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Mobile Health Technology for Pediatric Symptom Monitoring: A Feasibility Study
Jacqueline Vaughn1, Siddharth Gollarahalli, Ryan J Shaw
1Jacqueline Vaughn, BSN, RN, CHSE, is PhD Candidate, Duke University School of Nursing, Durham, North Carolina. Ryan J. Shaw, PhD, RN, is Associate Professor, Duke University School of Nursing, Durham, North Carolina. Sharron Docherty, PhD PNP-BC, FAAN, is Associate Professor, Duke University School of Nursing, Durham, North Carolina. Qing Yang, PhD, is Assistant Professor, Duke University School of Nursing, Durham, North Carolina. Sid Gollarahalli, BA, is Clinical Research Specialist, Duke Health, Durham, North Carolina. Chandni Malhotra, BS, is Undergraduate Research Assistant, Department of Statistics, North Carolina State University, Raleigh. Erika Summers-Goeckerman, MSN, RN, CPNP-AC, is Pediatric Blood and Marrow Transplant Nurse Practitioner, Hematology-Oncology, Duke Health, Durham, North Carolina. Nirmish Shah, MD, is Assistant Professor of Medicine, Hematology-Oncology, Duke Health, Durham, North Carolina.
Insights
Mobile health (mHealth) technology is feasible for monitoring pediatric blood and marrow transplant (PBMT) patients
Area of Science:
- Oncology
- Pediatric Hematology
- mHealth
Background:
- Pediatric blood and marrow transplant (PBMT) patients face significant symptom distress.
- Mobile health (mHealth) technologies offer potential for real-time symptom data collection.
- Limited research exists on mHealth for PBMT symptom monitoring.
Purpose of the Study:
- To explore the feasibility of using mHealth for symptom monitoring in PBMT patients.
- To evaluate study design, measures, and procedures for mHealth integration.
- To assess usability and acceptability of mHealth technologies.
Main Methods:
- Exploratory longitudinal pilot study with 10 PBMT patients.
- Utilized a smartphone mHealth app for symptom data and a wearable device for physiological data.
- Assessed feasibility via usability, acceptability, interviews, and surveys.
Main Results:
- Wearable device usability was 51%, and app usability was 56%.
- Children found the devices easy to use and acceptable.
- Study showed 83% enrollment and 30% attrition, with 70% participation for ≥40 days.
Conclusions:
- This pilot study demonstrates the feasibility of using mHealth for longitudinal symptom data collection in PBMT patients.
- mHealth can enhance understanding of symptom experiences and data patterns post-transplant.
- Further research can refine mHealth strategies for improved symptom management.
Background:
Pediatric blood and marrow transplant (PBMT) patients experience significant symptom distress. Mobile health (mHealth) technologies can be leveraged to improve understanding of the patient's symptom experience by providing continuous, real-time, in situ, patient-generated symptom data. This rich data stream can subsequently enhance symptom management strategies. However, limited research has been conducted in this area.
Objectives:
This pilot study seeks to (a) explore the feasibility of integrating mHealth technologies to monitor symptom data for PBMT patients and (b) evaluate the study design, measures, and procedures.
Methods:
An exploratory longitudinal design was employed to assess the feasibility of monitoring 10 PBMT patients' symptoms using data from two mHealth technologies: (a) a smartphone mHealth application (app) to collect symptom data and (b) a wearable tracking device (Apple watch) to collect physiological data. Feasibility was measured as usability and acceptability. Monthly patient interviews and an end-of-study feasibility survey were employed and analyzed to further understand reasons for sustained interest in and attrition from the study.
Results:
Overall usability of the wearable was 51%, and app was 56%. Children reported devices were easy to use and acceptable. The study demonstrated acceptability with an enrollment rate of 83% and an attrition rate of 30%, with 70% of the children remaining in the study for at least 40 days.
Discussion:
This pilot study is among the first to explore the feasibility of using mobile technologies to longitudinally obtain patient-generated symptom data to enhance understanding of the PBMT symptom experience. In addition, it will improve our understanding of how these data present, interact, and cluster together throughout the posttransplant period.
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