A Mobile App for Prevention of Cardiovascular Disease and Type 2 Diabetes Mellitus: Development and Usability Study

Abstract

Background Cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) are posing a huge burden on health care systems worldwide. Mobile apps can deliver behavior change interventions for chronic disease prevention on a large scale, but current evidence for their effectiveness is limited. Objective This paper reported on the development and user testing of a mobile app that aims at increasing risk awareness and engaging users in behavior change. It would form part of an intervention for primary prevention of CVD and T2DM. Methods The theoretical framework of the app design was based on the Behaviour Change Wheel, combined with the capability, opportunity, and motivation for behavior change system and the behavior change techniques from the Behavior Change Technique Taxonomy (version 1). In addition, evidence from scientific literature has guided the development process. The prototype was tested for user-friendliness via an iterative approach. We conducted semistructured interviews with individuals in the target populations, which included the System Usability Scale. We transcribed and analyzed the interviews using descriptive statistics for the System Usability Scale and thematic analysis to identify app features that improved utility and usability. Results The target population was Australians aged ≥45 years. The app included 4 core modules (risk score, goal setting, health measures, and education). In these modules, users learned about their risk for CVD and T2DM; set goals for smoking, alcohol consumption, diet, and physical activity; and tracked them. In total, we included 12 behavior change techniques. We conducted 2 rounds of usability testing, each involving 5 participants. The average age of the participants was 58 (SD 8) years. Totally, 60% (6/10) of the participants owned iPhone Operating System phones, and 40% (4/10) of them owned Android phones. In the first round, we identified a technical issue that prevented 30% (3/10) of the participants from completing the registration process. Among the 70% (7/10) of participants who were able to complete the registration process, 71% (5/7) rated the app above average, based on the System Usability Scale. During the interviews, we identified some issues related to functionality, content, and language and clarity. We used the participants’ feedback to improve these aspects. Conclusions We developed the app using behavior change theory and scientific evidence. The user testing allowed us to identify and remove technical errors and integrate additional functions into the app, which the participants had requested. Next, we will evaluate the feasibility of the revised version of the app developed through this design process and usability testing.

Remotely Conducted App-Based Intervention for Cardiovascular Disease and Diabetes Risk Awareness and Prevention: Single-Group Feasibility Trial

“…Five of these required users to enter numerical values, while the remaining questions had answer options provided. During the usability study, app testers needed less than 5 minutes to complete the process [ 6 ]. Participants could update their risk at any time.…”

“…It included links to external websites, educational videos, and the user guide. We published a detailed description of the app elsewhere [ 6 ].…”

“…The app consists of 4 modules: a calculator for 5-year CVD and T2DM risk; goal setting and tracking functions for diet, physical activity, smoking, and alcohol intake; and an education section. A detailed description of the app can be found elsewhere [ 6 ]. We conducted usability testing on the prototype and improved the app design based on participants’ feedback.…”

Barriers and Enablers to the Adoption of a Healthier Diet Using an App: Qualitative Interview Study With Patients With Type 2 Diabetes Mellitus

“…The BCTTv1 serves as a standardized language for describing distinct BCTs, which serve as the active ingredients in interventions; it lays the foundation for the reliable and systematic specification of behavior change interventions [15]. The appropriateness of an intervention and BCT can be assessed by applying the affordability, practicability, effectiveness/cost-effectiveness, acceptability, side effects/safety, and equity (APEASE) criteria, which acknowledge contextual factors that may influence implementation and have been previously used in the development of health apps to ensure app design simplicity and user-friendliness [25]. [24] which is published under the Creative Commons Attribution 4.0 International License (CC-BY) [26].…”

User-centered development of an mHealth app for cardiovascular prevention

“…In recent years, there has been a steady increase in the number of apps addressing CVD risk factors such as diabetes mellitus (DM), hypertension (HTN), and lifestyle habits such as physical inactivity, smoking, unhealthy diet, and stress. 5 – 10 Even though randomized trials reported improvements in lifestyle and risk factor control, the effects of mHealth apps on disease prevention and outcomes remain controversial. 11 – 15 One of the reasons for the inconsistency in reported results might be the varying quality of mHealth apps.…”