JMIR Publications

ABSTRACT

Background:

Fatigue is a prominent barrier to physical activity among individuals living with inflammatory bowel disease (IBD). Mobile health interventions that adapt activity recommendations to daily fatigue may offer personalized support, but their usability and acceptability require evaluation before effectiveness testing. IBD-Move is a just-in-time adaptive intervention that adjusts physical activity session type and duration according to self-reported fatigue.

Objective:

This study aimed to evaluate the usability and acceptability of IBD-Move through two iterative testing cycles and identify refinements to inform subsequent pilot testing.

Methods:

We conducted an in-person mixed-methods study with insufficiently active adults with self-reported IBD in remission. Different participants completed each testing cycle, with app revisions implemented between cycles. Participants performed five goal-oriented tasks using a think-aloud protocol: completing orientation, reviewing educational content, setting an activity goal, accessing and completing an activity session, and tracking activity. Usability measures included the mHealth App Usability Questionnaire (MAUQ) ease-of-use and interface-satisfaction subscales, task completion rates, completion times, and screen transitions. Acceptability was assessed using the MAUQ perceived-usefulness subscale and semi-structured interviews. Quantitative outcomes were summarized descriptively. Qualitative data were analyzed using Framework Analysis, with findings categorized using the Usability Problem Taxonomy and Theoretical Framework of Acceptability.

Results:

Eight participants completed testing (four per cycle; mean age 31, SD 14.1 years); four had Crohn disease and four had ulcerative colitis. Mean ease-of-use scores were 1.93 (SD 0.52) in Cycle 1 and 1.45 (SD 0.21) in Cycle 2; interface-satisfaction scores were 1.98 (SD 0.42) and 1.15 (SD 0.14), respectively. Lower scores indicated more favorable ratings. Mean participant task completion rates were 85% (SD 17%) and 95% (SD 9%), respectively. Perceived-usefulness scores were also more favorable in Cycle 2 (mean 1.67, SD 0.85) than Cycle 1 (mean 2.88, SD 0.82). Feedback from Cycle 1 informed revisions to instructions, activity session labels, and content layout, as well as removal of duplicated survey questions. Across both cycles, participants appreciated goal-setting and educational content relevant to living with IBD. Suggested improvements included easier navigation to goals and activity sessions, clearer exercise instructions, less demanding exercise options, and more engaging alternatives to text-based modules.

Conclusions:

Findings provide preliminary support for IBD-Move’s usability and acceptability and demonstrate the value of iterative user-informed development. Further refinements to navigation, activity guidance, and content delivery are warranted before real-world pilot testing. Future research should assess feasibility, sustained engagement, and potential effects on physical activity and fatigue in larger, more diverse samples.