Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jul 30, 2024
Open Peer Review Period: Jul 30, 2024 - Sep 24, 2024
Date Accepted: Dec 9, 2025
(closed for review but you can still tweet)
Adapting and validating tools to assess the usability and acceptability of mHealth tools among community health workers in rural Rwanda: Development of the Community Health Worker mHealth Usability and Acceptability Assessment Tool (CHW-MUAAT)
ABSTRACT
Background:
Mobile health (mHealth) applications are rapidly evolving as valuable resources, offering crucial support to healthcare workers for quality care. Achieving full potential necessitates a comprehensive assessment of their usability and acceptability among target users.
Objective:
This study aims to report the process of adapting existing tools to develop and validate a quantitative tool to assess community health workers’ (CHWs) perceived usability and acceptability of a mHealth application for postoperative home follow-up of women who had a cesarean delivery.
Methods:
This study was conducted in Kirehe district, located in rural Rwanda, spanning from October 2022 to March 2023. We translated the mHealth Usability Assessment Questionnaire (MUAQ) and questions from the Practitioner Opinion (Acceptability) Scale (POAS). We then supplemented these with usability questions that assess core functions of the mHealth application developed by our team. The validation consisted of 1) content validity testing with 8 experts with a recommended threshold of content validity index > 0.78, and 2) face validity testing with 10 target users with a recommended threshold of face validity index ≥ 0.60. Reliability testing was performed using data obtained from 30 target users during usability and acceptability testing, with Cronbach’s Alpha coefficient > 0.70 signifying a commendable internal consistency.
Results:
Of the 25 items assessed, 22 received a score of content validity index > 0.78 for both clarity and relevance scales. The face validity index was 0.991 for both clarity and relevance across all 22 questions. The set of questions exhibited a high level of internal consistency, as evidenced by a Cronbach’s alpha coefficient of 0.86 for the MUAQ usability questions, 0.73 for the POAS acceptability questions and 0.87 for questions added by the study team. The final tool, referred to as the Community Health Worker mHealth Usability and Acceptability Assessment Tool (CHW-MUAAT), included 22 items with high content validity among content experts, and high face validity and internal reliability among CHWs.
Conclusions:
The validated tool, along with the adaptation and validation process, will contribute to future assessment of usability and acceptability of mHealth applications for CHWs and potentially lead to greater integration of such innovative solutions and informed decision-making.
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