Currently submitted to: JMIR mHealth and uHealth
Date Submitted: Aug 27, 2026
Open Peer Review Period: Aug 28, 2026 - Oct 23, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited.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.
Needs Analysis of a Digital Multidomain Lifestyle Intervention for Spinal Cord In-jury: A User-Centered Mixed Methods Study
ABSTRACT
Background:
Individuals living with spinal cord injury (SCI) face long-term challenges related to health, participation, and self-management and are at increased risk of secondary health complications. Mobile health (mHealth) interventions may support health-promoting behavior in everyday life and prevent secondary health complications. To date, little is known about the needs of individuals living with SCI regarding a multidomain lifestyle mHealth app.
Objective:
This study aimed to investigate the needs, expectations, and preferences of individuals living with SCI related to a holistic multidomain lifestyle mHealth app.
Methods:
An explanatory sequential mixed methods design with a user-centered approach was used. An online survey was conducted among adults living with SCI in the DACH region (Germany, Austria, and German-speaking Switzerland), followed by two focus group interviews with individuals living with SCI and health professionals with expertise in SCI. Quantitative data were analyzed descriptively and exploratorily by SCI subgroups. Qualitative data were analyzed using the Rigorous and Accelerated Data Reduction (RADaR) technique, and findings were integrated at the interpretation stage.
Results:
A total of 172 survey participants and 14 focus group participants were included. Current use of health-supporting apps was low (25/172, 14.5%), with lack of awareness of existing apps (56/147, 38.1%) as the most frequent reason for nonuse. Needs were expressed across all six domains of lifestyle medicine with varying prominence. Subgroup differences were mainly observed in function-dependent aspects such as smartphone and tablet handling modes. Integrated findings identified accessibility, personalization, meaningful tracking, SCI-specific content, peer exchange, and professional support as central requirements for a future app.
Conclusions:
Individuals living with SCI expressed clear interest in a multidomain lifestyle mHealth app. However, awareness and current use of health-supporting apps were reported to be low. Future app development should prioritize personalization that accounts for both clinical characteristics and individual preferences, SCI-specific content with clear everyday benefit, and opportunities for peer exchange and professional support to promote meaningful self-management across multiple lifestyle domains with the potential to contribute to the prevention of secondary health conditions.
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