Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Apr 30, 2025
Open Peer Review Period: May 1, 2025 - Jun 26, 2025
Date Accepted: May 21, 2025
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Refining digital tools for tuberculosis treatment support: Lessons from an iterative, user-centered design process
ABSTRACT
Background:
Despite the potential of digital adherence technologies to support patient-centred monitoring for tuberculosis (TB), there is limited research on incorporating indirect and direct adherence monitoring or assessing patients’ experiences with these technologies. This paper describes the iterative refinement process of the TB Treatment Support Tools (TB-TST) intervention. The TB-TST includes a comprehensive mobile application for patients and healthcare providers and a direct adherence metabolite test to report and monitor adherence.
Objective:
Describe the iterative refinement process of the TB Treatment Support Tools (TB-TST) intervention.
Methods:
We used an iterative mixed-methods approach informed by the Information Systems Research (ISR) Framework and Design Thinking Process. The project consisted of interface evaluation, high-level system design, and iterative redesign. The iterative process was informed by findings from a randomised controlled pilot study, patient and expert feedback, human-centred design methods, and technical decision-making.
Results:
The iterative refinement process, guided by user feedback, usability testing, and technical assessments, led to major improvements in the TB-TST intervention. Key changes included enhanced user flow, integration of progress tracking, transition to a Progressive Web App (PWA) platform, and security upgrades. Successive design cycles streamlined patient and provider interfaces, improved communication features, and addressed technical limitations. Usability testing yielded high satisfaction scores, with refinements supporting easier navigation, better reporting functionalities, and improved patient engagement.
Conclusions:
Combining multiple methods guided by the ISR framework and elements of the Design Thinking Process can help researchers and developers leverage the strengths of mixed-method iterative designs to create highly personalised and effective digital health interventions.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.