Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Apr 30, 2026)
Date Submitted: Oct 17, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
WARIFA: A Co-Created App for Preventing Chronic Diseases
ABSTRACT
Background:
Non-communicable diseases (NCDs) such as cardiovascular diseases, diabetes, cancer, and chronic respiratory conditions are the leading causes of premature death globally. Mobile health (mHealth) applications, especially those enhanced by artificial intelligence (AI), offer promising tools for prevention and self-management. However, their effectiveness depends on user-centered design and inclusivity, particularly for underrepresented populations.
Objective:
This study aimed to describe the co-creation process of the WARIFA app, an AI-powered mHealth tool, designed to assess individual risk for NCDs and support behavior change through personalized recommendations.
Methods:
A mixed-methods, user-centered approach was employed across Norway, Spain, and Romania. The co-creation process included 18 focus groups (n=142) and 22 individual interviews with three target populations: individuals with type 1 diabetes (T1D), the general population, and seldom-heard groups. Participants were recruited through associations, social services, healthcare settings and via flyers placed in local centers. Data were collected via semi-structured focus groups and interviews, analyzed using descriptive deductive content analysis, and iteratively integrated into app development. Ethical approval was obtained for the app’s evaluation phase (Spain: CEIM 2024-330-1).
Results:
Key themes identified included usability, data privacy, functionality preferences, feedback given by the app, and device integration. Participants emphasized the need for simple navigation, personalized and evidence-based feedback, and real-time data visualization—especially for glucose monitoring in T1D users. The final app included risk calculators, lifestyle questionnaires, environmental data integration, and customizable features. Feedback content was grounded in World Health Organization and Europe Comission guidelines and tailored using the context engine. The app was tested on various Android devices and refined through continuous user input.
Conclusions:
The co-creation process ensured that the WARIFA app was aligned with users’ needs, enhancing its relevance, usability, and potential impact. The app’s effectiveness has been evaluated in a randomized controlled trial (NCT06918444). Clinical Trial: Evaluation of the WARIFA App and Its Impact on Healthy Lifestyle NCT06918444 clinicaltrials.gov
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