JMIR Publications

ABSTRACT

Background:

The OA Coach mobile application (app) is a digital self-management tool to support people with knee osteoarthritis (OA).

Objective:

To optimize notifications and educational messages within the OA Coach app using behavior change theory and co-design, motivating users to adopt long-term positive lifestyle choices.

Methods:

This is a mixed-methods study using focus groups and online surveys. We worked with consumers, health professionals, and researchers to refine daily call-to-action and encouragement notifications for the OA Coach app. Clarity, comprehensibility, and motivational impact were assessed through an online survey using 1-5 Likert scales and free text responses. We also co-designed weekly educational messages based on recommendations from international OA clinical practice guidelines. Data from three focus groups and a survey were used to guide selection of message topics, timing, clarity, and language for motivational impact.

Results:

Eighty notifications were refined to enhance clarity, engagement, and effectiveness in prompting meaningful actions by future OA Coach users. Key themes guiding modifications included reducing technical jargon, simplifying colloquial expressions, and removing language perceived to be patronizing or frustrating. Fourteen educational messages were co-designed to ensure the messages were relevant, supportive, and empowering.

Conclusions:

Evidence-based notifications and educational messages, underpinned by behavior change theory and international guideline recommendations, were iteratively co-designed and refined in collaboration with consumers, health professionals, and researchers. These notifications and messages were integrated into the OA Coach app to optimize engagement, support behavior change, and promote uptake of recommended care for knee OA. The updated OA Coach app is currently being evaluated in the COASTAL trial, comparing face-to-face, telehealth, and digitally delivered models of care for knee OA.