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Understanding Adoption and Preliminary Effectiveness of a Mobile App for Chronic Pain Management Among US Military Veterans: Pre-Post Mixed Methods Evaluation

Hogan, Timothy P
Etingen, Bella
McMahon, Nicholas
Bixler, Felicia R
Am, Linda
Wacks, Rachel E
Shimada, Stephanie L
Reilly, Erin D
Frisbee, Kathleen L
Smith, Bridget M
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Abstract

Background: The Veterans Health Administration Pain Coach mobile health app was developed to support veterans with chronic pain.

Objective: Our objective was to evaluate early user experiences with the Pain Coach app and preliminary impacts of app use on pain-related outcomes.

Methods: Following a sequential, explanatory, mixed methods design, we mailed surveys to veterans at 2 time points with an outreach program in between and conducted semistructured interviews with a subsample of survey respondents. We analyzed survey data using descriptive statistics among veterans who completed both surveys and examined differences in key outcomes using paired samples t tests. We analyzed semistructured interview data using thematic analysis.

Results: Of 1507 veterans invited and eligible to complete the baseline survey, we received responses from 393 (26.1%). These veterans received our outreach program; 236 (236/393, 60.1%) completed follow-up surveys. We conducted interviews with 10 app users and 10 nonusers. Among survey respondents, 10.2% (24/236) used Pain Coach, and 58% (14/24) reported it was easy to use, though interviews identified various app usability issues. Veterans who used Pain Coach reported greater pain self-efficacy (mean 23.1 vs mean 16.6; P=.01) and lower pain interference (mean 34.6 vs mean 31.8; P=.03) after (vs before) use. The most frequent reason veterans reported for not using the app was that their health care team had not discussed it with them (96/212, 45.3%).

Conclusions: Our findings suggest that future efforts to increase adoption of Pain Coach and other mobile apps among veterans should include health care team endorsement. Our findings regarding the impact of Pain Coach use on outcomes warrant further study.

Source

Hogan TP, Etingen B, McMahon N, Bixler FR, Am L, Wacks RE, Shimada SL, Reilly ED, Frisbee KL, Smith BM. Understanding Adoption and Preliminary Effectiveness of a Mobile App for Chronic Pain Management Among US Military Veterans: Pre-Post Mixed Methods Evaluation. JMIR Form Res. 2022 Jan 20;6(1):e33716. doi: 10.2196/33716. PMID: 35049515; PMCID: PMC8814923.

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DOI
10.2196/33716
PubMed ID
35049515
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©Timothy P Hogan, Bella Etingen, Nicholas McMahon, Felicia R Bixler, Linda Am, Rachel E Wacks, Stephanie L Shimada, Erin D Reilly, Kathleen L Frisbee, Bridget M Smith. Originally published in JMIR Formative Research (https://formative.jmir.org), 20.01.2022. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on https://formative.jmir.org, as well as this copyright and license information must be included.Attribution 4.0 International