platform’, and (3) ‘Anticipating the mHealth Platform’s Implications’. Co-design participants approached the mHealth platform with pre-existing concerns arising from their experiences of receiving or providing care. PLWH particularly addressed issues of stigma and questioned how mHealth could enable them to manage their HIV. Clinicians problematized the compatibility of mHealth with existing IT systems and questioned which patients should be targeted by mHealth. Imagining the potential of mHealth for HIV care, co-design participants suggested ‘medical functionalities’ (accessing test results, managing medicines and appointments, and digital communication channels), ‘social functionalities’ (peer-support network, international travel, etc.), and ‘general features’ (security and privacy, credibility, language, etc.). Co-design participants also anticipated potential implications of mHealth for self-management and the provision of care.

Conclusions:

Our approach to co-design enabled us to facilitate early engagement in the mHealth platform enabling patient and clinician feedback to become embedded in the development process at a pre-prototype phase. Although the technologies in question were not yet present, understanding how users approach, imagine and anticipate technology formed an important source of knowledge and proved highly significant within the technology design and development process.
Original languageEnglish
Number of pages15
JournalJMIR MHealth and UHealth
Volume6
Issue number10
DOIs
Publication statusPublished - 15 Sep 2018

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interview
functionality
grounded theory
credibility
privacy
health service
experience
incidence
travel
medicine
communication
present
costs
language
management

Bibliographical note

© Benjamin Marent, Flis Henwood, Mary Darking, EmERGE Consortium. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 19.10.2018. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included.

Keywords

  • mHealth
  • HIV
  • smartphone apps
  • telemedicine
  • digital health
  • health platform
  • selfmanagement
  • patient participation
  • co-design
  • community-based participatory research
  • healthcare

Cite this

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abstract = "Background: Despite advances in testing and treatment, HIV incidence rates within European countries are at best stable or else increasing. mHealth technology has been advocated to increase quality and cost-effectiveness of health services while dealing with growing patient numbers. However, studies suggested that mHealth applications are rarely adopted and often considered of low quality by users. Only a few studies (conducted in the US) have involved people living with HIV (PLWH) in the design of mHealth.Objective: The goal of this study was to facilitate a co-design process among PLWH and clinicians across five clinical sites in the European Union to inform the development of an mHealth platform to be integrated into clinical care pathways. We aimed to (1) elicit experiences of living with HIV and of working in HIV care, (2) identify mHealth functionalities that are considered useful for HIV care, and (3) identify potential benefits as well as concerns about mHealth.Methods: Between January and June 2016, 14 co-design workshops and 22 semi-structured interviews were conducted, involving 97 PLWH and 63 clinicians. Data were analysed thematically and iteratively, drawing on grounded theory techniques.Results: Findings were established into three thematic clusters: (1) ‘Approaching the mHealth platform’, (2) ‘Imagining the mHealth Platform’, and (3) ‘Anticipating the mHealth Platform’s Implications’. Co-design participants approached the mHealth platform with pre-existing concerns arising from their experiences of receiving or providing care. PLWH particularly addressed issues of stigma and questioned how mHealth could enable them to manage their HIV. Clinicians problematized the compatibility of mHealth with existing IT systems and questioned which patients should be targeted by mHealth. Imagining the potential of mHealth for HIV care, co-design participants suggested ‘medical functionalities’ (accessing test results, managing medicines and appointments, and digital communication channels), ‘social functionalities’ (peer-support network, international travel, etc.), and ‘general features’ (security and privacy, credibility, language, etc.). Co-design participants also anticipated potential implications of mHealth for self-management and the provision of care.Conclusions: Our approach to co-design enabled us to facilitate early engagement in the mHealth platform enabling patient and clinician feedback to become embedded in the development process at a pre-prototype phase. Although the technologies in question were not yet present, understanding how users approach, imagine and anticipate technology formed an important source of knowledge and proved highly significant within the technology design and development process.",
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author = "Benjamin Marent and Felicity Henwood and Mary Darking",
note = "{\circledC} Benjamin Marent, Flis Henwood, Mary Darking, EmERGE Consortium. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 19.10.2018. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included.",
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journal = "JMIR MHealth and UHealth",
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TY - JOUR

T1 - Development of an mHealth platform for HIV care

T2 - Gathering user perspectives through co-Design workshops and interviews

AU - Marent, Benjamin

AU - Henwood, Felicity

AU - Darking, Mary

N1 - © Benjamin Marent, Flis Henwood, Mary Darking, EmERGE Consortium. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 19.10.2018. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included.

PY - 2018/9/15

Y1 - 2018/9/15

N2 - Background: Despite advances in testing and treatment, HIV incidence rates within European countries are at best stable or else increasing. mHealth technology has been advocated to increase quality and cost-effectiveness of health services while dealing with growing patient numbers. However, studies suggested that mHealth applications are rarely adopted and often considered of low quality by users. Only a few studies (conducted in the US) have involved people living with HIV (PLWH) in the design of mHealth.Objective: The goal of this study was to facilitate a co-design process among PLWH and clinicians across five clinical sites in the European Union to inform the development of an mHealth platform to be integrated into clinical care pathways. We aimed to (1) elicit experiences of living with HIV and of working in HIV care, (2) identify mHealth functionalities that are considered useful for HIV care, and (3) identify potential benefits as well as concerns about mHealth.Methods: Between January and June 2016, 14 co-design workshops and 22 semi-structured interviews were conducted, involving 97 PLWH and 63 clinicians. Data were analysed thematically and iteratively, drawing on grounded theory techniques.Results: Findings were established into three thematic clusters: (1) ‘Approaching the mHealth platform’, (2) ‘Imagining the mHealth Platform’, and (3) ‘Anticipating the mHealth Platform’s Implications’. Co-design participants approached the mHealth platform with pre-existing concerns arising from their experiences of receiving or providing care. PLWH particularly addressed issues of stigma and questioned how mHealth could enable them to manage their HIV. Clinicians problematized the compatibility of mHealth with existing IT systems and questioned which patients should be targeted by mHealth. Imagining the potential of mHealth for HIV care, co-design participants suggested ‘medical functionalities’ (accessing test results, managing medicines and appointments, and digital communication channels), ‘social functionalities’ (peer-support network, international travel, etc.), and ‘general features’ (security and privacy, credibility, language, etc.). Co-design participants also anticipated potential implications of mHealth for self-management and the provision of care.Conclusions: Our approach to co-design enabled us to facilitate early engagement in the mHealth platform enabling patient and clinician feedback to become embedded in the development process at a pre-prototype phase. Although the technologies in question were not yet present, understanding how users approach, imagine and anticipate technology formed an important source of knowledge and proved highly significant within the technology design and development process.

AB - Background: Despite advances in testing and treatment, HIV incidence rates within European countries are at best stable or else increasing. mHealth technology has been advocated to increase quality and cost-effectiveness of health services while dealing with growing patient numbers. However, studies suggested that mHealth applications are rarely adopted and often considered of low quality by users. Only a few studies (conducted in the US) have involved people living with HIV (PLWH) in the design of mHealth.Objective: The goal of this study was to facilitate a co-design process among PLWH and clinicians across five clinical sites in the European Union to inform the development of an mHealth platform to be integrated into clinical care pathways. We aimed to (1) elicit experiences of living with HIV and of working in HIV care, (2) identify mHealth functionalities that are considered useful for HIV care, and (3) identify potential benefits as well as concerns about mHealth.Methods: Between January and June 2016, 14 co-design workshops and 22 semi-structured interviews were conducted, involving 97 PLWH and 63 clinicians. Data were analysed thematically and iteratively, drawing on grounded theory techniques.Results: Findings were established into three thematic clusters: (1) ‘Approaching the mHealth platform’, (2) ‘Imagining the mHealth Platform’, and (3) ‘Anticipating the mHealth Platform’s Implications’. Co-design participants approached the mHealth platform with pre-existing concerns arising from their experiences of receiving or providing care. PLWH particularly addressed issues of stigma and questioned how mHealth could enable them to manage their HIV. Clinicians problematized the compatibility of mHealth with existing IT systems and questioned which patients should be targeted by mHealth. Imagining the potential of mHealth for HIV care, co-design participants suggested ‘medical functionalities’ (accessing test results, managing medicines and appointments, and digital communication channels), ‘social functionalities’ (peer-support network, international travel, etc.), and ‘general features’ (security and privacy, credibility, language, etc.). Co-design participants also anticipated potential implications of mHealth for self-management and the provision of care.Conclusions: Our approach to co-design enabled us to facilitate early engagement in the mHealth platform enabling patient and clinician feedback to become embedded in the development process at a pre-prototype phase. Although the technologies in question were not yet present, understanding how users approach, imagine and anticipate technology formed an important source of knowledge and proved highly significant within the technology design and development process.

KW - mHealth

KW - HIV

KW - smartphone apps

KW - telemedicine

KW - digital health

KW - health platform

KW - selfmanagement

KW - patient participation

KW - co-design

KW - community-based participatory research

KW - healthcare

U2 - 10.2196/mhealth.9856

DO - 10.2196/mhealth.9856

M3 - Article

VL - 6

JO - JMIR MHealth and UHealth

JF - JMIR MHealth and UHealth

SN - 2291-5222

IS - 10

ER -