Currently submitted to: Journal of Medical Internet Research
Date Submitted: Jul 13, 2026
Open Peer Review Period: Jul 13, 2026 - Sep 7, 2026
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Theory-Guided Development and Usability Evaluation of a Web-Based Self-Management Module for Older Adults with COPD: A Mixed-Methods Study
ABSTRACT
Background:
Chronic obstructive pulmonary disease (COPD) imposes a substantial burden on older adults, yet existing digital self-management interventions often fail to address age-specific usability barriers and lack integration of established behavioral and technology acceptance theories. While web-based platforms hold promise for supporting COPD management, few have been systematically developed with direct input from older patients and validated through rigorous mixed-methods usability evaluation in the Chinese healthcare context.
Objective:
To describe the theory-guided development process and evaluate the usability of a web-based self-management module embedded within the SLH-COPD platform, specifically designed for older adults with COPD in China.
Methods:
This study employed a sequential exploratory mixed-methods design comprising three phases. In Phase 1 (Module Development), the COPD digital health intervention module was developed and finalized based on findings from prior research, a systematic literature review, and two rounds of Delphi expert consultation. Phase 2 involved the technical configuration and integration of the module into the SLH-COPD platform. In Phase 3 (Validation), alpha and beta testing were conducted with older adults with COPD; usability was assessed using the UMUX alongside objective behavioral data to inform iterative refinement of the module.
Results:
Using a mixed-methods design, this study successfully constructed and optimized a web-based self-management module for older adults with COPD, embedded within the SLH-COPD platform. A cross-sectional survey (n=199) identified five core domains of user needs, including symptom monitoring, medication management, and rehabilitation exercise. Following two rounds of Delphi Method (n=17, authority coefficient Cr=0.88), expert consensus was satisfactory, with Kendall’ s W values of 0.230, 0.321, and 0.285 for first-, second-, and third-level indicators, respectively (P<0.05). The final intervention framework comprised 5 first-level, 14 second-level, and 34 third-level indicators, demonstrating excellent content validity (S-CVI/Ave=0.988) and item-level CVIs (I-CVI) ranging from 0.80-1.00. Consistency testing using the AHP yielded a random CR of 0.009 (<0.1), indicating a scientifically sound weight allocation. Alpha testing resolved technical issues such as medication reminder delays and insufficient Shaanxi-localized content. Subsequent Beta testing revealed a mean UMUX score of 77.25 (SD=2.06), significantly exceeding the accepted usability threshold, with a task completion rate > 85%. Qualitative feedback confirmed that senior-friendly designs and plain-language, localized content effectively improved the user experience among low-literacy older adults.
Conclusions:
This study confirms that the theory-guided web-based self-management module for older COPD patients demonstrates adequate content validity and usability, with senior-friendly design effectively meeting user needs. It provides a replicable development and validation paradigm for digital chronic disease interventions in older adults. Future randomized controlled trials are needed to evaluate its clinical effectiveness and long-term adherence. Clinical Trial: Chinese Clinical Trial Registry (ChiCTR number)：PID331832
Citation
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