Changing Habits With the Happy Hands App: Qualitative Focus Group Study of a Hand Osteoarthritis Self-Management...

People with hand osteoarthritis represent a large patient group with limited access to recommended treatment. In recent years, there has been a notable shift in health care delivery, with increased use of digital technologies. The Happy Hands app (The University Information Technology Center [USIT]) is a digital self-management intervention developed to provide evidence-based treatment for people with hand osteoarthritis, with the goal of empowering them to self-manage their disease. Participants' experiences and perceptions of using this digital intervention are crucial for the adoption and continued use of the Happy Hands app.

The objective of this qualitative study was to explore participants' experience with using the Happy Hands app, focusing on whether and how it empowered them to self-manage their hand osteoarthritis.

The study is embedded within a randomized controlled trial (RCT). The participants were recruited from the intervention group in the RCT, who got access to the Happy Hands app. The 12-week self-management intervention included a hand exercise program and informational videos about hand osteoarthritis. Focus groups were conducted in various geographical areas in Norway. The focus groups were transcribed verbatim, coded, and analyzed inductively using reflexive thematic analysis.

Seven focus groups, with a total of 26 participants, were recruited from both specialist and primary health care. The mean age was 67 years. Three themes were developed from the analysis. The first theme, "Being acknowledged," highlights the essential role of recognition for people with hand osteoarthritis. It suggests that the Happy Hands app provided participants with a sense of validation and support. The second theme, "Changed perception of hand osteoarthritis," indicates that participants gained insights and knowledge about their condition. This new understanding empowered them to make more informed decisions about their care, fostering a sense of hope and motivation by demonstrating that effective measures are available to manage the disease. The third theme, "Changing habits with the Happy Hands app," describes how participants developed new habits after using the self-management intervention delivered through the app. The exercise program was experienced as motivating, flexible, well-structured, and committing. Some challenges were reported, including experiencing pain during or after exercising. The new habits included performing hand exercises and implementing ergonomic working methods, which were tailored to meet the individual needs and integrated into the participants' daily lives and routines.

The findings suggest that the Happy Hands app is a valuable tool for supporting people with hand osteoarthritis in managing their disease by helping them integrate hand osteoarthritis management into their daily lives.

ClinicalTrials.gov NCT05568875; https://clinicaltrials.gov/study/NCT05568875.