Evolving Adult ADHD Care: Preparatory Evaluation of a Prototype Digital Service Model Innovation for ADHD Care.

BACKGROUND: Given the prevalence of ADHD and the gaps in ADHD care in Australia, this study investigates the critical barriers and driving forces for innovation. It does so by conducting a preparatory evaluation of an ADHD prototype digital service innovation designed to help streamline ADHD care and empower individual self-management. METHODS: Semi-structured interviews with ADHD care consumers/participants and practitioners explored their experiences and provided feedback on a mobile self-monitoring app and related service innovations. Interview transcripts were double coded to explore thematic barriers and the enablers for better ADHD care. RESULTS: Fifteen interviews (9 consumers, 6 practitioners) revealed barriers to better ADHD care for consumers (ignorance and prejudice, trust, impatience) and for practitioners (complexity, sustainability). Enablers for consumers included validation/empowerment, privacy, and security frameworks, tailoring, and access. Practitioners highlighted the value of transparency, privacy and security frameworks, streamlined content, connected care between services, and the tailoring of broader metrics. CONCLUSIONS: A consumer-centred approach to digital health service innovation, featuring streamlined, private, and secure solutions with enhanced mobile tools proves instrumental in bridging gaps in ADHD care in Australia. These innovations should help to address the gaps in ADHD care in Australia. These innovations should encompass integrated care, targeted treatment outcome data, and additional lifestyle support, whilst recognising the tensions between customised functionalities and streamlined displays.

Cost and Effort Considerations for the Development of Intervention Studies Using Mobile Health Platforms: Pragmatic Case Study.

BACKGROUND: The research marketplace has seen a flood of open-source or commercial mobile health (mHealth) platforms that can collect and use user data in real time. However, there is a lack of practical literature on how these platforms are developed, integrated into study designs, and adopted, including important information around cost and effort considerations. OBJECTIVE: We intend to build critical literacy in the clinician-researcher readership into the cost, effort, and processes involved in developing and operationalizing an mHealth platform, focusing on Intui, an mHealth platform that we developed. METHODS: We describe the development of the Intui mHealth platform and general principles of its operationalization across sites. RESULTS: We provide a worked example in the form of a case study. Intui was operationalized in the design of a behavioral activation intervention in collaboration with a mental health service provider. We describe the design specifications of the study site, the developed software, and the cost and effort required to build the final product. CONCLUSIONS: Study designs, researcher needs, and technical considerations can impact effort and costs associated with the use of mHealth platforms. Greater transparency from platform developers about the impact of these factors on practical considerations relevant to end users such as clinician-researchers is crucial to increasing critical literacy around mHealth, thereby aiding in the widespread use of these potentially beneficial technologies and building clinician confidence in these tools.

Opportunities for Technology-Assisted Healthy Ageing in a Local Government Context.

Current legislation aims to enable older Australians to age in place, and puts public healthcare within the remit of local governments. As Australia's population ages, local governments will need to explore new methods of service delivery in order to meet the increasing need for services that promote healthy ageing. Information technology (IT) may provide one such solution, however older Australian adults are reported to have low levels of technology use. In this simple descriptive qualitative study, focus groups with local government staff and community-dwelling older adults explored their perspectives regarding: a) IT solutions that councils could use to promote community-based healthy ageing, and (b) the enablers and challenges for adopting such solutions. Twenty-four adults participated in focus groups, and eleven of these adults also provided written data in response to visual prompts. Field notes were recorded by attending researchers. These three data sources were combined through narrative synthesis. Local government staff and community-dwellers alike perceived the utility of IT solutions in connecting community members, and connecting people to services (such as transport and providers of health information). While local government staff identified that IT solutions could provide benefits to the council when implemented in conjunction with existing services (e.g., to track data and identify information about community engagement and needs), community-dwellers placed stronger emphasis on adopting technology which had a clear purpose for its use. Due to limited digital literacy and some ambivalence towards embracing technology, IT solutions should be implemented with support to increase digital literacy, be widely advertised, and be centered in community needs. Personas have been generated and provided as possible case studies for technology adoption.

Systems to Harness Digital Footprint to Elucidate and Facilitate Ageing in Place.

The rapid ageing of the population is a worldwide inexorable demographic transformation. At a time of immense social, political and economic change, the growing elderly population is at the forefront of global burden, placing an increasing strain on the federal, state, and local budgets. Many public policy responses to the impending ageing epidemic have begun, particularly with regards to dementia prevention and quality of life for older adults. However, to date, the fruition of such efforts remains to be discovered. Indeed, there is a need to find more novel and multifaceted ways of understanding the fragmentary changes and underlying mechanisms in the biopsychosocial contexts of ageing. Discovering better ways to measure these intricate domains will create better insight into how to improve clinical and public health information systems for the development of more personalisation support and services across the continuum of aged care. Technology now permeates all aspects of our everyday living. Digital footprints are data arising as a by-product of interactions we do as part of everyday living. The digital traces we live behind, be it on internet, social media, on mobile phone apps, as well as in health records (EHRs) could be used to infer how we behave and interact with environment, and how we feel in different situations. Commercial sector has very successfully used these footprints in the advertisement and marketing space. This type of information may provide clinicians with an unobtrusive way of monitoring older adults in their daily living, and provide an alternative means to traditional self-report and expert-rated assessment. In this paper we present two innovative digital footprint applications, Actionable Intime Insights and the SAIL Mobile app, which aim to facilitate "Ageing in Place" through adaptive, dynamic, early intervention strategies. These systems are devised to unveil contextual indicators of how a person is functioning mentally, socially, behaviourally and physically in their own environment, as to as assist those with chronic conditions better self-manage by facilitating assistance with care and medication needs just in time.