Development of a comprehensive mobile assessment of pressure (CMAP) system for pressure injury prevention for veterans with spinal cord injury

Abstract

Objective: This paper reports the iterative redesign, feasibility and usability of the Comprehensive Mobile Assessment of Pressure (CMAP) system’s mobile app used by Veterans with SCI.

Design: This three-year, multi-staged study used a mixed-methods approach.

Setting: Minneapolis VA Health Care System, Minneapolis, Minnesota.

Participants: Veterans with spinal cord injury (N = 18).

Interventions: Veterans with spinal cord injury engaged in iterative focus groups and personal interviews, sharing their needs and desires for the CMAP app redesign. App developers used these data for the redesign. The redesigned CMAP app was tested for six-weeks in users’ homes.

Outcome Measures: Quantitative (surveys) and qualitative (interviews) methods measured feasibility for self-management of seating pressure. Qualitative data were audio recorded, transcribed, anonymized, and coded. Survey data were analyzed using summary statistics.

Results: After the CMAP system’s redesign, the in-home use interview found: (1) any tool that can assist in prevention and monitoring of skin ulcers is important; (2) the desired key features are present in the app; (3) the main barrier to CMAP use was inconsistent functionality; (4) when functioning as expected, the live pressure map was the central feature, with reminders to weight shift also of high importance. The survey found: power wheelchair users tended to score closer than manual wheelchair users to the positive response end ranges on two separate surveys.

Conclusions: Overall both the power and manual wheelchair users reported that they wanted to use the system, felt confident using the system, and that the functions of the system were well integrated.

Keywords:

• Wheelchair seating
• Pressure injury prevention
• App
• Mixed methods

Acknowledgments

This study was funded by the Department of Defense (W81XWH-15-1-0484). Additional support for XX was provided by the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery. This material is the result of work supported by and conducted at the Minneapolis VA Health Care System.

Disclaimer statements

Contributors None.

Funding This study was funded by the Department of Defense, number W81XWH-15-1-0484.

Conflicts of interest Dr. Vos-Draper, Dr. Morrow and Mayo Clinic have a financial interest related to this research. This research has been reviewed by the University of Minnesota and Mayo Clinic Conflict of Interest Review Board and is being conducted in compliance with both policies. The materials presented here solely represent the views of the authors and does not represent the view of the U.S. Department of Veterans Affairs or the United States Government. The views expressed in the submitted article are the authors’ alone and not an official position of the institutions or funders.

ORCID

Christine M. Olney http://orcid.org/0000-0003-3940-6107

Tamara Vos-Draper http://orcid.org/0000-0002-9038-2764

John Ferguson http://orcid.org/0000-0002-9944-1003

Katherine Carroll http://orcid.org/0000-0002-9110-1354