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Development and Pilot Testing a Self-Reported Pediatric PROMIS App for Young Children Aged 5-7 Years
Wenjun Gao1, Changrong Yuan1, Yuchen Zou1
1School of Nursing, Navy Medical University, Shanghai, China.
Insights
A new smartphone app using Patient-Reported Outcomes Measurement Information System (PROMIS) methods effectively monitors emotional distress in young children. The app showed good usability and moderate agreement with parent reports, highlighting the importance of child self-reporting.
Area of Science:
- Pediatric Health
- Digital Health Technology
- Child Psychology
Background:
- Emotional distress is a significant concern in young children.
- Accurate assessment of emotional distress in children aged 5-7 years is challenging.
- Existing methods may not fully capture children's self-perceptions.
Purpose of the Study:
- To develop a smartphone application using PROMIS methods for monitoring emotional distress in children aged 5-7 years.
- To evaluate the usability and acceptability of the application among young children and parents.
- To assess the agreement between children's self-reports and parent proxy-reports of emotional distress.
Main Methods:
- Development of a smartphone application incorporating PROMIS emotional distress measures.
- Inclusion of an animated, self-reporting version for children and a parent proxy-reporting version.
- Three phases of user studies: prototype development, cognitive interviewing, usability testing, and pilot testing.
Main Results:
- The application demonstrated good usability and was well-accepted by children aged 5-7 years.
- Animated items were easily understood by the target age group.
- Moderate and significant correlations were found between child self-reports and parent reports, with parents underestimating depression and overestimating anger/anxiety.
Conclusions:
- The developed smartphone application is a usable and acceptable tool for assessing emotional distress in young children.
- Child self-reports are crucial and cannot replace parent reports; incorporating children's perspectives is vital in clinical care.
- This animated application serves as a valuable tool to amplify young children's voices in healthcare settings.
Purpose:
The aims of this study are threefold. Firstly, Using the state of science PROMIS (Patient-Reported Outcomes Measurement Information System) methods to develop a smartphone application to monitor the emotional distress for young children aged 5-7 years old; Secondly, to test the usability of this application; and thirdly, to determine the level of agreement between reports by parents and young children's self-report.
Design And Methods:
A multidisciplinary research team, made up of senior pediatric nurses and doctors, software engineers' team, and pediatric health researchers worked together to develop this application. Three phases of stakeholders and user studies were conducted. Phase 1 focused on prototype development; Phase 2 involved cognitive interview and usability testing; Phases 3 focused on the pilot testing of this application.
Results:
We included the original parent proxy reporting version of Patient Reported Outcome Measurement Information System-emotional distress in the application, as well as self-reporting animated version for young children. After many rounds of modification, all participants felt that this application was easy to use and the animated items were easy to understand for young children aged 5-7 years. Correlations between parents-children reports are significant and moderate, parents underestimated child depression, and overestimated child anger and anxiety compared to child self-report.
Conclusions:
This smartphone application and its Web-based administration portal demonstrate good usability and are well accepted by young children aged 5-7 years, which can be used to promote young children's participation when reporting or assessing symptoms of young pediatric patients.
Practice Implications:
Parent reports cannot be substituted for child reports and evaluations of pediatric patients' perspectives regarding treatment outcomes should be included in pediatric clinic. This animated application can be used as a smart measurement to investigate the symptoms for young children aged 5-7 years, so as to amplify young children's voice in clinical care.
