Dickerson, S. et al.:Developing of a web-based application to facilitate patient treatment adherence in individuals with sleep apnea treated with Continuous Positive Airway Pressure (CPAP) devices

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Developing a web- application to facilitate patient treatment adherence.

Suzanne S. Dickerson DNS RNAssociate Professor Grace Dean PhD RN Assistant Professor

Defining the Need

Evidence Based Literature review Research to define specific needs Experiential patient narratives Develop problem statement Determine appropriate behavioral strategies

to promote adherence and timeline for effectiveness

Choose theory

Gathering the team

Facilitate patient's adherence to CPAP treatment

Team members: Software engineer as principle engineer Clinical Sleep medicine expert Psy D for cognitive behavioral intervention

component Software design and development It support staff

Conceptualize the problem

brainstorming with Software systems engineer and PIs

Visualize the flow of the idea Understand how theory is

operationalizedI.e. Self Efficacy

Motivators

Vicarious learning

Support

Visualizing the problem

Defining expected outcomes

Motivational program that is web based, interactive, uses patient self management strategies. Capture data by collecting self report CPAP use survey

data and store on HIPPA approved server Track patient progress over time for use by patient

and provider Provide automated motivators based on answers to

questions and patient progress data Use motivation enhancers Provide resource library with motivational success

stories for vicarious learning.

50,000 foot view of topics

User data capture User progress tracking by

Investigators Peers Users themselves ( homepage)

Motivators automated or managed by investigators

Resource library ( user contributions?) Rolling news blog for investigators.

The Application

Codify the Protocols Easy capture and easy storage Interactions:

What is displayed, when, how, When are things available to use?

UI page designs (User Interaction) UI page flows ( graphic designers or interaction

designers)

The application cont.

Store the data Analyze data for next steps in the

intervention protocol Technology requirements/restrictions

• Web application• Runtime/deployment environment (server)• Runtime framework (server software,

webapp, infrastructure, libraries Data storage Development environment

Software development

Requirements Protocols Tech restrictions

Design –user centric UI interactions

Use case Design – tech centric

Components , techniques Build Test and repair Deploy and active Follow up

Timeline Initial 4 months

Timeline Task Team member

milestone

Month

1–4 Set up developmental Server and test security

Software development:

Finalized protocols

Write software initial requirements

Network Admini-strator

PIs

Principal engineer

Secure developmental server

Protocols

Base use cases

Technology platform selection

Next 2 months

Timeline Task Team member milestone

Month

4-6

Interaction and interface design

Data model design

PIs

Principal engineer

Graphic designer

Prototype users scenarios (personas)

Interaction task scenarios

UI screen designs

Data type and flow definitions

Time line 6-8 months

Timeline Task Team member

milestone

Month

6-8

Design tech-centric components techniques

Principal engineer

Graphic designer

Programmer

Model-View-Controller software design

Implementation Plan

Timeline 8-10 months

Timeline Task Team member milestone

Month

8-10

Build and test

PI

Principal engineer

Programmer

Completion of initial implementation plan

System test all functionality

Complete fixes for high priority defects; Finalize setup of the production environment

Release final deploy package

Final months

Timeline Task Team member

milestone

Months 10-12

Deploy and activate

PIs

Principal engineer

Programmer

Publish the application to the production environment

Production test to verify installation

Ready for feasibility study

Evaluation

Sleep quality PSQI Sleepiness scale ESS Quality of life CSAQLI Adherence- actual use. Future testing with R21 and R01 mechanisms

Dissemination

Publication on development strategies Feasibility study Multisite study

local then national Marketing and business plan Format in multiple languages

Obtaining funding

Finding grant mechanisms to support development of intervention

Seed monies internal research development funding

Corporate fundingFoundations or corporations that endorse idea

Questions??

Thank you