TY -的AU -德拉维加,李盟-巴勒莫,Rocio AU - Ritterband汤娅M PY - 2020 DA - 2020/9/1 TI -评估数字健康实现小儿慢性疼痛干预:比较这些地方和一些框架对实际试验数据和建议未来的研究乔- J地中海互联网Res SP - e19898六世- 22 - 9千瓦,移动健康KW -电子健康KW - mHealth KW -实现科学KW -慢性疼痛KW -青少年KW -手机AB -背景:数字健康干预措施已证明对包括儿科慢性疼痛在内的几种疾病有效。然而，以有效和持续的方式向最终用户提供干预措施的过程具有挑战性，仍然是一个新的研究领域。为了推进这一领域，已经建立了全面的框架。目的:本研究的目的是比较范围、有效性、采用、实施和维护(RE-AIM)和使用技术的行为干预(BIT)框架与从基于网络的青少年疼痛管理(WebMAP Mobile;随机对照试验(RCT)。方法:我们进行了一项混合有效性-实施的集群随机对照试验，采用阶梯楔形设计，在常规护理期后，在8个诊所依次实施干预措施。参与者为143名青少年(平均年龄14.5岁，SD 1.9;117/143(81.8%女性)慢性疼痛患者，其中73人随机接受积极干预。使用RE-AIM和BIT框架评估实施结果。 Results: According to the RE-AIM framework, the WMM showed excellent reach, recruiting a sample 19% larger than the size originally planned and consenting 79.0% (143/181) of eligible referred adolescents. Effectiveness was limited, with only global impression of change showing significantly greater improvements in the treatment group; however, greater treatment engagement was associated with greater reductions in pain and disability. Adoption was excellent (all the invited clinics participated and referred patients). Implementation was acceptable, showing good user engagement and moderate adherence and positive attitudes of providers. Costs were similar to planned, with a 7% increase in funds needed to make the WMM publicly available. Maintenance was evidenced by 56 new patients downloading the app during the maintenance period and by all clinics agreeing to continue making referrals and all, but one, making new referrals. According to the BIT, 82% (60/73) of adolescents considered the treatment acceptable. In terms of adoption, 93% (68/73) downloaded the app, and all of them used it after their first log-in. In terms of appropriateness at the user level, 2 participants were unable to download the app. Perceptions of the appearance, navigation, and theme were positive. Providers perceived the WMM as a good fit for their clinic, beneficial, helpful, and resource efficient. In terms of feasibility, no technical issues were reported. In terms of fidelity, 40% (29/73) completed the treatment. Implementation costs were 7% above the budget. With regard to penetration, 56 new users accessed the app during the maintenance period. In terms of sustainability, 88% (7/8) of clinics continued recommending the WMM after the end of the study. Conclusions: For the first time, a real-world digital health intervention was used as a proof of concept to test all the domains in the RE-AIM and BIT frameworks, allowing for comparisons. International Registered Report Identifier (IRRID): RR2-10.1016/j.cct.2018.10.003 SN - 1438-8871 UR - //www.mybigtv.com/2020/9/e19898 UR - https://doi.org/10.2196/19898 UR - http://www.ncbi.nlm.nih.gov/pubmed/32870158 DO - 10.2196/19898 ID - info:doi/10.2196/19898 ER -