JMIR Publications

ABSTRACT

Background:

The OA Coach mobile application (app) was developed to support individuals with knee osteoarthritis (OA) to self-manage their condition. The app aims to fill a current gap in the OA mobile app field combining key features such as symptom tracking, objective activity tracking, educational models, and encouragement notifications underpinned by behaviour change theory.

Objective:

The aim of this study was to describe the development of the OA Coach mobile app and assess its usability in a 6-week feasibility study.

Methods:

The OA Coach mobile app was developed to provide osteoarthritis (OA) education and support individuals with OA to self-manage their condition. The app was designed in consultation with consumers, rheumatologists, physiotherapists and OA researchers. The app prototype contained four screens: 1) a home screen to track goals and activities; 2) a progress page for an overview of body weight, knee pain, hours slept and step count; 3) a learning page with seven self-directed modules on the core aspects of OA management; and 4) an inbox, for communication with the study team. The study team conducted alpha-testing and any issues were resolved prior to the feasibility study. For the feasibility study, 30 participants were recruited between March and April 2024. Participants were eligible if they were aged ≥45 years old, had knee pain ≥ 4 on an 11-point numerical pain rating scale (NPRS) and knee stiffness lasting < 30 minutes in duration, or stiffness > 30 minutes and diagnosed with knee OA through a healthcare provider or radiographs. Participants were provided access to the app and asked to interact with the app daily for six weeks. The primary outcome was usability, assessed using the mHealth App Usability Questionnaire (MAUQ). Secondary outcomes included computer self-efficacy and osteoarthritis knowledge. Quantitative data was summarised descriptively. Qualitative feedback was collected through open-ended survey responses and discussed within the research team to improve the app.

Results:

A total of 30 participants completed the study. There was a 1:1 ratio of male to female participants, with an average (SD) age of 66.9 (9.1) years and a mean (IQR) pain level of 6.0 (1.8) on an 11-point NPRS. Twenty-nine responses from the MAUQ were available for analysis. Most statements scored > 5 out of 7 (“somewhat agree”), indicating that the app was easy to use. The mean (SD) satisfaction score of the app on the MAUQ was 4.7 (2.0) out of 7. Qualitative feedback from participants indicated the need for clear instructions on how to use and navigate the app, improved structure and integration of the exercise program, and improved tailoring of OA education and support.

Conclusions:

Overall, the OA Coach app was well accepted by participants. Based on participant feedback, the app will be revised to improve aspects of clarity, ease of use, and personalisation. The updated app will be tested against other methods of care delivery in a randomised controlled trial. Clinical Trial: Australian and New Zealand Clinical Trials Registry (registry number: 12623001223628)