Accepted for/Published in: JMIR Human Factors
Date Submitted: Apr 11, 2025
Date Accepted: Sep 11, 2025
mHealth app for adults with persisting postconcussion symptoms: a development and usability study
ABSTRACT
Background:
Diagnostics, treatment, and research of persisting postconcussion symptoms are challenging. Assessing symptoms is essential, but current implemented methods only allow for retrospective reporting of symptoms. An mobile health (mHealth) symptom mapping app for adults with persisting postconcussion symptoms may be an accessible and cost-efficient alternative.
Objective:
The aim of the current study was to develop a research-based mobile app for symptom mapping for adults with persisting postconcussion symptoms and investigate its usability, feasibility, and safety.
Methods:
This was a mixed-method development and usability study consisting of three iterative cycles, each including a) app design and programming, b) usability evaluation by the user group, and c) review by the clinician group. The outcomes were the mHealth App Usability Questionnaire and Mobile App Rating Scale scores, the number of days with logged symptom data during a home-testing period, and descriptions of adverse events throughout the study period. Semi-structured interviews were conducted to explore the user group experiences further.
Results:
Twenty-three adults with persisting postconcussion symptoms (median age 52 years, 80% female) were included in the user group, and six clinicians (median age 53 years, 50% female) with a mean of 13 years of experience working with people with persisting postconcussion symptoms were included in the clinician group. The app received a mean score of 5.0 (SD 1.1) on the mHealth App Usability Questionnaire (7-point Likert scale) from the user group and 4.1 (SD 0.4) on the Mobile App Rating Scale (5-point Likert Scale) from the clinician group. During the 28-day home-testing period, the adherence rate among the participants in the user group was 89% (IQR 0.78-0.96). Three themes were created through reflexive thematic analysis of the qualitative data: (1) Capturing the whole picture; (2) The balance between useful and cumbersome; and (3) To me there is more behind that number than to you.
Conclusions:
We developed a research-based mobile app for symptom mapping for people with persisting postconcussion symptoms. The app received high usability ratings from both the user and clinician groups, the app is a feasible alternative to traditional symptom mapping methods, and it is safe to use for its intended purpose. Clinical Trial: NCT05635656
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