User-Centered Design of a Mobile Health Intervention to Enhance Exacerbation-Related Self-Management in Patients With Chronic Obstructive Pulmonary Disease (Copilot): Mixed Methods Study

Abstract

Background Adequate self-management skills are of great importance for patients with chronic obstructive pulmonary disease (COPD) to reduce the impact of COPD exacerbations. Using mobile health (mHealth) to support exacerbation-related self-management could be promising in engaging patients in their own health and changing health behaviors. However, there is limited knowledge on how to design mHealth interventions that are effective, meet the needs of end users, and are perceived as useful. By following an iterative user-centered design (UCD) process, an evidence-driven and usable mHealth intervention was developed to enhance exacerbation-related self-management in patients with COPD. Objective This study aimed to describe in detail the full UCD and development process of an evidence-driven and usable mHealth intervention to enhance exacerbation-related self-management in patients with COPD. Methods The UCD process consisted of four iterative phases: (1) background analysis and design conceptualization, (2) alpha usability testing, (3) iterative software development, and (4) field usability testing. Patients with COPD, health care providers, COPD experts, designers, software developers, and a behavioral scientist were involved throughout the design and development process. The intervention was developed using the behavior change wheel (BCW), a theoretically based approach for designing behavior change interventions, and logic modeling was used to map out the potential working mechanism of the intervention. Furthermore, the principles of design thinking were used for the creative design of the intervention. Qualitative and quantitative research methods were used throughout the design and development process. Results The background analysis and design conceptualization phase resulted in final guiding principles for the intervention, a logic model to underpin the working mechanism of the intervention, and design requirements. Usability requirements were obtained from the usability testing phases. The iterative software development resulted in an evidence-driven and usable mHealth intervention—Copilot, a mobile app consisting of a symptom-monitoring module, and a personalized COPD action plan. Conclusions By following a UCD process, an mHealth intervention was developed that meets the needs and preferences of patients with COPD, is likely to be used by patients with COPD, and has a high potential to be effective in reducing exacerbation impact. This extensive report of the intervention development process contributes to more transparency in the development of complex interventions in health care and can be used by researchers and designers as guidance for the development of future mHealth interventions.

Needs, barriers and facilitators of older adults towards eHealth in general practice: a qualitative study

“…Simply developing and offering applications is insufficient and does not fit current practice (Ossebaard & Van Gemert-Pijnen, 2016). Co-creation, as a user-centred design, should be considered within the development of the implementation and dissemination of eHealth applications as well (Korpershoek et al, 2020).…”

Early-Stage Feasibility of a Mobile Health Intervention (Copilot) to Enhance Exacerbation-Related Self-Management in Patients With Chronic Obstructive Pulmonary Disease: Multimethods Approach

“…According to our results, a separate portal for HCPs and integration with current systems could potentially facilitate the use of the app, especially for physicians. However, HCPs’ perspectives toward system integration differ, which was also observed in conversations with HCPs during the development of the Copilot app [ 22 ]. On the basis of the literature, it could be expected that interoperability is important for integration of the app across health care settings [ 31 ].…”

“…Recently, much emphasis has been placed on the importance of taking into account the context in intervention research aiming at changing behaviors, to increase the likelihood of developing appropriate, implementable, effective, and sustainable interventions [ 38 ]. On the basis of HCPs’ perceptions that the app is feasible to implement and integrate into Dutch health care organizations, taking context into account in the development of the app seemed to have resulted in sufficient flexibility in the design of the app to work across a range of contexts [ 22 , 38 ].…”

“…The Copilot app was developed by following a user-centered design that included several phases of usability testing [ 22 ]. The usability of the Copilot app for patients was considered to be good [ 22 ]. More information about the Copilot app is provided in Figure 1 .…”

Privacy Policy Compliance of Chronic Disease Management Apps in China: Scale Development and Content Evaluation

“…Fortunately, the booming of mobile health (mHealth) offers opportunities for chronic diseases prevention, treatment, and daily self-management. The health benefits of mHealth interventions for patients with chronic diseases have been demonstrated [ 2 ]; mHealth apps can be used to collect and monitor health data [ 3 , 4 ], promote and support self-management [ 5 , 6 ], and provide medication and appointment reminders [ 7 ]. Different from other types of mHealth apps, such as online registration and online consultation, chronic disease management apps allow individuals to generate large quantities of data about their lifestyle, introducing risks to the security and privacy of patient data.…”