CC BY 4.0 Attribution 4.0 InternationalButler, SoniaSculley, DeanSantos, DerekGirones, XavierSingh-Grewal, DavinderCoda, Andrea2024-05-242024-05-242024-09-17Butler, S., Sculley, D., Santos, D., Girones, X., Singh-Grewal, D. and Coda, A. (2024) ‘Development and Delivery of an Integrated Digital Healthcare Approach for children with Juvenile Idiopathic Arthritis: Usability Study’, JMIR Pediatrics and Parenting, 7, p. e56816. Available at: https://doi.org/10.2196/56816.2561-6722https://eresearch.qmu.ac.uk/handle/20.500.12289/13739https://doi.org/10.2196/56816Derek Santos - ORCID: 0000-0001-9936-715X https://orcid.org/0000-0001-9936-715XBackground: Juvenile Idiopathic Arthritis (JIA) is a chronic inflammatory disorder, with no cure. Most children are prescribed: several medications aimed to control disease activity, manage symptom, and reduce pain. Physical activity is also encouraged to retain musculoskeletal function. The primary determinants of treatment success are maintaining long term adherence, ongoing monitoring from a paediatric rheumatologist, and involvement from an interdisciplinary team. To support these goals, a new digital intervention was developed, InteractiveClinics, aimed to prompt children to take their medications, report pain levels, and increase their physical activity. Objective: This study aims to evaluate the usability of InteractiveClinics, by children with JIA. Methods: As part of this pediatric cross-sectional usability study, twelve children were asked to wear a smart watch for two weeks, synchronized to the InteractiveClinics phone app and web-based platform. Personalized notifications were sent daily to the watch and phone, to prompt and record medication adherence and pain levels. Physical activity was automatically recorded by the watch. At the end of the study, all children and parents completed a post-intervention survey. Written comments were also encouraged to gain further feedback. Descriptive statistics were used to summarize the survey results, and all qualitative data employed thematic analysis. Results: Twelve children, aged 10 to 18 years (mean 14.2, SD 3.1, female 66.7%, 8/12) and one parent for each child (n=12, 66.7%, 8/12, female) were enrolled in the study. Reviewing the highest and lowest agreement areas of the survey, most children and parents liked the smart watch and web-based platform, they found it easy to learn and simple to use. They were also satisfied with the pain and physical activity module. However, usability and acceptability barriers were identified in the phone app and medication module that hindered uptake. Children required a more unique in-app experience, and their suggestive improvements included: more personalisation within the app, simplification by removing all non-relevant links, flexibility in response times, improved conferment through gamification, additional comment fields for the input of more data such as medication side effects or pain-related symptoms, more detailed graphical illustrations of the physical activity module, including a breakdown of metrics, and importantly, interconnections between modules, because medication adherence, pain levels and physical activity can each influence the other. Overall improving usefulness for children and parents. Conclusions: Usability of InteractiveClinics was positive. Children and parents liked the watch and web-based platform and were satisfied with the pain and physical activity module. However, children wanted a more unique in-app experience, through more personalisation, simplification, flexibility, conferment, comment fields, graphical illustrations, a breakdown of metrics, and interconnections. Certainly, inclusions needed to promote user adoption and advancement of new validated digital health interventions in pediatric rheumatology, to support the delivery of integrated care. Clinical Trial: Australian and New Zealand Clinical Trial Registry: ACTRN12616000665437.e56816en© Sonia Butler, Dean Sculley, Derek Santos, Xavier Gironès, Davinder Singh-Grewal, Andrea Coda. Originally published in JMIR Pediatrics and Parenting (https://pediatrics.jmir.org), 17.9.2024. 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 Pediatrics and Parenting, is properly cited. The complete bibliographic information, a link to the original publication on https://pediatrics.jmir.org, as well as this copyright and license information must be included.http://creativecommons.org/licenses/by/4.0/Article