Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 11, 2019
Date Accepted: Jan 24, 2020
User-centered design of an mHealth intervention to enhance exacerbation-related self-management in patients with Chronic Obstructive Pulmonary Disease (Copilot): a mixed-methods approach.
ABSTRACT
Background:
Adequate self-management skills are of great importance for patients with Chronic Obstructive Pulmonary Disease (COPD) to reduce the impact of COPD exacerbations. Using mHealth to support exacerbation-related self-management could be promising in engaging patients in their own health and changing health behaviors. However, mHealth initiatives continue to proliferate with little evidence for their effectiveness and knowledge is lacking on how to design apps that are effective, meet the needs of end-users and are perceived as useful. By following an iterative user-centered design process, an evidence driven and user-friendly mHealth intervention was developed to enhance exacerbation-related self-management in patients with COPD.
Objective:
The aim of this paper was to describe in detail the full user-centered design and development process of an evidence-driven and user-friendly mHealth intervention to enhance exacerbation-related self-management in patients with COPD.
Methods:
The user-centered design process consisted of four iterative phases: 1) background analysis and design conceptualization, 2) alpha usability testing, 3) iterative software development and 4) field usability testing. Patients with COPD, health care providers, COPD experts, designers, software developers and a behavioral scientist were involved throughout the design and development process. The intervention was developed using the Behavior Change Wheel (BCW), a theoretically-based approach for designing behavior change interventions, and logic modelling was used to map out the potential working mechanism of the intervention. Furthermore, principles of design thinking were used for the creative design of the intervention. Qualitative and quantitative research methods were used throughout the design and development process.
Results:
The background analysis and design conceptualization phase resulted in final guiding principles for the intervention, a logic model to underpin the working mechanism of the intervention and design requirements. Usability requirements were obtained from the usability testing phases. The iterative software development resulted in an evidence-driven and user-friendly mHealth intervention: A mobile app (Copilot) consisting of a symptom monitoring module and a personalized COPD action plan.
Conclusions:
By following a user-centered design process, an mHealth intervention was developed that meets the COPD patients’ needs and preferences, is likely to be used by COPD patients and has high potential to be effective in reducing exacerbation impact. This extensive report of the intervention development process contributes to more transparency in the development of complex interventions in health care and can be used by researchers and designers as guidance for the development of future mHealth interventions.
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