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dc.contributor.authorDinsmore, John
dc.date.accessioned2022-05-23T08:22:06Z
dc.date.available2022-05-23T08:22:06Z
dc.date.issued2021
dc.date.submitted2021en
dc.identifier.citationDoyle J, Murphy M, Gavin S, Pascale P, Hannigan C, Deparis S, Tommasi P, Smith S, Sillevis Smitt M, van Leeuwen C, Jacobs A, Lastra J, Medina J, Boyle G, Dinsmore J, ProACT - A Digital Platform to Support Self-Management of Multiple Chronic Conditions: Findings in Relation to Engagement during a one-year Proof-of-Concept Trial., Journal of Medical Internet Research (JMIR), 23, 12, 2021, 1 - 26en
dc.identifier.otherY
dc.identifier.urihttp://hdl.handle.net/2262/98653
dc.descriptionPUBLISHEDen
dc.description.abstractBackground: Populations globally are ageing, resulting in higher incidence rates of chronic diseases. Digital health platforms, designed to support those with chronic conditions to self-manage at home, offer a promising solution to help people monitor their conditions and lifestyle, maintain good health, and reduce unscheduled clinical visits. However, despite high prevalence rates of multimorbidity or multiple chronic conditions, most platforms tend to focus on a single disease. A further challenge is that despite the importance of users actively engaging with such systems, little research has explored engagement. Objective: The objectives of this study are to design and develop a digital health platform, ProACT, for facilitating older adults self-managing multimorbidity, with support from their care network, and evaluate end user engagement and experiences with this platform through a 12-month trial. Methods: The ProACT digital health platform is presented in this paper. The platform was evaluated in a year-long proof-of-concept action research trial with 120 older persons with multimorbidity in Ireland and Belgium. Alongside the technology, participants had access to a clinical triage service responding to symptom alerts and a technical helpdesk. Interactions with the platform during the trial were logged to determine engagement. Semistructured interviews were conducted with participants and analyzed using inductive thematic analysis, whereas usability and user burden were examined using validated questionnaires. Results: This paper presents the ProACT platform and its components, along with findings on engagement with the platform and its usability. Of the 120 participants who participated, 24 (20%) withdrew before the end of the study, whereas 3 (2.5%) died. The remaining 93 participants actively used the platform until the end of the trial, on average, taking 2 or 3 health readings daily over the course of the trial in Ireland and Belgium, respectively. The participants reported ProACT to be usable and of low burden. Findings from interviews revealed that participants experienced multiple benefits as a result of using ProACT, including improved self-management, health, and well-being and support from the triage service. For those who withdrew, barriers to engagement were poor health and frustration when technology, in particular sensing devices, did not work as expected. Conclusions: This is the first study to present findings from a longitudinal study of older adults using digital health technology to self-manage multimorbidity. Our findings show that older adults sustained engagement with the technology and found it usable. Potential reasons for these results include a strong focus on user-centered design and engagement throughout the project lifecycle, resulting in a platform that meets user needs, as well as the integration of behavior change techniques and personal analytics into the platform. The provision of triage and technical support services alongside the platform during the trial were also important facilitators of engagement. International Registered Report Identifier (IRRID): RR2-10.2196/22125en
dc.format.extent1en
dc.format.extent26en
dc.language.isoenen
dc.relation.ispartofseriesJournal of Medical Internet Research (JMIR);
dc.relation.ispartofseries23;
dc.relation.ispartofseries12;
dc.rightsYen
dc.subjectDigital healthen
dc.subjectAgingen
dc.subjectMultimorbidityen
dc.subjectChronic diseaseen
dc.subjectSelf-managementen
dc.subjectIntegrated careen
dc.subjectLongitudinal studyen
dc.subjectEngagementen
dc.subjectUsabilityen
dc.subjectMobile phoneen
dc.titleProACT - A Digital Platform to Support Self-Management of Multiple Chronic Conditions: Findings in Relation to Engagement during a one-year Proof-of-Concept Trial.en
dc.typeJournal Articleen
dc.contributor.sponsorEuropean Commissionen
dc.type.supercollectionscholarly_publicationsen
dc.type.supercollectionrefereed_publicationsen
dc.identifier.peoplefinderurlhttp://people.tcd.ie/dinsmorj
dc.identifier.rssinternalid243501
dc.identifier.doihttps://doi.org/10.2196/22672
dc.relation.ecprojectidinfo:eu-repo/grantAgreement/EC/FP7/689996
dc.rights.ecaccessrightsopenAccess
dc.contributor.sponsorGrantNumber689996en
dc.subject.TCDThemeAgeingen
dc.subject.TCDThemeDigital Engagementen
dc.subject.TCDThemeNext Generation Medical Devicesen
dc.subject.TCDTagBehaviour Changeen
dc.subject.TCDTagChronic Illnessen
dc.subject.TCDTagChronic Illness self-managementen
dc.subject.TCDTagDigital Healthen
dc.subject.TCDTagDigital Integrated Careen
dc.subject.TCDTagIntegrated Careen
dc.subject.TCDTagOLDER PERSONSen
dc.subject.TCDTagTelemedicineen
dc.subject.TCDTagmultimorbidityen
dc.identifier.orcid_id0000-0001-8387-3496
dc.subject.darat_impairmentChronic Health Conditionen
dc.subject.darat_thematicHealthen
dc.status.accessibleNen


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