Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Dec 12, 2020
Date Accepted: Oct 5, 2021
Development and Usability Testing of an Intelligent Individualized Cardiovascular Application for Risk Elimination (iCARE) for Individuals with Coronary Heart Disease
ABSTRACT
Background:
Death and disability from coronary heart disease can be largely reduced by improving risk factor management. However, adhering to evidence-based recommendations is challenging and requires interventions at the level of the patient, provider, and health system.
Objective:
To develop an Individualized Cardiovascular Application system for Risk Elimination (iCARE) to facilitate adherence to health behaviors and preventive medications, and to test the usability of the iCARE.
Methods:
We developed the iCARE based on a user-centered design approach, which included four phases: 1) functional design, 2) iterative design, 3) expert inspections and walkthroughs of the prototypes, and 4) usability testing with end-users. The usability testing of the iCARE included two parts: task analysis, and usability evaluation using a questionnaire in which a two-step procedure was applied using the modified Health Information Technology Usability Survey. The usability test was conducted in individuals with a diagnosis of coronary heart disease, from January 2019 to March 2019 (first step), and June 2020 (second step) in two university affiliated hospitals in Beijing, China.
Results:
The iCARE consists of a patient’s application, a care provider application, and a cloud platform. The iCARE has a set of algorithms that triggered tailored feedback and can send individualized interventions based on data from initial assessment and health monitoring via manual entry or wearable devices. For the first-step usability testing, a total of 88 hospitalized patients (71.3% male) with coronary heart disease were included in the study, they were on average 60 years old (standard deviation: 9.9). The mean score of usability testing was 90.1 (interquartile distance: 83.3-99.0). Among enrolled participants, 87.5% were satisfied with iCARE; 92.0% and 81.4% reported that iCARE was useful and easy to use, respectively. For the second-step usability testing, 61 individuals with CHD who were from an intervention arm and used the iCARE for at least 6 months were included. They were on average 53 years old (standard deviation: 8.2), with 85.2% being male. The mean total score on usability testing based on the questionnaire was 89.0 (interquartile distance: 77.0-99.5). Among enrolled participants, 88.5% were satisfied with the use of the App; 93.4% perceived the App as useful, and 70.5% as easy to use.
Conclusions:
This study developed an individualized, evidence-based, and theory-driven iCARE to improve patients’ adherence to health behaviors and medication management. The iCARE system was identified to be highly acceptable, useful, and easy to use among individuals with a diagnosis of coronary heart disease. Clinical Trial: Chinese Clinical Trial Registry: ChiCTR-INR-16010242. Registered 24 December 2016. http://www.chictr.org.cn/index.aspx
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