Mobile App to Help People With Chronic Illness Reflect on Their Strengths: Formative Evaluation and Usability Testing

Abstract

Background Supporting patient engagement and empowerment is increasingly seen as essential in providing person-centered health care to people with chronic illness. Mobile apps helping patients reflect on their concerns as preparation for consultations with their health care providers can have beneficial effects on the consultation quality. However, apps focusing on empowerment and personal strengths are still scarce. Objective This study aimed to (1) develop a mobile app to support patients with rheumatic diseases in reflecting on their strengths in preparation for consultations with health care providers and (2) explore patients’ perceived usability of the app in a nonclinical test setting. Methods A prototype app was developed based on input from patients and health care providers, as reported in previous studies. The app was designed for use in self-management support settings aiming to promote awareness of strengths and to focus attention on strengths in the patient-health care provider dialogue. The features included in the prototype were as follows: (1) introduction to the topic of strengths, (2) list of examples of strengths to promote reflection and registration of own strengths, (3) summary of registered strengths, (4) value-based goal setting, (5) linking of strengths to goals, (6) summary of all registrations, and (7) options to share summary digitally or as a print version. In this study, the app was refined through a formative evaluation with patients and health care providers recruited from a specialized rheumatology hospital unit. Patients’ perceptions of the app’s usability were explored in a test setting with self-report measurements and semistructured interviews. The interviews were audiotaped, transcribed, and analyzed with directed content analysis. Data from questionnaires were analyzed with descriptive statistics. Results Developmental and formative evaluation included 18 patients and 7 health care providers. The evaluation resulted in minor adjustments to the prototype but no major changes in features. The usability testing included 12 patients. All participants found the usability acceptable; the median score on the System Usability Scale was 86.3 (range 70-100). All reported that it was meaningful and relevant to use the app. Out of 12 participants, 9 (75%) reported becoming more aware of their own strengths by using the app; 1 (8%) disagreed and 2 (17%) provided a neutral response. The results on the goal-related feature were mixed, with half of the patients finding it useful to link strengths to concrete goals. A statistically significant positive change from pre- to postintervention was identified on measures of self-efficacy and negative emotions. Conclusions In this formative evaluation of a mobile app to promote patients’ reflections on their strengths, patients perceived the app as meaningful and supporting awareness. The results suggest the usefulness of building in functionality to support use of strengths and goal attainment. Further studies on efficacy and usability in a clinical setting, including health care providers, are needed.

Mobile App-based documentation of patient-reported outcomes — 3-months results from a proof-of-concept study on modern rheumatology patient management

“…However, when Apps with PROMs are commonly used, some patients will be unfamiliar with scores depicted to them requiring their education [ 4 ]. More educational content has recently also been identified for the next iteration step of an App developed by Kristjansdottir et al [ 47 ].…”

Factors Affecting the Perceived Usability of the COVID-19 Contact-Tracing Application “Thai Chana” during the Early COVID-19 Omicron Period

“…Previously, there have been several studies related to the usability of medical mobile applications. For patients with rheumatic diseases, Kristjansdottir et al [ 17 ] analyzed the usability of the mobile application among 12 rheumatic patients and they found that the satisfaction point was 86.3/100. Islam et al [ 18 ] explored the usability issues of the mHealth application, and the study showed that the services and functions were acceptable.…”

“…Islam et al [ 18 ] explored the usability issues of the mHealth application, and the study showed that the services and functions were acceptable. Kuhns et al [ 16 , 17 , 18 , 19 ] exposed the usability of a mobile application for HIV prevention for transgender women, and they found the satisfaction score of the application to be 4.59/5. Moreover, the participants suggested enhancing application engagement by adding user experience and user interface for attracting new users [ 20 ].…”

Evaluating a Strengths-Based mHealth Tool (MyStrengths): Explorative Feasibility Trial

“…Some explained that these types of strengths are out of their control and are thus elements they cannot impact or work on acquiring. Addressing this type of issue, Kristjánsdóttir et al [ 84 ] grouped strengths into 4 categories (ie, personal strengths, strategies, resources in the environment, joy, and meaning), giving the users the choice of which category of strengths to assess. For MyStrengths, it might be that giving users the option to hide unwanted strengths could reduce the negative experiences from being reminded of strengths that are, for instance, out of reach.…”