JMIR Publications

ABSTRACT

Background:

To inform the development of an intervention, it is essential to have a well-developed theoretical understanding of how an intervention causes change as stated in the United Kingdom Medical Research Council (MRC) guidelines for developing complex interventions. Theoretical foundations are often ignored in the development of mobile health applications (apps) intended to support pain self-management for cancer patients.

Objective:

The study aims to systematically set a theory- and evidence-driven design for a pain self-management app.

Methods:

The Behaviour Change Wheel (BCW) framework, a step-by-step theoretical approach to the development of interventions, was adopted to achieve the aim of the study. This started by understanding the behaviour and what needs to be changed to support better pain management. The application of the framework, ultimately, guided the identification of the active contents of the app. The apps’ contents were characterised using the behaviour change technique taxonomy version 1 (BCTTv1).

Results:

The theoretical analysis revealed that patients may have deficits in their capability, opportunity, and motivation preventing them from performing pain self-management. The app needs to use education, persuasion, training, and enablement intervention functions as, based on the analysis, they were found the most likely to address the specified factors. Eighteen BCTs were selected to describe precisely how the intervention functions can be presented to induce the desired change regarding the intervention context. In other words, they were selected to form the active content of the app, which potentially serve to weaken the barriers and support patients to be pain self-managed while using the app.

Conclusions:

The study fully reports the design and development of a pain self-management app underpinned by theory and evidence and intended for cancer patients. It provides a model example of the BCW framework application for health app development. The work presented in this study is the first systematic theory- and evidence-driven design for a pain app for cancer patients. This systematic approach can support clarity in evaluating the intervention's underlying mechanisms and support future replication.