JMIR Publications

ABSTRACT

Background:

Canada’s legalization of recreational cannabis use (CU) has made even more evident the need for innovative interventions promoting lower-risk CU. Young adults 18 to 25 are the age group with the highest prevalence of CU. Protective behavioral strategies (PBS) have been proven to help manage CU and reduce negative CU consequences. To date, few interventions have focused on PBS. To fill this gap, a mobile application (app) prototype using PBS as a means of influencing CU was developed with and for young adults.

Objective:

To describe the development process and usability testing of Joint Effort, a CU self-management mobile app prototype centered on promoting the use of PBS among young adult past-month cannabis users (< 1 month).

Methods:

Intervention Mapping (IM) and a co-design approach were used. Six steps were followed: 1) focus groups were conducted to identify needs and preferences regarding CU interventions; 2) matrix of change objectives was used to select target behaviors and determinants; 3) theory-based intervention methods and practical applications were selected; 4) focus groups were held to validate intervention structure and examples of tailored messages; 5) preliminary intervention content was created; and 6) intervention content was transposed to a mobile app prototype. Usability was assessed through qualitative semi-structured interviews and the User Version of the Mobile Application Rating Scale (uMARS) completed by a sample of 20 university students with a mean age of 21.8 years (median: 22), of which 70% were women and 75% were undergrads. Qualitative data were analyzed using thematic analysis.

Results:

Four themes were identified from the interviews: Joint Effort was visually pleasing and easy to use; content was well-adapted to the target audience and non-judgmental; customization functions were appreciated; and the app was helpful and relevant to initiate behavior change. The prototype obtained a quality mean score of 4.43/5.0 (SD: 0.53) per item on the uMARS. Mean scores were obtained on five subscales: engagement (4.14/5 ±0.53), functionality (4.60/5 ±0.47), aesthetics (4.53/5 ±0.52), information quality (4.44/5 ±0.61), and subjective items (3.36/5 ±0.53).

Conclusions:

Our findings highlight the added value of IM and a co-design approach that emphasizes the importance of incorporating user feedback in the development of mobile apps. On the strength of the usability results obtained, the Joint Effort prototype has since been developed into an iOS mobile app and further larger-scale evaluations are ongoing to assess its acceptability, feasibility, and efficacy.