A Mobile Phone App to Stimulate Daily Physical Activity in Patients with Chronic Obstructive Pulmonary Disease: Development, Feasibility, and Pilot Studies

Sigrid Nw Vorrink, Helianthe Sm Kort, Thierry Troosters, Jan-Willem J Lammers, Sigrid Nw Vorrink, Helianthe Sm Kort, Thierry Troosters, Jan-Willem J Lammers

Abstract

Background: Patients with chronic obstructive pulmonary disease (COPD) demonstrate reduced levels of daily physical activity (DPA) compared to healthy controls. This results in a higher risk of hospital admission and shorter survival. Performing regular DPA reduces these risks.

Objective: To develop an eHealth intervention that will support patients with COPD to improve or maintain their DPA after pulmonary rehabilitation.

Methods: The design process consisted of literature research and the iterative developing and piloting phases of the Medical Research Council (MRC) model for complex clinical interventions and the involvement of end users. Participants were healthy adults and persons with COPD.

Results: The mobile phone interface met all the set requirements. Participants found that the app was stimulating and that reaching their DPA goals was rewarding. The mean (SD) scores on a 7-point scale for usability, ease of use, ease of learning, and contentment were 3.8 (1.8), 5.1 (1.1), 6.0 (1.6), and 4.8 (1.3), respectively. The mean (SD) correlation between the mobile phone and a validated accelerometer was 0.88 (0.12) in the final test. The idea of providing their health care professional with their DPA data caused no privacy issues in the participants. Battery life lasted for an entire day with the final version, and readability and comprehensibility of text and colors were favorable.

Conclusions: By employing a user-centered design approach, a mobile phone was found to be an adequate and feasible interface for an eHealth intervention. The mobile phone and app are easy to learn and use by patients with COPD. In the final test, the accuracy of the DPA measurement was good. The final version of the eHealth intervention is presently being tested by our group for efficacy in a randomized controlled trial in COPD patients.

Keywords: chronic obstructive pulmonary disease; mobile phones; motor activity; telemedicine.

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Design process.
Figure 2
Figure 2
In version 1, the y-axis provides a measure for activity, while the x-axis provides a measure for intensity. The DPA goal is met when the blue ball (representation of current activity status) is kept in the green circle at all times. The widget shows a current status towards reaching a DPA goal (pilot study C1).
Figure 3
Figure 3
In version 2, the left axis shows amount of steps, while the right axis gives a measure of intensity. The DPA goal is reached when the open circles (representation of current activity status) are kept in the rising green circles at all times (pilot study C2).
Figure 4
Figure 4
In version 3, the bar on the left side combines amount and intensity of steps. The DPA goal is met when the vertical stripe (representation of current activity status) is kept in the rising rectangle at all times until the green area is reached. Absolute number of steps and current advice on DPA progress are also shown (pilot study C3).

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