Pressure reliefs (PRs) are self-care practices essential for individuals with spinal cord injury (SCI) to prevent life-threatening pressure injuries (PIs). Despite the benefits, individuals often do not do these exercises at home, leading to increased patient morbidity and mortality. To examine how digital technology could improve this population's adherence to PR exercises, we conducted a technology probe study with five individuals with SCI over ten consecutive business days. A chat-based intervention was created to send user-scheduled PR reminders, which were personalized with visual elements and progress trackers. Participants were interviewed before and after interacting with the probe to better understand their experiences with PIs and PR practices. Results shed light on specific factors that may impact individuals with SCI's behaviours towards PRs and four considerations to design a customisable reminder intervention: (1) easy to use and friendly technology, (2) design-your-own- schedule feature, (3) communication style feature, and (4) dialogue support features. Personalisation supported with gamified visual progress tracking and motivational messages emerged as a strong strategy to increase PR adherence. Both sets of findings expand upon the human-computer interaction (HCI) literature for mobile health tools that encourage self-care practices; in particular, to the specific needs of individuals with SCI and the use of visual elements to increase engagement.
Keywords: Assistive technology; adherence; chat-based reminder; pressure relief; spinal cord injury; technology probe study.
Digital technology, such as chat-based reminders personalized with visual elements and progress trackers, has the potential to improve adherence to pressure reliefs among individuals with spinal cord injury (SCI).Human-centered design is essential for creating effective digital interventions for this population, and four key features of a customizable reminder intervention include easy-to-use technology, a design-your-own schedule feature, communication style options, and dialogue support features.Gamified visual progress trackers and motivational messages may be useful strategies to increase adherence to pressure reliefs and make these exercises more enjoyable for individuals with SCI.This study contributes to the growing body of research on gamification, mHealth, and human-computer interaction, and highlights the potential for digital interventions to improve self-care practices among individuals with disabilities.