JMIR Publications

ABSTRACT

Background:

Existing evidence supports the many benefits of physical activity in breast cancer survivorship. However, few of these individuals are adhering to the recommended levels of activity. A physical activity coaching app that provides personalized feedback, guidance and motivation to the user might have the potential to engage these individuals into a more active lifestyle, in line with the general recommendations. To develop a successful tool it is important to involve the end-users in the design process and to make theoretically grounded design decisions.

Objective:

The aim of this work was to execute the design process and early prototype evaluation of a personalized physical activity coaching app for post-treatment breast cancer survivors. In particular, the study explored a design combining behavioral theory and tailored coaching strategies.

Methods:

The design process was led by a multidisciplinary team, including technical and health professionals, and involved the input from a total of 22 survivors. The process relied on three stages. In stage 1, the literature was reviewed and 14 patients were interviewed, to understand the needs and considerations of the target population towards physical activity apps. In stage 2, the global use case for the tool was defined, then the features were ideated and refined based on theory, and a digital interactive prototype was created. In stage 3, the prototype went through usability testing with 8 patients, and was subjected to quality and behavior change potential evaluations by 2 HCI experts.

Results:

The design process has led to the conceptualization of a personalized coaching app for walking activities that addresses the needs of breast cancer survivors. The main features of the tool include: a training plan and schedule; adaptive goal setting; real-time feedback and motivation during walking sessions; activity status through the day; activity history; weekly summary reports; and activity challenges. The system was designed to measure users’ cadence during walking, use this measure to infer their training zone, and provide real-time coaching to control the intensity of the walking sessions. The outcomes from user testing and expert evaluation of the digital prototype were very positive, with the results from SUS, MARS and ABACUS scales of 95 out of 100, 4.6 out of 5 and 14 out of 21, respectively.

Conclusions:

Implementing a user-centered design approach for the development and early evaluation of an app brings essential considerations to tailor the solution to the user needs and context. Also, considering theory on behavior change and tailored coaching provided important insights for the conceptualization of the tool features. This is critical to optimizing the usability, acceptability and long-term effectiveness of the tool. After successful early in-lab testing, the app will be developed and evaluated in a feasibility study in real-world setting.