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Experience sampling methodology in pediatrics: a qualitative analysis of user perspectives on the PROfeel blended
Anna M Braspenning1,2, Maartje D Stutvoet3, Sanne L Nijhof3
1Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands.
Insights
This study explored user perspectives on a blended mobile health intervention for pediatric fatigue management. Findings suggest user engagement is key for integrating this approach into pediatric care.
Area of Science:
- Pediatric Health
- Digital Health Interventions
- Qualitative Research Methods
Background:
- Children with chronic conditions often experience persistent fatigue, influenced by biological and psychosocial factors.
- Mobile Health (mHealth) utilizing Experience Sampling Methodology (ESM) offers personalized insights into symptom management.
- Blended care models, combining digital and in-person support, can improve adherence and understanding of mHealth insights.
Purpose of the Study:
- To explore user and healthcare professional perspectives on a blended mHealth intervention (PROfeel) for pediatric fatigue management.
- To assess the feasibility and potential for integrating ESM-supported blended mHealth into pediatric care settings.
Main Methods:
- An exploratory qualitative study using semi-structured interviews with patients (N=11), important others (N=11), and healthcare professionals (N=20).
- The intervention, PROfeel, involved a smartphone-based ESM period followed by in-person feedback and shared decision-making.
- Participants included patients aged 13-25, primarily parents as important others, and various healthcare professionals.
Main Results:
- Patients and important others valued insights from ESM but found the effort challenging; ownership was fostered through independent use and parental support.
- Healthcare professionals focused on balancing patient value with intervention effort, defining roles, and addressing concerns about effectiveness and feasibility.
- Patient-reported value was crucial for PROfeel use, weighed against intervention demands and eligibility.
Conclusions:
- ESM-supported blended care holds promise for early intervention in pediatric chronic conditions, accommodating autonomy and supporting insight interpretation.
- Successful integration into pediatric care requires active end-user involvement to maximize patient value and address practical implementation challenges.
- Hospital-wide implementation could cater to diverse clinical needs, but requires careful consideration of roles and resources.
Introduction:
Children with chronic health conditions are at risk for persistent somatic symptoms such as fatigue, influenced by biological and psychosocial factors. Experience Sampling Methodology (ESM) in mobile Health (mHealth) enables personalized insights into symptom-related factors, potentially improving self-management and quality of life. Blended care-combining digital and in-person support-enhances adherence and interpretation of ESM insights. Despite its potential, no blended ESM intervention has yet transitioned into pediatric care. This study explores direct and indirect user perspectives on the use and implementation of ESM-supported blended mHealth in pediatric care.
Methods:
We conducted an exploratory qualitative study on PROfeel, an ESM-supported blended mHealth intervention for fatigue management. PROfeel includes a smartphone-based ESM period, followed by face-to-face feedback and shared decision-making for tailored lifestyle goals. Semi-structured interviews were conducted with patients (N = 11), important others (IOs, N = 11), and healthcare professionals (HCPs, N = 20). Patients, aged 13-25, used PROfeel in a research setting. IOs were primarily parents. HCPs included physicians, nurses, and psychologists.
Results:
Patients and IOs identified three themes: (1) wish for improvement vs. ESM effort, (2) value of insights, and (3) support and ownership. Patients were motivated by improvement but found ESM effort challenging. Insights into fatigue and lifestyle factors were valued, though lifestyle change remained limited. Independent use fostered ownership, while parents provided support. HCPs identified the themes (1) balancing patient value and effort, (2) defining roles within the intervention, and (3) concerns about effectiveness, financial coverage, and time. Patient value was the key determinant for PROfeel use, balanced against intervention effort and eligibility criteria. HCPs stressed the need for aligned roles and practical feasibility.
Discussion:
ESM-supported care shows promise for children with chronic conditions and may serve as an early intervention. Blended care accommodates autonomy levels and supports ESM insight interpretation. Implementation in hospital-wide care could suit varied clinical needs. Active involvement of end users is essential to maximize patient value and ensure successful integration into pediatric care.
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