Evaluating the Usability, Acceptability, User Experience, and Design of an Interactive Responsive Platform to Improve Perinatal Nurses’ Stigmatizing Attitudes Toward Substance Use In Pregnancy (Preprint)
Authors: Rubyan Michael , Gouseinov Yana , Morgan Mikayla , Rubyan Deborah , Jahagirdar Divya , Choberka David , Boyd Carol , Shuman Clayton 
Published: October 2024

BACKGROUND

Perinatal nurses are increasingly encountering patients who have engaged in perinatal substance use (PSU) and despite growing evidence demonstrating the need to reduce nurses’ stigmatizing attitudes toward PSU there are limited interventions available to target these attitudes and support behavior change – especially those that reflect the overwhelming evidence that education alone is not sufficient to change practice behavior. Arts-based interventions are associated with increasing nursing empathy, changing attitudes towards patients, and improving reflective practice as well as decreasing stigma. We adapted ArtSpective™ for PSU, a previously evaluated arts-based intervention to reduce stigma among perinatal nurses, into an interactive digital responsive platform that facilitates delivery of the intervention asynchronously.

OBJECTIVE

The aim of this study was to evaluate the usability, acceptability, and feasibility of the interactive responsive platform version of ArtSpective™ for PSU, designed to deliver an adapted version of the in-person intervention to improve nurses’ stigmatizing attitudes toward PSU, following a mixed methods approach. Our goal was to elicit user experience strengths and weaknesses related to the design of the responsive platform and identify approaches to overcome them.

METHODS

This study used a mixed-methods approach to explore both the usability and user experience of the platform and its acceptability as an intervention to address stigma and implicit bias related to PSU. Theatre testing was used to qualitatively explore usability and acceptability perspectives with nurses and experts and a modified version of the previously validated 8-item Abbreviated Acceptability Rating Profile for quantitative assessment. Analyses of quantitative data regarding acceptability and satisfaction were performed using descriptive statistics (mean, standard deviation, frequency, percentage). All qualitative data were analyzed iteratively, using an inductive framework analysis approach.

RESULTS

A total of 21 nurses and 4 experts in stigma, implicit bias, and instructional design completed theatre-testing sessions. The mean duration of interviews for nurses was 31.92 (SD 11.32) minutes and for experts 40.73 (SD 8.57) minutes. All participants indicated that they found the digital adaptation of the intervention to be highly acceptable with mean acceptability items ranging from 5.0 (SD 1.0) to 5.5 (SD 0.6) on a 1-6 agreement scale. Nurses reported high satisfaction with the platform on a 1-6 agreement scale with mean satisfaction items ranging from 5.14 (SD 0.56) to 5.29 (SD 0.63) on a 1-6 agreement scale. A total of 1,797 interview segments were coded from the theatre-testing sessions with four major themes: appearance, navigation, characterization, and overall platform and 16 subthemes identified. Consistent with the quantitative findings, the results were positive overall with participants expressing high satisfaction related to the appearance of the platform, the ease with which they were able to navigate the various modules, their engagement, the clarity of the presentation, and its feasibility to be completed asynchronously.

CONCLUSIONS

Developing and evaluating the usability of a digital adaptation of ArtSpective™ for PSU resulted in strong support for the usability, acceptability, and satisfaction of the program and provided insight into key aspects related to acceptability and usability that should be considered when designing a digital adaptation of an arts-based intervention for healthcare providers.