Perceptions about smartphone-based interventions to promote physical activity in inactive adults with knee pain - A qualitative study

PurposeSmartphone-based interventions offer a promising approach to address inactivity in people with knee osteoarthritis (OA). We explored perceptions towards smartphone-based interventions to improve physical activity, pain, and depressed mood in inactive people with knee pain.MethodsThis qualitative study included six focus groups at Boston University with inactive people with knee pain (n = 35). A smartphone app, developed by our team, using constructs of Social Cognitive Theory, was used to obtain participant feedback.ResultsParticipants discussed wanting to use smartphone-based interventions for personalized exercise advice, for motivation (e.g., customized voice messages, virtual incentives), and to make exercise "less boring" (e.g., music, virtual gaming). Preferred app features included video tutorials on how to use the app, the ability to select information that can be viewed on the home screen, and the ability to interact with clinicians. Features that received mixed responses included daily pain tracking, daily exercise reminders, peer-interaction for accountability, and peer-competition for motivation. All participants discussed privacy and health data security concerns while using the app.ConclusionsUsing a co-design approach, we report preferences and concerns related to using smartphone-based physical activity interventions in inactive people with knee pain. This information may help improve acceptability of such interventions in this population. Knee Osteoarthritis (OA) is a leading cause of disability and chronic pain in middle- and older-age adults worldwide. Despite recommendations to be physically active, people with knee OA, especially those who experience depressive symptoms, are largely inactive.Smartphone-based interventions have the potential to improve physical activity in this population leading to improved pain, mood, and function. However, little is known about preferences for such interventions in individuals with knee pain who are inactive and who may also experience depressed mood. We examined the perceptions of inactive people with knee pain on using smartphone-based interventions to improve physical activity, pain, and mood, using an intervention framework grounded in Social Cognitive Theory as an example.We reported preferred app features in this population such as flexibility to view specific data, video tutorials on how to use the app, ability to interact with the clinician. We reported features that received mixed reviews such as daily pain tracking, daily reminders to exercise, peer-interaction and peer-competition for accountability and motivation respectively.Overall, people in our study wanted to use smartphone apps to improve motivation for exercise, to make exercise less boring, and to receive personalized exercise advise but they also had concerns related to privacy and health data security with using smartphone-based interventions