Preventing Ankle Sprains With a Smartphone; Implementation Effectiveness of an Evidence Based App
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Abstract
Background
Ankle sprains continue to pose a significant burden to the individual athlete, as well as society as a whole. However, the uptake of effective preventive measures by the athletic population is lagging behind. In an attempt to bridge this implementation gap a freely available evidence based App for iOS and Android was developed; Versterk Je Enkel.
Objective
To describe the implementation effectiveness of the Versterk je Enkel App.
Methods
The App was evaluated within its practical context using the RE-AIM Framework. For the purpose of the current evaluation Maintenance was not described. Maintenance is the extent to which the intervention is sustained over time. The App implements an 8 week training program for the prevention of ankle sprain recurrences. Exercises are no longer required after 8 weeks of training and, as such, prolonged use is no goal.
The App contains a neuromuscular training program described and evaluated for preventive effectiveness in a previous randomized controlled trial. The training program offers a set of exercises for the prevention of ankle sprain recurrences and has been linked to 50% reduction in recurrence risk. The App contained a full translation of these materials into an interactive package containing videos of individual exercises and an interactive training schedule providing feedback through push messaging.
The App was launched in September 2011. The launch of the App was accompanied by a press release. In addition, advertisements and banners to guide potential users to the App were placed in printed media and relevant sports and sports medical websites. Data for the evaluation of the App was registered in May 2012, resulting in a follow-up of 7 months.
Results
Reach: The App only reached 7% of the intended target population, i.e. athletes who suffered an ankle sprain. This can be regarded as a low percentage in light of the attention given to the App.
Effectiveness: Users rated the App the with a score of 8.1 out of 10. In written reviews users appreciated the clarity and ease of use of the App.
Adoption: Of all users 38% did not actively use the App, whereas 33% used the App frequently (i.e. multiple times per week). As such, there is a large share of users that do not actively use the App. Many may have downloaded the App only out of interest, without the specific intent to actually use the embedded exercise program.
Implementation: Only 32% of all active users indicated to have followed the entire program, and 59% states to have followed part of the program.
Conclusions
Although the App generated a large interest in the athletic community, actual reach and implementation of the program within the target population were low. Probably due to the broad and unfocused dissemination of the App. User feedback, however, was very positive. User friendliness and interactivity were acclaimed App features. As such, it was concluded that App may provide a very useful tool for practice when delivered specifically to the target population, e.g. through coaches or therapists.
Ankle sprains continue to pose a significant burden to the individual athlete, as well as society as a whole. However, the uptake of effective preventive measures by the athletic population is lagging behind. In an attempt to bridge this implementation gap a freely available evidence based App for iOS and Android was developed; Versterk Je Enkel.
Objective
To describe the implementation effectiveness of the Versterk je Enkel App.
Methods
The App was evaluated within its practical context using the RE-AIM Framework. For the purpose of the current evaluation Maintenance was not described. Maintenance is the extent to which the intervention is sustained over time. The App implements an 8 week training program for the prevention of ankle sprain recurrences. Exercises are no longer required after 8 weeks of training and, as such, prolonged use is no goal.
The App contains a neuromuscular training program described and evaluated for preventive effectiveness in a previous randomized controlled trial. The training program offers a set of exercises for the prevention of ankle sprain recurrences and has been linked to 50% reduction in recurrence risk. The App contained a full translation of these materials into an interactive package containing videos of individual exercises and an interactive training schedule providing feedback through push messaging.
The App was launched in September 2011. The launch of the App was accompanied by a press release. In addition, advertisements and banners to guide potential users to the App were placed in printed media and relevant sports and sports medical websites. Data for the evaluation of the App was registered in May 2012, resulting in a follow-up of 7 months.
Results
Reach: The App only reached 7% of the intended target population, i.e. athletes who suffered an ankle sprain. This can be regarded as a low percentage in light of the attention given to the App.
Effectiveness: Users rated the App the with a score of 8.1 out of 10. In written reviews users appreciated the clarity and ease of use of the App.
Adoption: Of all users 38% did not actively use the App, whereas 33% used the App frequently (i.e. multiple times per week). As such, there is a large share of users that do not actively use the App. Many may have downloaded the App only out of interest, without the specific intent to actually use the embedded exercise program.
Implementation: Only 32% of all active users indicated to have followed the entire program, and 59% states to have followed part of the program.
Conclusions
Although the App generated a large interest in the athletic community, actual reach and implementation of the program within the target population were low. Probably due to the broad and unfocused dissemination of the App. User feedback, however, was very positive. User friendliness and interactivity were acclaimed App features. As such, it was concluded that App may provide a very useful tool for practice when delivered specifically to the target population, e.g. through coaches or therapists.
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