From theory to practice: insights into intervention development of the NON-STOP app for children with Perthes’ disease

Listen to Simon and Amy discuss the paper 'From theory to practice: insights into intervention development of the NON-STOP app for children with Perthes’ disease' published in the July 2025 issue of Bone & Joint Open.

Click here to read the paper.

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Transcript

[00:00:00] Welcome back to another episode of AI Talks with Bone & Joint from the publishers of Bone & Joint Open. Today we shall explore the paper from 'From theory to practice: insights into intervention development of the NON-STOP app for children with Perthes’ disease', published in July 2025 by AM Galloway and colleagues. I am Simon and I'm joined by my co-host Amy. 

Hello everyone. I'm looking forward to diving into this one. It's a fascinating examination of the development of a digital self-management tool known as the NON-STOP app designed for children with Perthes’ disease. Simon what prompted this research?

The researchers found that many healthcare interventions, particularly digital tools like apps, often lack a robust theoretical foundation. This can lead to poor engagement and effectiveness. Thus, they aim to provide practical guidance on developing complex interventions with a solid methodological basis using the NON-STOP app as their case study. 

Intriguing. So what methodologies did they employ in the development of the NON-STOP app? 

They [00:01:00] utilized the Medical Research Council framework for developing complex interventions. They also incorporated psychological theories, specifically the social determination theory, and engaged with stakeholders including Patient and Public Involvement Engagement, children with Perthes’ disease, their families and clinicians. This ensured the app was user-centric and grounded in solid psychological principles.

That sounds comprehensive. Could you provide more details about the specific features of the NON-STOP app? 

Certainly. The NON-STOP app was divided into four key sections. First, the learning section, which offered information about Perthes’ disease, management strategies, nutrition, and general wellbeing. The content was engaging, accurate, and tailored to the users.

Second, the activity section, which showcase strengthening and stretching exercises in cartoon format. Next, the progress section included an activity diary where users could log their daily or weekly app usage and monitor their progress, and didn't they have a fun element involving an avatar? 

Yes. The [00:02:00] fourth element was Bobby the bone, a customizable avatar that children could personalize as they continue to engage with the app.

This feature was designed to increase motivation by giving users a sense of autonomy, competence, and relatedness, which are core principles of the social determination theory. 

That's rather clever. They also conducted feasibility testing, didn't they? What did they find? 

Indeed, they carried out a feasibility test to explore app engagement and acceptability. While the detailed results are still being analyzed, the preliminary findings indicated positive user feedback and identified some areas for refinement. The app is currently being evaluated as part of a national clinical trial comparing surgical and non-surgical interventions for children with Perthes’ disease.

It's fascinating to see such a well-rounded approach. Were there any key challenges or considerations they highlighted for future work? 

Yes, they mentioned several. One significant challenge was the time and resources required to develop such an intervention. They also emphasized the importance of involving a diverse group of stakeholders [00:03:00] and maintaining a strong evidence base. Additionally, they noted the need for continuous refinement based on user feedback to enhance the app's effectiveness. 

So to summarize, the development of the NON-STOP app for children with Perthes’ disease was a rigorously planned and executed project. By utilizing the MRC framework and social determination theory and engaging stakeholders deeply, the researchers have set a strong example for future digital health interventions.

Exactly. Amy. The NON-STOP app development process highlights the value of integrating structured methodologies, psychological theories, and stakeholder engagement in creating effective healthcare interventions. It truly exemplifies moving from theory to practice. 

Thank you for that insight, Simon and with that we wrap up this episode of AI Talks with Bone & Joint.

If you enjoyed today's episode, make sure to subscribe and join us next time for more discussions on cutting edge research in orthopaedics. 

Thank you for listening everyone.