Project Details


Longstanding knee pain is the most common musculoskeletal complaint presented by adolescents (age 10-19) in general practice. One in two adolescents will continue to experience pain after 2 years. but exercises and self-management education may improve the prognosis of adolescents with knee pain. However, adherence to current evidence-based treatments remain poor. Mobile health (mHealth) applications hold potentials for supporting adolescents’ self-management, enhancing treatment adherence, and fostering patient-centered approaches. Still, it remains unclear how mHealth apps should be designed to act as tools for supporting individual- and collaborative management of adolescents’ knee pain in complex care settings.

The silver bullet study identified principles for designing mHealth core-features which are both robust enough to support adolescents’ everyday management of their knee pain, yet flexible enough to act as pathways for enhancing patient-parent-clinician collaboration and shared decision-making. The principles were visualized in a conceptual model which informs future mHealth design.

Key findings

The data analysis revealed how adolescents, parents and clinicians took on different roles within the collaborative situation, with different roles, tasks, and management challenges. Five themes were identified; “adolescents as explorers of pain and social rules”, “parents as advocates and mediators” and “GPs as guides, gatekeepers and reflective practitioners” describing participants role, “collaborative barriers and tensions” referred to the contextual elements, while “visions for an mHealth application” identified beneficial core-features. The synthesis informed a conceptual model, outlining three principles for designing mHealth core-features as pathways for reducing collaborative tensions through role negotiations and shared decision-making.

In summary, the formation of a shared language for addressing the condition was highlighted as a major barrier in the clinical encounter, future designs should aim to empower users to fall into the role as explores, mediators and guides and provide pathways for mutual insights into the individual challenges of each user group.
Short titleSearching for the silver bullet
Effective start/end date01/07/201901/06/2021


  • mhealth
  • mobile apps
  • Knee pain
  • self-management
  • shared decision-making
  • Rehabilitation
  • uhealth
  • General practice


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