Expert review of child and caregiver critiques of a therapeutic guided imagery therapy mobile application targeting disorders of gut-brain interaction in children

Authors: HOLLIER, JOHN - Baylor College Of Medicine; STRICKLAND, TIANTA - Baylor College Of Medicine; FORDIS, C - Baylor College Of Medicine; SHULMAN, ROBERT - Children'S Nutrition Research Center (CNRC); Thompson, Deborah - Debbe

Submitted to: Digital Health
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/19/2024
Publication Date: 5/22/2024
Citation: Hollier, J.M., Strickland, T.A., Fordis, C.M., Shulman, R.J., Thompson, D.J. 2024. Expert review of child and caregiver critiques of a therapeutic guided imagery therapy mobile application targeting disorders of gut-brain interaction in children. Digital Health. https://doi.org/10.1177/20552076241245376.
DOI: https://doi.org/10.1177/20552076241245376

Interpretive Summary: A guided imagery therapy mobile application (GIT App) is a novel platform for treating children with disorders of gut-brain interaction (DGBI). Previous feedback from child/caregiver dyads suggested modifications for our App prototype. It was important for their critiques to be vetted by relevant experts prior to further App refinement. An expert review of our therapeutic App revealed findings consistent with end-users and provided insight for modifying the interface and GIT sessions. Based on this experience, we recommend expert vetting of end-user suggestions as a routine checkpoint when developing therapeutic Apps.

Technical Abstract: A guided imagery therapy mobile application (GIT App) is a novel platform for treating children with disorders of gut-brain interaction (DGBI). Previous feedback from child/caregiver dyads suggested modifications for our App prototype. However, their feedback had the potential to affect the intervention's efficacy. Thus, we aimed to have their critiques vetted by relevant experts prior to further App refinement. Our objective was to compare expert reviews of the GIT App with end-users' (i.e., child/caregiver dyads') feedback. This mixed-methods study with experts included a hands-on App evaluation, a survey assessing usability, and focus groups comparing their perspectives with those previously provided by end-users. Eight medical and technology experts were enrolled. Their average usability survey score of the GIT App was 69.0+/-27.7, which was marginally above the 50th percentile. While the expert and end-user usability assessments were generally favorable, both groups agreed that the App's reminder notification feature location was not intuitive, detracting from its usability. Experts agreed with end-users that the App's aesthetics were acceptable and suggested increasing icon and font sizes. Like the end-users, the experts did not achieve consensus regarding the ideal session length or inclusion of background sounds and screen animations. Lastly, the experts agreed with end-users that gamification techniques (e.g., gift cards and virtual badges) would promote user engagement. An expert review of our therapeutic App revealed findings consistent with end-users and provided insight for modifying the interface and GIT sessions. Based on this experience, we recommend expert vetting of end-user suggestions as a routine checkpoint when developing therapeutic Apps.