JMIR Publications

ABSTRACT

Background:

Despite the effectiveness of bariatric surgery in the treatment of severe obesity, a substantial proportion of patients experience insufficient weight loss or weight regain over time. Evidence indicates that behavioral factors and mental health conditions play a central role in these outcomes, representing strategic targets for educational and technology-based self-monitoring interventions.

Objective:

This study aimed to develop and validate the content of a mobile application designed to support patients in mental health self-monitoring and to encourage behavioral changes, with the goal of improving surgical outcomes, preventing weight regain, and promoting long-term psychological well-being.

Methods:

This was a formative research study focused on the development and content validation of an educational digital health intervention, conducted according to the Systematic Instructional Design model, encompassing the analysis, design/development, and validation phases. Content validation was performed by an expert committee based on Pasquali’s criteria. Interrater agreement was quantitatively assessed using the Content Validity Index (CVI), considering the domains of clarity and relevance.

Results:

The application was developed with 11 screens and integrates validated psychometric instruments for self-monitoring of major mental health conditions, including the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Modified Yale Food Addiction Scale 2.0 (mYFAS 2.0), and Alcohol Use Disorders Identification Test (AUDIT). In addition, the platform includes body weight monitoring, physical activity tracking, and access to educational content on healthy eating and mental health. The app was designed based on scientific evidence and incorporates motivational strategies such as goal setting, automated alerts, and encouragement of multidisciplinary follow-up. All screens achieved full agreement regarding relevance. One screen did not reach the minimum clarity threshold in the first evaluation round and was subsequently revised. In the second round, it achieved 92.3% clarity and 100% relevance.

Conclusions:

The findings indicate that the developed application demonstrates adequate content validity and represents a promising digital tool to support postoperative care for patients undergoing bariatric surgery by enabling self-monitoring of key mental health conditions and promoting behavioral strategies aimed at preventing weight regain. Clinical Trial: This study did not constitute a clinical trial.