1
|
Tacey A, Behne J, Patten RK, Ngo MT, Thomas R, Ancilleri J, Bone C, Paredes Castro A, McCarthy H, Harkin K, Gilmartin-Thomas JF, Takla A, Downie C, Mulcahy J, Ball M, Sharples J, Dash S, Lawton A, Wright B, Sleeth P, Kostecki T, Sonn C, McKenna MJ, Apostolopoulos V, Lane R, Said CM, De Gori M, McAinch A, Tran P, Levinger I, Parker A, Woessner MN, Pascoe M. Development of a Digital Health Intervention to Support Patients on a Waitlist for Orthopedic Specialist Care: Co-Design Study. JMIR Form Res 2023; 7:e41974. [PMID: 38064257 PMCID: PMC10746964 DOI: 10.2196/41974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/02/2022] [Accepted: 10/20/2023] [Indexed: 12/25/2023] Open
Abstract
BACKGROUND The demand for orthopedic specialist consultations for patients with osteoarthritis in public hospitals is high and continues to grow. Lengthy waiting times are increasingly affecting patients from low socioeconomic and culturally and linguistically diverse backgrounds who are more likely to rely on public health care. OBJECTIVE This study aimed to co-design a digital health intervention for patients with OA who are waiting for an orthopedic specialist consultation at a public health service, which is located in local government areas (LGAs) of identified social and economic disadvantage. METHODS The stakeholders involved in the co-design process included the research team; end users (patients); clinicians; academic experts; senior hospital staff; and a research, design, and development agency. The iterative co-design process comprised several key phases, including the collation and refinement of evidence-based information by the research team, with assistance from academic experts. Structured interviews with 16 clinicians (female: n=10, 63%; male: n=6, 38%) and 11 end users (age: mean 64.3, SD 7.2 y; female: n=7, 64%; male: n=4, 36%) of 1-hour duration were completed to understand the requirements for the intervention. Weekly workshops were held with key stakeholders throughout development. A different cohort of 15 end users (age: mean 61.5, SD 9.7 y; female: n=12, 80%; male: n=3, 20%) examined the feasibility of the study during a 2-week testing period. The System Usability Scale was used as the primary measure of intervention feasibility. RESULTS Overall, 7 content modules were developed and refined over several iterations. Key themes highlighted in the clinician and end user interviews were the diverse characteristics of patients, the hierarchical structure with which patients view health practitioners, the importance of delivering information in multiple formats (written, audio, and visual), and access to patient-centered information as early as possible in the health care journey. All content was translated into Vietnamese, the most widely spoken language following English in the local government areas included in this study. Patients with hip and knee osteoarthritis from culturally and linguistically diverse backgrounds tested the feasibility of the intervention. A mean System Usability Scale score of 82.7 (SD 16) was recorded for the intervention, placing its usability in the excellent category. CONCLUSIONS Through the co-design process, we developed an evidence-based, holistic, and patient-centered digital health intervention. The intervention was specifically designed to be used by patients from diverse backgrounds, including those with low health, digital, and written literacy levels. The effectiveness of the intervention in improving the physical and mental health of patients will be determined by a high-quality randomized controlled trial.
Collapse
Affiliation(s)
- Alexander Tacey
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
- Department of Orthopaedic Surgey, Western Health, Melbourne, Australia
| | - Jack Behne
- Department of Physiotherapy, Western Health, Melbourne, Australia
| | - Rhiannon K Patten
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
| | - Minh Truc Ngo
- Department of Orthopaedic Surgey, Western Health, Melbourne, Australia
| | - Rees Thomas
- College of Health and Biomedicine, Victoria University, Melbourne, Australia
| | - Jessica Ancilleri
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
| | - Chelsea Bone
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
| | | | - Helen McCarthy
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
- College of Health and Biomedicine, Victoria University, Melbourne, Australia
| | - Katherine Harkin
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
- First Year College, Victoria University, Melbourne, Australia
| | - Julia Fm Gilmartin-Thomas
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Melbourne, Australia
- Department of Medicine, Western Health, The University of Melbourne, Melbourne, Australia
| | - Amir Takla
- Australian Sports Physiotherapy, Melbourne, Australia
- Department of Health Professions, Swinburne University of Technology, Melbourne, Australia
- School of Physiotherapy, Melbourne School of Health science, The University of Melbourne, Melbourne, Australia
| | - Calum Downie
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Melbourne, Australia
| | - Jane Mulcahy
- College of Health and Biomedicine, Victoria University, Melbourne, Australia
| | - Michelle Ball
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
| | - Jenny Sharples
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
| | - Sarah Dash
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
| | - Amy Lawton
- College of Health and Biomedicine, Victoria University, Melbourne, Australia
| | - Breanna Wright
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
- College of Health and Biomedicine, Victoria University, Melbourne, Australia
| | - Peter Sleeth
- College of Health and Biomedicine, Victoria University, Melbourne, Australia
| | - Tina Kostecki
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
- School of Social Sciences, University of Tasmania, Launceston, Australia
| | - Christopher Sonn
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
| | - Michael J McKenna
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
| | - Vasso Apostolopoulos
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Melbourne, Australia
| | - Rebecca Lane
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
| | - Catherine M Said
- Department of Physiotherapy, Western Health, Melbourne, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Melbourne, Australia
- School of Physiotherapy, Melbourne School of Health science, The University of Melbourne, Melbourne, Australia
| | - Mary De Gori
- Department of Physiotherapy, Western Health, Melbourne, Australia
| | - Andrew McAinch
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Melbourne, Australia
| | - Phong Tran
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
- Department of Orthopaedic Surgey, Western Health, Melbourne, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Melbourne, Australia
| | - Itamar Levinger
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Melbourne, Australia
| | - Alexandra Parker
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
| | - Mary N Woessner
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
| | - Michaela Pascoe
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
| |
Collapse
|