Smartphone App for Adolescents With Idiopathic Scoliosis

This study is a quasi-experimental, one-group pretest-posttest study designed to evaluate the feasibility, acceptability, and preliminary effectiveness of a smartphone application (DinSkoliose) for adolescents with idiopathic scoliosis (AIS).

AIS is a common spinal condition that often requires long-term conservative treatment, including brace use and physiotherapy scoliosis-specific exercises. Treatment success is highly dependent on adherence; however, adherence is often limited by physical discomfort, psychological factors, and lack of continuous support.

The DinSkoliose app is a personalized, theory-informed digital health intervention developed specifically for this study using a user-centered co-design approach. The app is grounded in behavioral theories of motivation and self-management and includes features to support treatment adherence, such as tracking of brace use and exercises, monitoring of symptoms (e.g., pain and mood), educational information, reminders, and structured social support.

Participants will use the app over a 12-week period in their natural environment alongside their usual care, with no additional clinical intervention. Outcomes will be assessed at baseline and post-intervention using validated questionnaires measuring health behaviors, self-management, self-efficacy, social support, and patient activation. App usability, engagement, and acceptability will also be evaluated.

In addition, semi-structured interviews will be conducted after the intervention to explore participants' experiences and identify strengths and areas for improvement. The results will inform further development of the app and future evaluation in larger controlled studies.

The study population will consist of adolescent patients with AIS.

The Inclusion criteria for participants in our study are those:

• who are diagnosed with AIS;
• who give written informed consent,
• who are at the age between 10 - 24 years old;
• under 16 years old for whom parental consent has been provided (as required by the National Research Ethics Committee);
• who can speak, read, and write in Norwegian or English;
• who have access to and ability to use smart phone;
• who have internet access.

The Exclusion criteria for participants in our study are those who:

• have a history of other type of scoliosis (such as congenital, neuromuscular, degenerative);
• are younger than 10 years old and older than 24 years old;
• have any additional diagnosis that could affect the intervention outcome (severe mental health disorders or diagnosis of a developmental disorder that prevents understanding and compliance with intervention, leg length discrepancy).