Setting the Stage for an App-Based Caregiver-Mediated Intervention for Autism: Findings from A Stakeholder...

The use of mobile technology to support clinical practice (mHealth) has the potential to support access to caregiver-mediated interventions for autistic children, improving accessibility, scalability, and cost-effectiveness. However, rarely stakeholders' perspectives have been integrated in the development of mHealth tools. This study aims to investigate stakeholders' needs, attitudes, and expectations regarding a to-be-developed mHealth caregiver-mediated intervention based on the WHO Caregiver Skills Training program.

We conducted focus groups and interviews with 13 caregivers and 14 clinicians.

Thematic analysis identified four main themes: "Usage scenarios", "Purposes", "Threats to app success", and "Strategies for app success". Stakeholders emphasized the need for an app that could support caregivers at different stages and roles, regardless of previous exposure to in-person CST. Stakeholders expected an app that could integrate psychoeducation, support home practice, and promote psychological wellbeing. Perceived threats to the app's effectiveness pertained to the self-directed delivery, in absence of a therapist; while strategies proposed to counter such threats included incorporating engaging content, gamification and customization features, and overall ease of use of the app.

Findings are discussed in relation to the development of a prototype based on caregivers' needs and recommendations from expert clinicians. Future directions involve conducting formal usability testing of the initial prototype and evaluating the app's acceptability and effectiveness.