JMIR Publications

ABSTRACT

Background:

Rheumatoid Arthritis (RA) affects over 18 million people worldwide, commonly leading to flares, debilitating symptoms, reduced function, and increased cardiovascular disease risk. Regular physical activity is internationally recommended to address these challenges. However, people with RA face barriers to physical activity and lack tailored physical activity support. Digital physical activity interventions offer a potential resource-efficient strategy for increasing physical activity in RA. To improve the effectiveness and implementation of complex interventions, the UK Medical Research Council emphasizes the need for stronger end-user engagement and behavioral science integration. Together with physical activity experts, rheumatology providers, and people with RA, we completed an environmental scan, umbrella review, and priority setting exercise to inform the co-development of an RA-specific digital physical activity intervention: JustOneMove.ca.

Objective:

To describe the co-design process, present the Just One Move intervention, and summarize mixed methods findings from our evaluation survey.

Methods:

The study was informed by principles of patient-oriented research, user-centered design, and behavioral science (BCW: behavior change wheel, TDF: theoretical domains framework). After mapping physical activity barriers to the BCW and TDF, we completed a 4-step user-centered process to co-design Just One Move (Phase 1). We collaborated with people with RA and web design experts to review, design, refine, and develop the intervention using design sprint methodology. Data on resources required and partner involvement during Phase 1 were summarized descriptively. A mixed methods evaluation survey (Phase 2) gathered perspectives on usability and usefulness. The evaluation survey included demographics, physical activity self-report, the mobile app rating scale (MARS), and open-ended questions about Just One Move. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed using content analysis.

Results:

Co-design was completed in 7 months, with 30 meetings averaging 60 minutes each. The co-design team included 20 people with RA, 5 research team members, including a rheumatologist, physiotherapist, and physical activity behavior change expert, and 2 external collaborators specializing in healthcare design and web development. Co-design blended research evidence and user preferences through design thinking. Challenges included balancing creativity with feasibility and defining clear expectations. The Just One Move intervention features 4 elements: a library of RA-friendly movements, a personalized action planner, a collection of inspiring stories from people with RA, and an expert toolkit with practical tips for moving well with RA. Across 37 survey respondents with a median age of 62.0, average intervention quality was 4.0/5 and perceived impact was 3.7/5. Just One Move was easy to use and inspired confidence to move more. However, users wanted clearer instructions and more customizable content to improve the platform.

Conclusions:

Evidence-informed co-design can produce high-quality, impactful digital physical activity interventions for people with RA. Future work will examine the effectiveness of JustOneMove.ca to increase physical activity.