Exploring User Needs and Preferences for Mobile Apps for Sleep Disturbance: Mixed Methods Study

Abstract

BackgroundMobile health (mHealth) apps demonstrate promise for improving sleep at scale. End-user engagement is a prerequisite for sustained use and effectiveness.ObjectiveWe assessed the needs and preferences of those with poor sleep and insomnia to inform the development of an engaging sleep app.MethodsWe triangulated results from qualitative (focus groups and app reviews) and quantitative (online survey) approaches. A total of 2 focus groups were conducted (N=9). An online survey tested themes identified from the focus groups against a larger population (N=167). In addition, we analyzed 434 user reviews of 6 mobile apps available on app stores.ResultsCommon focus group themes included the need to account for diverse sleep phenotypes with an adaptive and tailored program, key app features (alarms and sleep diaries), the complex yet condescending nature of existing resources, providing rationale for information requested, and cost as a motivator. Most survey participants (156/167, 93%) would try an evidence-based sleep app. The most important app features reported were sleep diaries (148/167, 88%), sharing sleep data with a doctor (116/167, 70%), and lifestyle tracking (107/167, 64%). App reviews highlighted the alarm as the most salient app feature (43/122, 35%) and data synchronization with a wearable device (WD) as the most commonly mentioned functionality (40/135, 30%).ConclusionsThis co-design process involving end users through 3 methods consistently highlighted sleep tracking (through a diary and WD), alarms, and personalization as vital for engagement, although their implementation was commonly criticized in review. Engagement is negatively affected by poorly designed features, bugs, and didactic information which must be addressed. Other needs depend upon the type of user, for example, those with severe insomnia.

Design Features for Improving Mobile Health Intervention User Engagement: Systematic Review and Thematic Analysis

“…Some parameters, such as sociodemographic characteristics, basic health status, and individual preferences and habits, could be measured with a quick survey within an app [ 54 , 55 , 57 , 62 , 63 ]. Users also liked continuous monitoring features that allowed them to record their progress toward their goal on a daily basis (eg, health and behavior changes and adherence to an intervention) [ 40 , 42 , 43 , 45 , 58 , 64 - 67 ] or diary entries or notes that helped them track their progress [ 40 , 45 , 60 ]. Moreover, users also indicated a preference for sensor-based automated tracking as opposed to self-reported data, which they often forgot to input and found were not as convenient [ 47 , 52 , 59 , 63 , 68 ].…”

“…Studies indicated the importance of building an assessment on the basis of feedback on the acquired data; users quickly lost interest when they did not receive feedback that was customized [ 41 , 69 ]. The preference was for the mobile device to provide personalized information, including tailored intervention content matched to their basic characteristics [ 40 , 43 , 45 , 46 , 51 , 54 , 55 , 57 - 65 , 67 , 68 , 70 , 71 ] and feedback on continuous monitoring data, for example, their health and behavior progress over time, predicted possible causes and consequences of a health problem and advice on the behavior under investigation [ 41 - 43 , 47 , 49 , 52 , 53 , 58 , 59 , 63 , 68 ]. There was a strong interest among users for visualization of continuous monitoring data, for example, presenting data as graphs and tables [ 47 , 49 , 53 , 58 , 63 , 67 , 69 ].…”

“…Users wanted reminders to schedule a task, such as taking medicine, making and keeping clinic appointments, and continuing a health plan [ 49 , 55 , 58 , 60 , 63 , 66 , 68 ]; to return to their mobile device [ 42 , 46 , 64 , 70 ]; and to motivate them with information and advice [ 40 , 45 , 52 , 61 , 67 , 72 ]. The preferred forms of reminders included email messages, text messages, words of the day, and pop-ups [ 45 , 49 , 52 , 61 , 70 ].…”

“…The users expressed interest in communicating with other people with similar experiences through online forums, communities, by instant messages within an mHealth tool, or by connecting via other types of social media; they wanted to be able to post information, share their stories, ask and answer questions, and find mutual accountability partners [ 40 , 45 , 46 , 54 - 56 , 58 - 60 , 63 , 66 , 67 , 69 , 72 ].…”

User Perceptions of Virtual Hospital Apps in China: Systematic Search

“…There is little research on how user engagement happens and why users abandon a virtual hospital app. To the best of our knowledge, user reviews and basic app data are accessible and valuable [ 15 , 16 ], but have not been fully explored, especially for virtual hospital apps. Hence, we conducted a systematic search using statistical analysis and aspect-based content analysis to review apps of this theme, determine user engagement, and discuss user needs, expectations, concerns, and preferences for virtual hospital apps.…”