Recommendations for Developing Support Tools With People Suffering From Chronic Obstructive Pulmonary Disease: Co-Design and Pilot Testing of a Mobile Health Prototype

Abstract

Background Gaps exist between developers, commissioners, and end users in terms of the perceived desirability of different features and functionalities of mobile apps. Objective The objective of this study was to co-design a prototype mobile app for people with chronic obstructive pulmonary disease (COPD). We present lessons learned and recommendations from working on a large project with various stakeholders to develop a mobile app for patients with COPD. Methods We adopted a user-centered, participatory approach to app development. Following a series of focus groups and interviews to capture requirements, we developed a prototype app designed to enable daily symptom recording (experience sampling). The prototype was tested in a usability study applying the think aloud protocol with people with COPD. It was then released via the Android app store, and experience sampling data and event data were captured to gather further usability data. Results A total of 5 people with COPD participated in the pilot study. Identified themes include familiarity with technology, appropriate levels for feeding back information, and usability issues such as manual dexterity. Moreover, 37 participants used the app over a 4-month period (median age 47 years). The symptoms most correlated to perceived well-being were tiredness (r=0.61; P<.001) and breathlessness (r=0.59; P<.001). Conclusions Design implications for COPD apps include the need for clearly labeled features (rather than relying on colors or symbols that require experience using smartphones), providing weather information, and using the same terminology as health care professionals (rather than simply lay terms). Target users, researchers, and developers should be involved at every stage of app development, using an iterative approach to build a prototype app, which should then be tested in controlled settings as well as in the wild (ie, when deployed and used in real-world settings) over longer periods.

Patient-facing genetic and genomic mobile apps in the UK: a systematic review of content, functionality, and quality

“…Involving future end users in the codesign process is more likely to ensure that the content is appropriate, acceptable, and the final app is utilised. During the design of a health app for Chronic Obstructive Pulmonary Disease (COPD), researchers found that target users, researchers, and developers should be involved at every stage of app development, using an agile approach, including the building of a prototype app, which should then be tested in controlled settings as well as in the wild (Davies et al 2020).…”

The Use of an Electronic Painting Platform by Family Caregivers of Persons with Dementia: A Feasibility and Acceptability Study

“…We also added background music to the app, which has a similar effect to that of music therapy of providing a relaxing environment for the participants to draw paintings and reduce their stress. It is crucial to adopt a co-design approach when developing mobile health tools to support laymen in health promotions and health education [39].…”

Use of Ecological Momentary Assessment to Measure Dyspnea in COPD

“…The first study, a 2020 mHealth Prototype design pilot study, used a 3-Phase process to develop an EMA app with input from patients with COPD. 44 During the first phase of the study, participants reported that symptom monitoring was important to their own COPD self-management due to difficulties recalling details and managing the complexity of COPD. Patients with COPD worked with researchers to make recommendations on symptom and medication monitoring and determined five symptoms to assess via EMA: breathlessness, coughing, mucus, tiredness, and sleep quality.…”

“…While the RESP-FIT study did not find any age-related technological issues in older participants, 34 Phase 2 of the Prototype study (n=5) reported that a sliding scale was not user-friendly and recommended a larger font size on mobile applications for older participants. 44 Thus, digital literacy should be considered and further explored in EMA research in COPD. Finally, generation of large datasets with a complex structure leads to complicated and challenging statistical analyses.…”