Development and initial evaluation of a digital service package for community-dwelling older females with pelvic floor dysfunction.

backgroundPelvic Floor Dysfunction (PFD) is common, especially among older people, causing physical and psychological issues and high costs. Pelvic floor muscle training (PFMT) is a first-line, non-surgical treatment; however, resource limitations pose challenges. Digital interventions show potential, yet there’s a lack of a comprehensive digital service package for community-dwelling older females with PFD. This study aims to develop such a package, guided by the BCW model and a remote digital health studies framework, and initially evaluate its implementation quality to benefit patients with PFD and primary care.

methodsThis study’s design was based on the MRC Framework, human-centered design, and co-design. It involved a two-stage process: developing a digital service package for community-dwelling older PFD females and initially evaluating its implementation qualities. The development used a three-step procedure: a rapid literature review, patient interviews, and a two-round Delphi survey among experts. Guided by relevant models, the initial package was constructed and refined. Established procedures and success criteria for digital packages were adopted in the evaluation stage.

resultsDeveloping a digital service package for community-dwelling older PFD females resulted in a final version with three main sections. It includes content and form, use mechanisms, and an application platform. The content and form of the digital service package include evidence-based science popularization on pelvic floor anatomy, disease mechanisms, preventive measures, and rehabilitation skills, delivered through diversified formats such as visual materials, follow-up videos, and expert lectures, with fragmented knowledge systematically integrated into a structured framework. It also emphasizes interpersonal interaction via patient support communities, doctor-patient counseling channels, and family involvement, alongside personalized home training programs tailored to individual needs, rehabilitation goals, and daily habits. The mechanisms of use incorporate material support like urination pads and self-management guides, as well as social support through the involvement of healthcare providers, peers, and family members; regular reminders via text or voice calls reinforce training compliance, while monitoring systems and feedback loops enable dynamic evaluation of progress, and incentive mechanisms reward patients for achieving stage-specific rehabilitation goals. The application platform leverages WeChat’s high usability among older adults, integrating group chat functionalities with mini-programs and AI-driven autoreplies for basic queries. It features separate portals for patients and administrators to support long-term follow-up and evaluate the quality of implementation. An evaluation with 18 participants showed it met all pre-defined success criteria for practicality, attitudes, acceptability, usability, and cost.

conclusionThe digital service package innovatively realizes three core functions: reinforcing early intervention, supporting remote monitoring, and enhancing patients’ self-management ability. It has a scientific content structure, dynamic personalized management, and a multifunctional platform. This digital service package can be used to improve the adherence to rehabilitation training of community-dwelling older females with PFD during the rehabilitation process due to external factors such as heavy financial burden and insufficient time for health management. The initial evaluation shows its high implementation quality, marking an essential digital chronic disease intervention for older people. Future efforts should focus on technology upgrades, long-term tracking, and cross-domain cooperation to boost primary healthcare effectiveness and elderly healthcare equity.