JMIR Publications

ABSTRACT

Background:

Lifestyle modification involving both patients and their significant others (dyads) is critical in the long-term management of chronic kidney disease (CKD). However, achieving sustained behavioral changes remains challenging. Digital interventions, particularly using widely adopted platforms like instant messaging apps, present a promising approach to support CKD dyads in lifestyle modification.

Objective:

This study aimed to develop, optimize, and test the usability of a digital dyadic empowerment platform named “Kidney Lifestyle” using the LINE instant messaging app. The platform was designed based on the Digital Dyadic Empowerment Framework (DDEF) to facilitate collaborative lifestyle modification among CKD dyads.

Methods:

We adopted a three-phase Agile-based iterative development cycle: (1) iterative development and trial use, (2) heuristic evaluation, and (3) usability testing. In Phase 1, platform prototype was co-developed with healthcare professionals and technical partners, then trialed by CKD dyads who provided qualitative and quantitative feedback on interface clarity, ease of use, acceptance, intention to continue usage, and overall satisfaction. In Phase 2, multidisciplinary experts independently conducted heuristic evaluations, rating platform compliance with Nielsen’s ten usability principles on a scale from -1 (does not comply) to 1 (complies), and provided suggestions for improvement. In Phase 3, experienced CKD dyads from Phase 1 performed six representative tasks using the platform. Task success rates, completion times, and operational errors were quantitatively recorded, and usability perceptions were assessed using the After-Scenario Questionnaire (ASQ; 1-7 scale) and the System Usability Scale (SUS; 0-100 scale).

Results:

Phase 1 results indicated high user acceptance and satisfaction (overall platform satisfaction: mean 4.1 out of 5) among 10 CKD dyads (19 individuals). Participants valued real-time interaction, convenience in monitoring health data, and educational resources. In Phase 2, five experts conducted heuristic evaluation, revealing high overall usability compliance (average compliance scores ranged from 89% to 93%), although issues related to navigation complexity and the need for enhanced interactive feedback were identified. In Phase 3, usability testing was conducted with 5 CKD dyads (10 individuals), showing high task success rates (60%-100%) and task completion times ranging from 1 to 5 minutes. However, navigation difficulties within the LINE Official Account were noted, resulting in a marginally acceptable average SUS score of 67.5. The ASQ indicated higher usability satisfaction for the extended App tasks (mean average = 5.64) compared to those within LINE (mean average = 3.87).

Conclusions:

The LINE-based digital dyadic empowerment platform “Kidney Lifestyle” (LINE ID: @509kgajt) demonstrated promising usability, high user engagement, and strong clinical potential for supporting lifestyle modification among CKD dyads. However, usability issues within the instant messaging interface highlight the importance of simplifying navigation pathways and enhancing user feedback. Future research should include a larger-scale feasibility trial and further optimization to enhance usability and clinical integration.