JMIR Publications

ABSTRACT

Background:

Smartphone apps are a growing field supporting the prevention of chronic diseases. The User Experience (UX) is an important predictor for app usage and should be considered in mobile health research. Long-term skin protection behaviour is important for those affected by work-related skin diseases (WRSD). However, changing health behaviour is complex and requires high level of self-management. In cases of severe or recurrent WRSD, patients are offered an inpatient rehabilitation programme over 3 weeks. We developed a maintenance programme consisting of the “MiA app” combined with an individual face-to-face goal-setting interview to support patients in their self-management and implementation of appropriate skin protection behaviour.

Objective:

The objectives of this paper are to a) describe the intervention in a standardised manner, b) evaluate the UX, subjective quality and perceived impact of the MiA app, c) evaluate the adherence of the MiA app.

Methods:

We followed a user-centered and multi-stage iterative process in two steps which combined qualitative and quantitative data. The maintenance programme was tested over 12 weeks after discharge. The UX, subjective quality and perceived impact were evaluated formatively based on the User Version of the Mobile Application Rating Scale (uMARS) after 12 weeks (t2). Adherence was measured by the frequency of interactions with the app.

Results:

Forty-two patients took part with a dropout of 43% at t2. The average age was 49.5 years and 57.1% were male. We found a high rating of the UX with an average score of 80.18 (± 8.94 SD) by a theoretical maximum of 100, but there are few exceptions in the usability and interaction with the app. The app was rated with an average of 4 out of 5 stars which indicate a high subjective quality. Further, the app seemed to influence important determinants to implement skin protection behaviour. Adherence to the “skin protection tracking” was higher over in the study period than to the skin documentation and goal assessment. The number of adherents in skin protection tracking was higher in skin care and skin cleansing (each 67%) compared to skin protection (31%) on day 1 and decreases until day 84 in all dimensions (each 29% in skin care and skin cleansing; 21% in skin protection).

Conclusions:

The results in terms of adherence meet the expectations and are consistent with other studies evaluating the usage of apps for chronic diseases. Interaction with the app could be increased in the future using artificial intelligence to determine the eczema severity by photos. It should be investigated which subgroups have difficulties with usability to individualise more the support during onboarding. There is a need for further research regarding the effectiveness of the MiA app regarding the skin protection behaviour, quality of life and eczema severity.