JMIR Publications

ABSTRACT

Background:

Regular physical activity (PA) is a key lifestyle component to hypertension prevention. Previous studies have already shown that mobile health apps can be an effective tool to improve PA behaviours. However, adherence and poor engagement in with these apps is a challenge. A potential solution to overcome this challenge may be to combine financial incentive with innovative behaviour theory, such as the Multi-Process Action Control (M-PAC) framework. Currently, there is a lack of PA financial incentive-driven M-PAC mHealth program aimed for hypertension prevention.

Objective:

To describe the process of developing an eight-week mHealth PA and financial incentive hypertension education program (Healthy Hearts) and to evaluate the acceptability and usability of the Healthy Hearts program.

Methods:

The Integrate, Design, Assess, Share (IDEAS) framework was used to guide the development of the Healthy Hearts program. The development process consisted of two phases. In phase 1, we used the M-PAC framework to adopt an existing web-based hypertension prevention program to a mobile app. The app was developed using a no-code app development platform (Pathverse) to help decrease overall development time. In phase 2, we conducted acceptability and usability testing to evaluate Lesson 1 of the Healthy Hearts program to further enhance the user experience. Focus group interviews and the mHealth App Usability Questionnaire were applied to evaluate program acceptability and usability.

Results:

Intervention development successfully created an eight-week financial incentive hypertension education program for adults aged 40-65 not currently meeting the Canadian PA Guidelines (<150 minutes of moderate-to-vigorous PA per week). This program was 8 weeks in length and was composed of 25 lessons guided by the M-PAC framework. Usability testing of the first lesson was successful, with 6 participants recruited for 2 rounds of testing, and feedback was gathered to enhance the content, layout, and design of the Healthy Hearts program to prepare the mHealth program for Study 2. Results of round 1 usability testing suggested that the content delivered in the lessons was too long. Content was therefore divided into multiple lessons prior to round 2 of usability testing, where feedback was only on design preferences.

Conclusions:

This study has reinforced the importance of an interactive usability testing process between the users and the research team to design an mHealth PA intervention. Through this process, the users were able to provide valuable feedback on the content, design, and layout of the program before advancing to feasibility testing. A study is now needed to evaluate the feasibility of the Healthy Hearts mHealth program.