Digital intervention to promote exercise in people with chronic kidney disease: a pilot, feasibility and acceptability study
Thái Bình Trần1,2,3, Jennifer Nguyễn2, Meg Letton1,2,4, Kim Delbaere4,5, Carolina Sandler2,6,7,8, Zoltan Endre3, Ria Arnold1,2 1School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong,, New South Wales, Australia2School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Randwick,, New South Wales, Australia3Department of Nephrology, Prince of Wales Hospital and Clinical School, University of New South Wales, Randwick,, New South Wales, Australia4Neuroscience Research Australia, Randwick, New South Wales, Australia5School of Population Health, Faculty of Medicine and Health, University of New South Wales, Randwick,, New South Wales, Australia6School of Health Sciences, Western Sydney University, Campbelltown,, New South Wales, Australia7The Kirby Institute, University of New South Wales, Randwick,, New South Wales, Australia8Menzies Health Institute Queensland, Griffith University, Brisbane,, Queensland, Australia
Abstract
Background
Exercise is an important yet under-recognised aspect of tertiary kidney care. Digital technology may provide a feasible strategy to encourage participation in an exercise program.
Aim
This study aimed to explore the feasibility of the TeleClinical-Care application (TCC-app) to deliver exercise for people with chronic kidney disease (CKD) 3b-4.
Method
Participants aged 18-75 with stable CKD were recruited to use TCC-app for two weeks. Participants completed six fortnightly exercise sessions and recorded daily blood pressure measures. Feasibility was assessed using a compliance metric that was set a-priori (60% or ≥40 exercises). Acceptability was determined via user-experience questionnaires and semi-structured interviews. Quantitative data capture, including objective and subjective measures, was performed pre- and post-program.
Results
In April-August 2022, 37 participants gave permission to be contacted, 25 (68%) provided informed consent, 19 completed two-weeks use and 15 (41%) were deemed compliant. User-experience questionnaires showed 90% of participants reporting ‘Good/Very good’ user-friendliness. Participants enjoyed being physically active and reportedly liked TCC-app’s high accessibility and capacity to monitor health status. However, participants also reported a complicated interface, inaccurate exercise demonstration and limited social facilitation. They suggested individualised content, gamified components, automated data transmission and a simple and attractive interface as modifications to improve usability. Quantitative data capture showed a trend towards improving for a ‘risk of mood disorders’ questionnaire among compliant participants.
Discussion
The TCC-app was feasible and acceptable to deliver exercise for people with CKD 3b-4. Future research may consider exploring the influence of socio-cultural and economic backgrounds on uptake before evaluations in large scale trials.
Biography
Thái Bình (Bình) Trần is a doctoral candidate at the University of Wollongong. Between 2018 and 2022, Bình trained as an exercise physiologist and clinical researcher at the University of New South Wales and Prince of Wales Clinical School. In 2023, he obtained an Australia Government Research Training Program scholarship to begin doctoral training. His current area of research is allied health service, including exercise physiology as part of regular care in tertiary kidney management. Outside of research, Bình works as an exercise physiologist delivering disability care, neurological rehabilitation, and mental healthcare for communities in the South-Western Sydney regions.