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Cited by 44Usability and User Interface DesignMobile Health and mHealth ApplicationsPressure Ulcer Prevention and Management

Co-designing a Self-Management App Prototype to Support People With Spinal Cord Injury in the Prevention of Pressure Injuries: Mixed Methods Study

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Amann, Julia, Fiordelli, Maddalena, Brach, Mirjam, Bertschy, Sue, Scheel-Sailer, Anke, Rubinelli, Sara·2020·JMIR mHealth and uHealth
DOI 10.2196/18018PMC PMC7380902

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Abstract

Background: Spinal cord injury is a complex chronic health condition that requires individuals to actively self-manage. Therefore, an evidence-based, self-management app would be of value to support individuals with spinal cord injury in the prevention of pressure injuries. Objective: The main objectives of this study were to (1) establish a co-design approach for developing a high-fidelity prototype app for the self-management of individuals with spinal cord injury, (2) design the prototype that resulted from this process, and (3) conduct the first usability assessment of the prototype app. Methods: We adopted a co-design approach to develop an evidence-based app prototype. Starting from a preliminary content model (based on clinical guidelines for the prevention of pressure injuries) and three research-based user personas, we conducted an ideation workshop involving individuals with spinal cord injury and health care professionals. The ideation workshop formed the basis for two consecutive design sprints. The result of this co-design phase was an interactive app prototype. The prototype was evaluated in two rounds of usability testing (N=4 and N=15, respectively) using a combination of qualitative and quantitative methods. Results: The co-design process resulted in a high-fidelity prototype with two key components: a self-management component and a communication component. The final prototype included a combination of features to support individuals with spinal cord injury in the prevention of pressure injuries, namely a smart camera, pressure injury diary, expert consultation, reminders, and knowledge repository. Findings of the usability testing showed that most participants navigated the app fluently with little back and forth navigation and were able to successfully complete a set of assigned tasks. These positive results are supported by the average system usability score achieved (78.5/100; range 47.5-95.0) and our qualitative analysis of the semistructured interviews. Despite an overall positive evaluation of the app prototype, we identified areas for improvement (eg, inclusion of a search function). Conclusions: Individuals with spinal cord injury often need to navigate competing interests and priorities, paired with uncertainty about the accuracy and relevance of clinical recommendations. Understanding what matters to individuals with spinal cord injury can help guide the design of behavioral interventions that are useful and acceptable to these individuals in their daily lives. This study shows that involving individuals with spinal cord injury and health care professionals in co-designing a self-management app can foster knowledge cocreation at the intersection of lived experience, medical expertise, and technical solutions.

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  • Three articles used Personas in other target populations: prevention of pressure injuries in people with spinal cord injury, family-delivered eternal tube care, and pediatric chronic illness care.

    “Three articles used Personas in other target populations, i.e., prevention of pressure injuries in people with spinal cord injury (Amann et al., 2020), family-delivered eternal tube care (Cheng et al., 2020), and pediatric chronic illness care (Kaplan et al., 2017).”

    From Using Personas in the development of eHealth interventions for chronic pain: A scoping review and narrative synthesis (2023) · cites this paper as Amann et al., 2020

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References 58 · Cited by 44

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Authors
Amann, J., Fiordelli, M., Brach, M., Bertschy, S., Scheel-Sailer, A., & Rubinelli, S.
Affiliations
  • ETH Zurich (CH)
  • Swiss Paraplegic Research (CH)
  • University of Lucerne (CH)
Corresponding author
Amann, Julia
ORCID
Venue
JMIR mHealth and uHealth
Publisher
JMIR Publications Inc.
Published
2020-07-09
Volume
8
Issue
7
Pages
e18018
ISSN
2291-5222 (ISSN-L)
DOI
10.2196/18018
PMC
PMC7380902
OpenAlex
W3041222525
Cited by
44
References
58
Citations by year
2026: 5 · 2025: 13 · 2024: 5 · 2023: 7 · 2022: 8 · 2021: 5 · 2020: 1
FWCI
3.82
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JMIR mhealth and uhealth (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Repository for Publications and Research Data (ETH Zurich) (submittedVersion, cc-by)
  • ETH Zürich Research Collection (cc-by)
Topics
  • Physical Sciences › Computer Science › Human-Computer Interaction › Usability and User Interface Design
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Health Professions › Occupational Therapy › Pressure Ulcer Prevention and Management
Keywords
spinal cord injury, pressure ulcer prevention, self-management, mobile health apps, co-design, usability testing, mobile application prototype, personas, design sprint, ideation workshops, behavioral interventions
MeSH terms
Self-Management, Chronic Disease, Pressure Ulcer, Female, Humans, Male, Spinal Cord Injuries, User-Computer Interface, Mobile Applications

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