eprintid: 10149282
rev_number: 7
eprint_status: archive
userid: 699
dir: disk0/10/14/92/82
datestamp: 2022-05-27 11:45:39
lastmod: 2022-05-27 11:45:39
status_changed: 2022-05-27 11:45:39
type: article
metadata_visibility: show
sword_depositor: 699
creators_name: Crehan, Caroline
creators_name: Chiume, Msandeni
creators_name: Mgusha, Yamikani
creators_name: Dinga, Precious
creators_name: Hull-Bailey, Tim
creators_name: Normand, Charles
creators_name: Sassoon, Yali
creators_name: Nkhoma, Deliwe
creators_name: Greenwood, Kim
creators_name: Lorencatto, Fabiana
creators_name: Lakhanpaul, Monica
creators_name: Heys, Michelle
title: Usability-Focused Development and Usage of NeoTree-Beta, an App for Newborn Care in a Low-Resource Neonatal Unit, Malawi
ispublished: pub
divisions: UCL
divisions: G25
divisions: D13
divisions: B02
keywords: neonate, low resource, mHealth, mobile app, usability, user experience, user centred design, agile
note: © 2022 Crehan, Chiume, Mgusha, Dinga, Hull-Bailey, Normand, Sassoon, Nkhoma, Greenwood, Lorencatto, Lakhanpaul and Heys. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).
abstract: Background: Neonatal mortality is high in low-resource settings. NeoTree is a digital intervention for neonatal healthcare professionals (HCPs) aiming to achieve data-driven quality improvement and improved neonatal survival in low-resource hospitals. Optimising usability with end-users could help digital health interventions succeed beyond pilot stages in low-resource settings. Usability is the quality of a user's experience when interacting with an intervention, encompassing their effectiveness, efficiency, and overall satisfaction.

Objective: To evaluate the usability and usage of NeoTree beta-app and conduct Agile usability-focused intervention development.

Method: A real-world pilot of NeoTree beta-app was conducted over 6 months at Kamuzu Central Hospital neonatal unit, Malawi. Prior to deployment, think-aloud interviews were conducted to guide nurses through the app whilst voicing their thoughts aloud (n = 6). System Usability Scale (SUS) scores were collected before the implementation of NeoTree into usual clinical care and 6 months after implementation (n = 8 and 8). During the pilot, real-world user-feedback and user-data were gathered. Feedback notes were subjected to thematic analysis within an Agile “product backlog.” For usage, number of users, user-cadre, proportion of admissions/outcomes recorded digitally, and median app-completion times were calculated.

Results: Twelve overarching usability themes generated 57 app adjustments, 39 (68%) from think aloud analysis and 18 (32%) from the real-world testing. A total of 21 usability themes/issues with corresponding app features were produced and added to the app. Six themes relating to data collection included exhaustiveness of data schema, prevention of errors, ease of progression, efficiency of data entry using shortcuts, navigation of user interface (UI), and relevancy of content. Six themes relating to the clinical care included cohesion with ward process, embedded education, locally coherent language, adaptability of user-interface to available resources, and printout design to facilitate handover. SUS scores were above average (88.1 and 89.4 at 1 and 6 months, respectively). Ninety-three different HCPs of 5 cadres, recorded 1,323 admissions and 1,197 outcomes over 6 months. NeoTree achieved 100% digital coverage of sick neonates admitted. Median completion times were 16 and 8 min for admissions and outcomes, respectively.

Conclusions: This study demonstrates optimisation of a digital health app in a low-resource setting and could inform other similar usability studies apps in similar settings.
date: 2022-04-28
date_type: published
publisher: Frontiers Media SA
official_url: https://doi.org/10.3389/fpubh.2022.793314
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1956685
doi: 10.3389/fpubh.2022.793314
medium: Electronic-eCollection
lyricists_name: Lakhanpaul, Monica
lyricists_id: MLAKH52
actors_name: Flynn, Bernadette
actors_id: BFFLY94
actors_role: owner
full_text_status: public
publication: Frontiers in Public Health
volume: 10
article_number: 793314
event_location: Switzerland
issn: 2296-2565
citation:        Crehan, Caroline;    Chiume, Msandeni;    Mgusha, Yamikani;    Dinga, Precious;    Hull-Bailey, Tim;    Normand, Charles;    Sassoon, Yali;                     ... Heys, Michelle; + view all <#>        Crehan, Caroline;  Chiume, Msandeni;  Mgusha, Yamikani;  Dinga, Precious;  Hull-Bailey, Tim;  Normand, Charles;  Sassoon, Yali;  Nkhoma, Deliwe;  Greenwood, Kim;  Lorencatto, Fabiana;  Lakhanpaul, Monica;  Heys, Michelle;   - view fewer <#>    (2022)    Usability-Focused Development and Usage of NeoTree-Beta, an App for Newborn Care in a Low-Resource Neonatal Unit, Malawi.                   Frontiers in Public Health , 10     , Article 793314.  10.3389/fpubh.2022.793314 <https://doi.org/10.3389/fpubh.2022.793314>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10149282/1/fpubh-10-793314.pdf