Previously submitted to: JMIR mHealth and uHealth (no longer under consideration since Jul 08, 2026)
Date Submitted: Dec 10, 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Warning: This is an author submission that is not peer-reviewed or edited.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.
Developing a Smartphone Application for Young People and their Caregivers following Treatment for Pediatric Cancer: Utilization of Co-design
ABSTRACT
Background:
Families at the end of pediatric cancer treatment experience significant unmet information and supportive care needs. Mobile health innovations provide an opportunity to address unmet needs through delivery of timely and accessible health information. Comprehensive co-design with key stakeholders is necessary to ensure innovations are effective and sustainable.
Objective:
To develop and test a digital survivorship companion application (app), LotusLab, designed for young people and caregivers at the end of pediatric cancer treatment. The aim of this paper is to describe the co-design process and influence on app prototype design.
Methods:
A three-year iterative co-design study consisting of five phases 1) planning and design, 2) alpha testing, 3) content development, 4) beta testing and 5) refinement and sustainability planning. Key stakeholders were invited to participate in the development and testing of LotusLab. Convenience and purposive sampling were undertaken via consumer networks and engagement of oncology healthcare providers. Co-design activities were designed to assess and continuously improve the app’s usability, acceptability, utility and feasibility.
Results:
Nineteen young people (aged 10-25 years), 40 parent caregivers and 28 healthcare providers participated in 16 different co-design activities including participation in the development of video, written and audio content, user-testing of app functionality and language translation of content. Feedback was collated through focus groups, interviews and surveys. Findings directly informed app content and functionality, and identification of barriers and enablers to sustainable implementation.
Conclusions:
Comprehensive engagement with young people, caregivers and healthcare providers across all stages of app development ensured LotusLab is acceptable, usable and tailored to the specific needs of families at the end of pediatric cancer treatment. Documenting the co-design process contributes to research on the design of mobile health tools and can inform others developing similar interventions. Next steps include ongoing evaluation of LotusLab within ‘real-world’ models of early survivorship care.
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