Cocreative Development of the QoL-ME: A Visual and Personalized Quality of Life Assessment App for People With Severe Mental Health Problems

Abstract

Background Quality of life (QoL) is a prominent outcome measure in mental health. However, conventional methods for QoL assessment rely heavily on language‐based communication and therefore may not be optimal for all individuals with severe mental health problems. In addition, QoL assessment is usually based on a fixed number of life domains. This approach conflicts with the notion that QoL is influenced by individual values and preferences. A digital assessment app facilitates both the accessibility and personalization of QoL assessment and may, therefore, help to further advance QoL assessment among individuals with severe mental health problems. Objective This study focused on the development of an innovative, visual, and personalized QoL assessment app for people with severe mental health problems: the QoL-ME. Methods This study targeted 3 groups of individuals with severe mental health problems: (1) people with psychiatric problems, (2) people treated in forensic psychiatry, and (3) people who are homeless. A group of 59 participants contributed to the 6 iterations of the cocreative development of the QoL-ME. In the brainstorming stage, consisting of the first iteration, participants’ previous experiences with questionnaires and mobile apps were explored. Participants gave their feedback on initial designs and wireframes in the second to fourth iterations that made up the design stage. In the usability stage that comprised the final 2 iterations, the usability of the QoL-ME was evaluated. Results In the brainstorming stage, participants stressed the importance of privacy and data security and of receiving feedback when answering questionnaires. Participants in the design stage indicated a preference for paging over scrolling, linear navigation, a clean and minimalist layout, the use of touchscreen functionality in various modes of interaction, and the use of visual analog scales. The usability evaluation in the usability stage revealed good to excellent usability. Conclusions The cocreative development of the QoL-ME resulted in an app that corresponds to the preferences of participants and has strong usability. Further research is needed to evaluate the psychometric quality of the QoL-ME and to investigate its usefulness in practice.

Visual and Personalized Quality of Life Assessment App for People With Severe Mental Health Problems: Qualitative Evaluation

“…They found the application easy to use, appreciated its linear structure and prized the calm and clean layout. These results confirm the findings from the usability evaluation that made up the last part of the development of QoL-ME [ 20 ] and serve as additional corroboration of the design recommendations [ 41 , 46 ] consulted during the apps’ development. Several respondents preferred combining the visual material used in the additional modules with a word or short sentence to denote the content of its item.…”

“…This process was guided by the feedback and ideas of patients. The prototype was subjected to a usability evaluation in the final stage [ 20 ].…”

“…Both patient empowerment and shared decision making have become important goals in mental health services [ 18 , 19 ]. To meet these 3 challenges, an innovative personalized visual quality of life assessment app was developed called QoL-ME [ 20 ]. The QoL-ME app consists of a core version that can be supplemented with additional modules.…”

“…After filling out the questions, respondents receive direct feedback from the app in the form of an overview of their answers. The QoL-ME app was developed cocreatively in close collaboration with patients, family members, and care professionals [ 20 , 21 ].…”

“…End users played a vital role in the development of the QoL-ME app. In the context of this development, participants rated the usability of the app as “very high [ 20 ].” It is unknown, however, whether the intensive user-involvement and positive usability rating translate to an instrument that is of use to patients in real-life settings.…”