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. 2018 Dec 10;1(2):e11080.
doi: 10.2196/11080.

Clinical Adoption of mHealth Technology to Support Pediatric Cystic Fibrosis Care in Sweden: Qualitative Case Study

Meghan Longacre  1 , Stuart Grande  1 , Andreas Hager  2 , Meera Montan  2 , Rikard Palmer Bergquist  2 , Maria Martensson  3 , Greg Kotzbauer  1
Affiliations

Clinical Adoption of mHealth Technology to Support Pediatric Cystic Fibrosis Care in Sweden: Qualitative Case Study

Meghan Longacre et al. JMIR Pediatr Parent. .

Abstract

Background: Mobile health (mHealth) technologies have potential to improve self-management and care co-ordination of pediatric chronic diseases requiring complex care, such as cystic fibrosis (CF). Barriers to implementation include the lack of support and infrastructure to use mHealth in the clinical microsystem. Coproducing mHealth technology with patients, clinicians, and designers may increase the likelihood of successful integration into the clinical setting.

Objective: This study explored the development, adoption, and integration of a new, co-produced mHealth platform (Genia) for the management of pediatric CF in Sweden.

Methods: A retrospective, qualitative case study approach was used. The case was defined as the process of introducing and using Genia at the Pediatric Cystic Fibrosis Center at Skåne University Hospital in Lund, Sweden. Data sources included interviews, presentations, meeting notes, and other archival documents created between 2014 and 2017. To be included, data sources must have described or reflected upon the Genia adoption process. Iterative content analysis of data source materials was conducted by 2 qualitatively trained researchers to derive themes characterizing the mHealth clinical adoption process.

Results: In total, 4 core themes characterized successful clinical integration of Genia in Lund: cultural readiness to use mHealth; use of weekly huddles to foster momentum and rapid iteration; engagement in incremental "Genia Talk" to motivate patient adoption; and co-design approach toward pediatric chronic care.

Conclusions: Principles of quality improvement, relational co-ordination, user-centered design, and coproduction can facilitate the integration of mHealth technology into clinical care systems for pediatric CF care.

Keywords: cystic fibrosis; mHealth; mobile phone; pediatrics; qualitative case study; technology.

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Conflict of interest statement

Conflicts of Interest: AH, MM, and RPB are employees of Upstream Dream, a private company that developed the Genia app. ML, SG, and GK are affiliated with The Geisel School of Medicine at Dartmouth and have no financial conflicts of interest to report.

Figures

Figure 1
Figure 1
Genia flow.
Figure 2
Figure 2
Screenshots of sample Genia app pages developed Upstream Dream.
See this image and copyright information in PMC

References

    1. O'Sullivan BP, Freedman SD. Cystic fibrosis. Lancet. 2009 May 30;373(9678):1891–904. doi: 10.1016/S0140-6736(09)60327-5. - DOI - PubMed
    1. Bishay LC, Sawicki GS. Strategies to optimize treatment adherence in adolescent patients with cystic fibrosis. Adolesc Health Med Ther. 2016;7:117–124. doi: 10.2147/AHMT.S95637. doi: 10.2147/AHMT.S95637. - DOI - DOI - PMC - PubMed
    1. Goodfellow NA, Hawwa AF, Reid AJ, Horne R, Shields MD, McElnay JC. Adherence to treatment in children and adolescents with cystic fibrosis: a cross-sectional, multi-method study investigating the influence of beliefs about treatment and parental depressive symptoms. BMC Pulm Med. 2015 Apr 26;15:43. doi: 10.1186/s12890-015-0038-7. https://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-015-0038-7 - DOI - DOI - PMC - PubMed
    1. Sawicki GS, Heller KS, Demars N, Robinson WM. Motivating adherence among adolescents with cystic fibrosis: youth and parent perspectives. Pediatr Pulmonol. 2015 Feb;50(2):127–36. doi: 10.1002/ppul.23017. http://europepmc.org/abstract/MED/24616259 - DOI - PMC - PubMed
    1. Kaplan HC, Thakkar SN, Burns L, Chini B, Dykes DM, McPhail GL, Moore E, Saeed SA, Eslick I, Margolis PA, Opipari-Arrigan L. Protocol of a Pilot Study of Technology-Enabled Coproduction in Pediatric Chronic Illness Care. JMIR Res Protoc. 2017 Apr 28;6(4):e71. doi: 10.2196/resprot.7074. http://www.researchprotocols.org/2017/4/e71/ - DOI - PMC - PubMed

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