JMIR Publications

ABSTRACT

Background:

Although surveys and apps are available for women to report when they urinate and their bladder symptoms, they do not include their decisions regarding toileting. Real world factors can interfere with toileting decisions which may have an influence on bladder health, but this premise lacks data. The problem is absence of an appropriate robust data collection tool.

Objective:

The PLUS (Prevention of Lower Urinary Tract Symptoms) Research Consortium engaged a multidisciplinary team to build and test an Android and iOS data collection app named Where I Go. The goal was to design a comprehensive reporting system for capturing the environmental, sociocultural, and physical factors that influence women’s decisions for toileting. Aims include having 1) an innovative feature for reporting on physiologic urge sensation when “thinking about my bladder” and shortly before “I just peed,” 2) real–time reporting and short look–back opportunities, and 3) ease of use anywhere.

Methods:

The app was developed by a transdisciplinary team including a plain language specialist, usability specialist, creative designers, programming experts, and scientific content experts. Both real–time and ecological momentary assessment were employed to capture factors that influence toileting decisions, including perceived access to toileting, degree of busyness/stress/focus, beverage intake amount, urge degree, and/or leakage. Restriction on a maximal number of taps for any screen was six. PLUS consortium investigators pilot–tested the app. Formal usability testing relied on recruitment of community–¬¬dwelling women at four different PLUS research sites to use the app for two consecutive days. Outcome measures were System Usability Scale (SUS, 0–100 range) and the functional Mobile Application Rating Scale (fMARS, 1–5 range). These scales were embedded at the end of Where I Go. A priori estimate of sample size need was 40 women completing the study, with average SUS cut point score set at 74+.

Results:

Integrity of the build process was documented through multiple 5–min videos presented to the PLUS Consortium and through Where I Go screen shots of the final product. Participants included 44 women, with 41 (93%) participants completing the data collection. Participants ranged in age from 21–85 years, were predominantly non–Hispanic white (57%), college educated (57%), and with incomes below $75,000 (62%). Mean SUS score was 78.0 (95% CI: 74.7–81.4) which was higher than 75% of the 500 products tested by the SUS developers. Mean fMARS score was 4.4 (CI: 4.2–4.6).

Conclusions:

Where I Go is a novel app with good usability for women to report toileting decisions, urination, and fluid intake. Future research using the app could test the influence of real–time factors on women’s bladder health. Clinical Trial: Not applicable.