Darcy Ummels

Using an activity tracker in daily clinical practice | 121 6 Conversations during therapy about measuring physical activity To obtain insight into how the MISS Activity is used during therapy, each conversation in the consultation room between the patient and therapist involving the MISS Activity (15–30 min of the conversation) was recorded with an audio recorder. Reflection sessions with psychosomatic therapists After every act and observe phase (2), a reflection session was held with the participating therapists. The goal of these reflection sessions was to share and elaborate on how the MISS Activity was used and to share experiences regarding use in daily clinical practice. The research team (DU, AB) supported these reflection sessions by leading the session and ensuring that the draft manual and the process of clinical reasoning were discussed. As a supplementary support tool, the patient journey method 54 was used to create insight into how and when the therapists could use the MISS Activity. The patient journey method is a method to visualize the points over time when both the therapists and the patients come in contact with the MISS Activity. Participants drew a timeline and described when and how they came in contact with the MISS Activity. Together with the therapist, the research team (DU, EB, SB, AB) improved the draft manual by adapting it to the specific context of the specialized mental healthcare center and the needs of the therapists based on the experiences of the therapists. These group sessions with the therapists and researchers took place at the specialized mental healthcare center, lasted 45 ‐ 90 min, and were audio ‐ recorded. Gender, age, years of work experience, and the number of years working at the specialized mental healthcare center were also noted during the first session. Semi ‐ structured interviews with the patients After the act and observe phase (2), a semi ‐ structured interview was conducted by DU with the involved patients to collect information on how they used the MISS Activity in their therapy and to share experiences. These results were used by the research team to improve the draft manual. The patients could choose a convenient location for the interview (e.g., home or specialized mental healthcare center). The topic list and interview guide for the interview were based on a previously developed framework which is based on expert meetings and literature. 28 This framework was originally developed to assess the feasibility of activity trackers and was slightly adapted for this study. Additions were based on literature about the needs of healthcare professionals and patients regarding the use of measurement tools and eHealth as a measurement