Abstract：
BACKGROUND: The Set Brave Goals app is the first digital health app (DHA) aimed at helping children with spina bifida (SB) aged 8-17 years old to select and track their urinary and fecal continence goals. Developed by children, parents, providers and researchers, its usability, or appropriateness to a purpose (\"user-friendliness\"), remains unknown. In an alpha testing stage, our aim was to determine the usability of the app prior to clinical use.
METHODS: We recruited children with SB and their parents in clinic and via social media. A recruitment goal of 10 children exceeded industry standard of 5 participants (10 participants are expected to identify approximately 96% of usability problems). Participants downloaded and used the app for a week. They completed a questionnaire, including the System Usability Scale (SUS) and closed and open-ended questions. The SUS is a 10-item validated usability questionnaire most widely used in DHA usability testing (scores range from 0 to 100, 100 representing greatest usability). Median/mean SUS scores for DHAs are 68. Mann-Whitney-U and t-tests were used.
RESULTS: Ten children with SB participated (median age: 14 years old, 6 female, 8 shunted, 8 using bladder catheterizations). Twenty parents participated (17 mothers, median age: 42 years old). Median SUS score was 77.5 for children and 73.8 for parents, corresponding to \"good\" to \"excellent\" usability (Summary Figure). There were no significant differences between child/parent scores (p = 0.69) or those for other DHAs (p = 0.11). It took a median 5-10 min to go through the app (2 parents felt it took too much time). All participants felt the app was easy to understand and use (100%). Most participants would recommend it to children and parents (children: 89%, parents: 80%), and believed it would be valuable to children (90%, 75%) and urologists (80%, 80%). Free text responses related to more varied color schemes, keeping free-text notes within the app and more flexible goal/alarm setting. These changes were incorporated into the app.
CONCLUSIONS: Usability testing prior to clinical launch identified areas for app improvement. Although this study sample met industry standards, findings are limited by a small group of participants. The app will undergo further refinement during prospective beta testing.
CONCLUSIONS: The Set Brave Goals app for children with SB has acceptable usability parameters. This justifies proceeding with wider use to formalize children\'s continence goal setting/tracking and testing its value to children with SB and their healthcare providers.
METHODS: We recruited children with SB and their parents in clinic and via social media. A recruitment goal of 10 children exceeded industry standard of 5 participants (10 participants are expected to identify approximately 96% of usability problems). Participants downloaded and used the app for a week. They completed a questionnaire, including the System Usability Scale (SUS) and closed and open-ended questions. The SUS is a 10-item validated usability questionnaire most widely used in DHA usability testing (scores range from 0 to 100, 100 representing greatest usability). Median/mean SUS scores for DHAs are 68. Mann-Whitney-U and t-tests were used.
RESULTS: Ten children with SB participated (median age: 14 years old, 6 female, 8 shunted, 8 using bladder catheterizations). Twenty parents participated (17 mothers, median age: 42 years old). Median SUS score was 77.5 for children and 73.8 for parents, corresponding to \"good\" to \"excellent\" usability (Summary Figure). There were no significant differences between child/parent scores (p = 0.69) or those for other DHAs (p = 0.11). It took a median 5-10 min to go through the app (2 parents felt it took too much time). All participants felt the app was easy to understand and use (100%). Most participants would recommend it to children and parents (children: 89%, parents: 80%), and believed it would be valuable to children (90%, 75%) and urologists (80%, 80%). Free text responses related to more varied color schemes, keeping free-text notes within the app and more flexible goal/alarm setting. These changes were incorporated into the app.
CONCLUSIONS: Usability testing prior to clinical launch identified areas for app improvement. Although this study sample met industry standards, findings are limited by a small group of participants. The app will undergo further refinement during prospective beta testing.
CONCLUSIONS: The Set Brave Goals app for children with SB has acceptable usability parameters. This justifies proceeding with wider use to formalize children\'s continence goal setting/tracking and testing its value to children with SB and their healthcare providers.
摘要：
背景：设定勇敢目标应用程序是第一个数字健康应用程序（DHA），旨在帮助8-17岁的脊柱裂（SB）儿童选择和跟踪他们的尿失禁和大便失禁目标。由儿童开发，父母,提供者和研究人员，它的可用性，或对目的的适当性(“用户友好性”)，仍然未知。在阿尔法测试阶段，我们的目的是在临床使用前确定应用的可用性.
方法：我们在诊所和社交媒体上招募了患有SB的儿童及其父母。招募10名儿童的目标超过了5名参与者的行业标准（预计10名参与者将识别大约96％的可用性问题）。参与者下载并使用该应用程序一周。他们完成了一份调查问卷,包括系统可用性量表(SUS)和封闭式和开放式问题。SUS是一个10个项目验证的可用性问卷，在DHA可用性测试中使用最广泛（分数范围从0到100，100代表最大的可用性）。DHA的中值/平均SUS分数为68。使用Mann-Whitney-U和t检验。
结果：10名SB儿童参加（中位年龄：14岁，6女,8分流，8使用膀胱导管插入术)。20位父母参加了（17位母亲，中位年龄：42岁）。儿童的SUS中位数为77.5，父母的中位数为73.8，对应于“良好”到“优秀”可用性(摘要图)。儿童/父母得分（p=0.69）或其他DHAs得分（p=0.11）之间没有显着差异。通过该应用程序需要平均5-10分钟（2位父母认为花费了太多时间）。所有参与者都认为该应用程序易于理解和使用（100％）。大多数参与者会推荐给孩子和父母(儿童:89%，父母：80％），并认为它对儿童很有价值(90%，75%)和泌尿科医生(80%，80%)。与更多不同的配色方案相关的自由文本响应，在应用程序中保持自由文本注释和更灵活的目标/报警设置。这些更改已合并到应用程序中。
结论：临床发布前的可用性测试确定了应用改进的领域。尽管本研究样本符合行业标准，研究结果受到一小群参与者的限制。该应用程序将在预期的beta测试中进行进一步的改进。
结论：为SB儿童设定勇敢目标应用程序具有可接受的可用性参数。这证明有理由进行更广泛的使用，以形式化儿童的失禁目标设置/跟踪，并测试其对SB儿童及其医疗保健提供者的价值。
方法：我们在诊所和社交媒体上招募了患有SB的儿童及其父母。招募10名儿童的目标超过了5名参与者的行业标准（预计10名参与者将识别大约96％的可用性问题）。参与者下载并使用该应用程序一周。他们完成了一份调查问卷,包括系统可用性量表(SUS)和封闭式和开放式问题。SUS是一个10个项目验证的可用性问卷，在DHA可用性测试中使用最广泛（分数范围从0到100，100代表最大的可用性）。DHA的中值/平均SUS分数为68。使用Mann-Whitney-U和t检验。
结果：10名SB儿童参加（中位年龄：14岁，6女,8分流，8使用膀胱导管插入术)。20位父母参加了（17位母亲，中位年龄：42岁）。儿童的SUS中位数为77.5，父母的中位数为73.8，对应于“良好”到“优秀”可用性(摘要图)。儿童/父母得分（p=0.69）或其他DHAs得分（p=0.11）之间没有显着差异。通过该应用程序需要平均5-10分钟（2位父母认为花费了太多时间）。所有参与者都认为该应用程序易于理解和使用（100％）。大多数参与者会推荐给孩子和父母(儿童:89%，父母：80％），并认为它对儿童很有价值(90%，75%)和泌尿科医生(80%，80%)。与更多不同的配色方案相关的自由文本响应，在应用程序中保持自由文本注释和更灵活的目标/报警设置。这些更改已合并到应用程序中。
结论：临床发布前的可用性测试确定了应用改进的领域。尽管本研究样本符合行业标准，研究结果受到一小群参与者的限制。该应用程序将在预期的beta测试中进行进一步的改进。
结论：为SB儿童设定勇敢目标应用程序具有可接受的可用性参数。这证明有理由进行更广泛的使用，以形式化儿童的失禁目标设置/跟踪，并测试其对SB儿童及其医疗保健提供者的价值。
