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      A Tailored mHealth App for Improving Health and Well-Being Behavioral Transformation in UK Police Workers: Usability Testing via a Mixed Methods Study

      research-article
      , BPT, PGDHHM, MSc 1 , , MA, PhD 2 , , , BSc (Hons), PG Cert, EngD, MSc 1 , , BSc (Hons), PhD 2 , , BSc (Hons), MSt 3
      (Reviewer), (Reviewer)
      JMIR Human Factors
      JMIR Publications
      nutrition, activity, behavior change, telemedicine, mobile health, police, lifestyle management, management, usability testing, design, build, prototype, testing, survey, interview, development, user center, officer, law enforcement, cop, detective, policeman, policing, mobile phone

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          Abstract

          Background

          When considering the policing environment of 2022, many roles previously in the domain of warranted officers (police officer) are now performed by nonwarranted police staff equivalents. These police staff roles have expanded rapidly into other areas such as investigations, custody, and contact management, which were traditionally seen as police officer functions and put staff under some of the same stresses as police officers. A UK police force requested help in investigating technologies that could be used to improve health and well-being for both officers and staff.

          Objective

          The aim of this study was to create a health and well-being app for police officers and staff, which considered the unique requirements of the users throughout the designing, building, prototyping, and testing stages.

          Methods

          This study involved quantitative approaches (demographic web-based survey questions and the System Usability Scale) and qualitative approaches (open web-based survey questions and semistructured interviews). Unsupervised usability testing of a prototype app was undertaken by members (N=48) of the commissioning client using their smartphones. After completing a preregistration application for screening purposes, participants downloaded a trial version of the app. Then, they completed a web-based questionnaire after testing the app for 10 days. A subsample of participants (9/48, 19%) was interviewed. Deductive thematic analysis was undertaken to identify key themes and subthemes.

          Results

          Data collected during usability testing concerned the 6 domains of the app—food and diet, activity, fluid intake, sleep, good mental health, and financial well-being—and informed the creation of improved design during prototyping. Some usability and design issues and suggestions for improvements were also addressed and implemented—including shift management and catch-up cards—during this cycle of development.

          Conclusions

          This study highlights the importance of coparticipation with officers and staff across the entire development cycle, to coproduce a human-centered design methodology to enable the development of a considered and user-centered solution. It demonstrates the need for producing a multifunctional tool rather than focusing purely on an individual element for this user group. It also highlights how linking and being able to track optional, personalized elements of health data against one another, cross-referenced to individual shift patterns, might help to inform and provide users with a chance for reflection and therefore influence behavior change.

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          Most cited references69

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          The Person-Based Approach to Intervention Development: Application to Digital Health-Related Behavior Change Interventions

          This paper describes an approach that we have evolved for developing successful digital interventions to help people manage their health or illness. We refer to this as the “person-based” approach to highlight the focus on understanding and accommodating the perspectives of the people who will use the intervention. While all intervention designers seek to elicit and incorporate the views of target users in a variety of ways, the person-based approach offers a distinctive and systematic means of addressing the user experience of intended behavior change techniques in particular and can enhance the use of theory-based and evidence-based approaches to intervention development. There are two key elements to the person-based approach. The first is a developmental process involving qualitative research with a wide range of people from the target user populations, carried out at every stage of intervention development, from planning to feasibility testing and implementation. This process goes beyond assessing acceptability, usability, and satisfaction, allowing the intervention designers to build a deep understanding of the psychosocial context of users and their views of the behavioral elements of the intervention. Insights from this process can be used to anticipate and interpret intervention usage and outcomes, and most importantly to modify the intervention to make it more persuasive, feasible, and relevant to users. The second element of the person-based approach is to identify “guiding principles” that can inspire and inform the intervention development by highlighting the distinctive ways that the intervention will address key context-specific behavioral issues. This paper describes how to implement the person-based approach, illustrating the process with examples of the insights gained from our experience of carrying out over a thousand interviews with users, while developing public health and illness management interventions that have proven effective in trials involving tens of thousands of users.
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            Supporting thinking on sample sizes for thematic analyses: a quantitative tool

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              Sleep disorders, health, and safety in police officers.

              Sleep disorders often remain undiagnosed. Untreated sleep disorders among police officers may adversely affect their health and safety and pose a risk to the public. To quantify associations between sleep disorder risk and self-reported health, safety, and performance outcomes in police officers. Cross-sectional and prospective cohort study of North American police officers participating in either an online or an on-site screening (n=4957) and monthly follow-up surveys (n=3545 officers representing 15,735 person-months) between July 2005 and December 2007. A total of 3693 officers in the United States and Canada participated in the online screening survey, and 1264 officers from a municipal police department and a state police department participated in the on-site survey. Comorbid health conditions (cross-sectional); performance and safety outcomes (prospective). Of the 4957 participants, 40.4% screened positive for at least 1 sleep disorder, most of whom had not been diagnosed previously. Of the total cohort, 1666 (33.6%) screened positive for obstructive sleep apnea, 281 (6.5%) for moderate to severe insomnia, 269 (5.4%) for shift work disorder (14.5% of those who worked the night shift). Of the 4608 participants who completed the sleepiness scale, 1312 (28.5%) reported excessive sleepiness. Of the total cohort, 1294 (26.1%) reported falling asleep while driving at least 1 time a month. Respondents who screened positive for obstructive sleep apnea or any sleep disorder had an increased prevalence of reported physical and mental health conditions, including diabetes, depression, and cardiovascular disease. An analysis of up to 2 years of monthly follow-up surveys showed that those respondents who screened positive for a sleep disorder vs those who did not had a higher rate of reporting that they had made a serious administrative error (17.9% vs 12.7%; adjusted odds ratio [OR], 1.43 [95% CI, 1.23-1.67]); of falling asleep while driving (14.4% vs 9.2%; adjusted OR, 1.51 [95% CI, 1.20-1.90]); of making an error or safety violation attributed to fatigue (23.7% vs 15.5%; adjusted OR, 1.63 [95% CI, 1.43-1.85]); and of exhibiting other adverse work-related outcomes including uncontrolled anger toward suspects (34.1% vs 28.5%; adjusted OR, 1.25 [95% CI, 1.09-1.43]), absenteeism (26.0% vs 20.9%; adjusted OR, 1.23 [95% CI, 1.08-1.40]), and falling asleep during meetings (14.1% vs 7.0%; adjusted OR, 1.95 [95% CI, 1.52-2.52]). Among a group of North American police officers, sleep disorders were common and were significantly associated with increased risk of self-reported adverse health, performance, and safety outcomes.
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                Author and article information

                Contributors
                Journal
                JMIR Hum Factors
                JMIR Hum Factors
                JMIR Human Factors
                JMIR Human Factors
                JMIR Publications (Toronto, Canada )
                2292-9495
                2023
                4 August 2023
                : 10
                : e42912
                Affiliations
                [1 ] Bournemouth University, Faculty of Science and Technology Bournemouth United Kingdom
                [2 ] Bournemouth University, Faculty of Health and Social Sciences Bournemouth United Kingdom
                [3 ] Hampshire Constabulary Southampton United Kingdom
                Author notes
                Corresponding Author: Andy Pulman apulman@ 123456bournemouth.ac.uk
                Author information
                https://orcid.org/0000-0003-3837-8896
                https://orcid.org/0000-0001-7506-6897
                https://orcid.org/0000-0002-9138-9319
                https://orcid.org/0000-0003-3531-5566
                https://orcid.org/0000-0003-0422-3490
                Article
                v10i1e42912
                10.2196/42912
                10439470
                37540549
                e19848e7-a849-4d99-8011-de907342ad6b
                ©Richa Mehra, Andy Pulman, Huseyin Dogan, Jane Murphy, Fiona Bitters. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 04.08.2023.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Human Factors, is properly cited. The complete bibliographic information, a link to the original publication on https://humanfactors.jmir.org, as well as this copyright and license information must be included.

                History
                : 4 October 2022
                : 17 April 2023
                : 24 April 2023
                : 30 April 2023
                Categories
                Original Paper
                Original Paper

                nutrition,activity,behavior change,telemedicine,mobile health,police,lifestyle management,management,usability testing,design,build,prototype,testing,survey,interview,development,user center,officer,law enforcement,cop,detective,policeman,policing,mobile phone

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