title: Mobile Technology Use by People Experiencing Multiple Sclerosis Fatigue: Survey Methodology.
abstract: BACKGROUND
  Fatigue is one of the most commonly reported symptoms of multiple sclerosis (MS). It has a profound impact on all spheres of life, for people with MS and their relatives. It is one of the key precipitants of early retirement. Individual, group, and Internet cognitive behavioral therapy-based approaches to supporting people with MS to manage their fatigue have been shown to be effective.
  
  
  OBJECTIVE
  The aim of this project was to (1) survey the types of mobile devices and level of Internet access people with MS use or would consider using for a health intervention and (2) characterize the levels of fatigue severity and their impact experienced by the people in our sample to provide an estimate of fatigue severity of people with MS in New Zealand. The ultimate goal of this work was to support the future development of a mobile intervention for the management of fatigue for people with MS.
  
  
  METHODS
  Survey methodology using an online questionnaire was used to assess people with MS. A total of 51 people with MS participated. The average age was 48.5 years, and the large majority of the sample (77%) was female.
  
  
  RESULTS
  Participants reported significant levels of fatigue as measured with the summary score of the Neurological Fatigue Index (mean 31.4 [SD 5.3]). Most (84%) respondents scored on average more than 3 on the fatigue severity questions, reflecting significant fatigue. Mobile phone usage was high with 86% of respondents reporting having a mobile phone; apps were used by 75% of respondents. Most participants (92%) accessed the Internet from home.
  
  
  CONCLUSIONS
  New Zealand respondents with MS experienced high levels of both fatigue severity and fatigue impact. The majority of participants have a mobile device and access to the Internet. These findings, along with limited access to face-to-face cognitive behavioral therapy-based interventions, create an opportunity to develop a mobile technology platform for delivering a cognitive behavioral therapy-based intervention to decrease the severity and impact of fatigue in people with MS.
authors.affiliation: Department of Psychology, Faculty of Health and Enviromental Sciences, Auckland University of Technology, Auckland, New Zealand.
authors.forename: Kirsten
authors.identifier: http://orcid.org/0000-0002-7069-172X
authors.initials: K
authors.lastname: Van Kessel
authors.affiliation: Centre for eHealth, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
authors.forename: Duncan R
authors.identifier: http://orcid.org/0000-0002-9259-9246
authors.initials: DR
authors.lastname: Babbage
authors.affiliation: Centre for Person-Centred Research, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
authors.forename: Nicholas
authors.identifier: http://orcid.org/0000-0003-3191-4596
authors.initials: N
authors.lastname: Reay
authors.affiliation: Centre for Person-Centred Research, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
authors.forename: Warren M
authors.identifier: http://orcid.org/0000-0002-6570-8873
authors.initials: WM
authors.lastname: Miner-Williams
authors.affiliation: Department of Rehabilitation, School of Health Sciences, University of Brighton, Brighton, United Kingdom.
authors.forename: Paula
authors.identifier: http://orcid.org/0000-0003-4038-0442
authors.initials: P
authors.lastname: Kersten
keywords: app; cognitive behavioral therapy; fatigue; intervention; mobile phone technology; multiple sclerosis; symptoms