Changing habits with the Happy Hands app: A qualitative study of participants’ experiences with a hand osteoarthritis self-management intervention (Preprint)

BACKGROUND People with hand osteoarthritis represent a large patient group with limited access to recommended treatment. In recent years, there has been a notable shift in healthcare delivery, with increased use of digital technologies. The Happy Hands app is a digital self-management intervention developed to provide evidence-based treatment for people with hand osteoarthritis, with the goal of empowering them to self-manage their disease. Participants’ experiences and perceptions of using this digital intervention remain unknown, and understanding these perspectives is crucial for the adoption and continued use of the Happy Hands app. OBJECTIVE The objective of this qualitative study is to explore how people with hand osteoarthritis experience using the Happy Hands app. METHODS The study is embedded within a randomized controlled trial (RCT). The participants were recruited from the intervention group in the RCT, and had completed a 12-week digital self-management intervention in the Happy Hands app. The self-management intervention included a hand exercise program and informational videos about hand osteoarthritis. Focus group were conducted across all four health regions in Norway. The focus groups were transcribed verbatim, coded and analysed inductively using reflexive thematic analysis. RESULTS A total of 26 participants, 18 women and 8 men, were recruited from both specialist- and primary healthcare. The median age was 67 years. Three themes were developed from the analysis. The first theme, “Being acknowledged,” highlights the essential role of recognition for people with hand osteoarthritis. It suggests that the Happy Hands app provided participants with a sense of validation and support. The second theme, “Changed perception of hand osteoarthritis,” indicates that participants gained insights and knowledge about their condition. This new understanding empowered them to make more informed decisions about their care, fostering a sense of hope and motivation by demonstrating that effective measures are available to manage the disease. The third theme “Changing habits with the Happy Hands app” describes how participants developed new habits after using the self-management intervention delivered through the app. The exercise program was experienced as motivating, flexible, well-structured and committing. Some challenges were reported, including experiencing pain during or after exercising. The new habits included performing hand exercises and implementing ergonomic working methods, which were tailored to meet the individual needs and integrated into the participants’ daily lives and routines. CONCLUSIONS The findings suggest that the Happy Hands app is a valuable tool for supporting people with hand osteoarthritis in managing their disease by helping them integrate hand OA management into their daily lives. CLINICALTRIAL NCT05568875