JMIR Publications

ABSTRACT

Background:

Fatigue is a highly prevalent and debilitating symptom of systemic lupus erythematosus (SLE), significantly affecting the quality of life and employment of those living with the disease. Non-pharmacologic approaches, such as physical activity interventions, have shown promise in reducing fatigue, but are often resource-intensive and lack grounding in behavior change theory. Mobile health (mHealth) technology offers a scalable approach to delivering behavioral interventions.

Objective:

This study describes the development of an mHealth application (app), grounded in behavior change theory, to support fatigue self-management in individuals with SLE by promoting physical activity.

Methods:

We employed a human-centered design (HCD) approach to develop an mHealth app grounded in the self-determination theory of motivation and the social cognitive theory of behavior change. The process included two phases: (1) Inspiration and (2) Ideation. In the Inspiration phase, key user needs were identified from the input of 12 adults with SLE who took part in two focus groups. During the Ideation phase, a prototype was developed and iteratively refined based on feedback from 12 adults with SLE who participated in multiple rounds of semi-structured interviews and surveys.

Results:

In the Inspiration phase, key priorities for the mHealth intervention were identified, including symptom tracking (fatigue, pain, sleep, and physical activity), reliable educational content, social connection, and reminders. In the Ideation phase, a prototype was developed based on these findings and refined through two rounds of user feedback interviews. Eighty percent of interviewees reported they were likely or highly likely to use the app. Several themes around preferences for the app emerged from the interviews, including the importance of: 1) community/social connection; 2) accessibility and inclusion, 3) options for customization; 4) integration of the app with existing digital health tools, and 4) notifications for reminders and motivational messages.

Conclusions:

Using an HCD approach, we developed an mHealth app tailored to the needs of individuals with SLE, integrating behavior change theory to support fatigue self-management. Through engagement with end users, we iteratively refined the app to address key priorities and enhance usability. This study demonstrates the feasibility of using HCD to develop an mHealth app grounded in behavior change theory, and provides a framework for creating rigorous digital health interventions for individuals with SLE and other chronic conditions.