Design, development, utility and usability testing of the EMPOWER-SUSTAIN Self-Management Mobile App© among primary care physicians and patients with metabolic syndrome

Maryam Hannah Daud; Fakhrul Hazman Yusoff; Suraya Abdul-Razak; Noorhida Baharudin; Mohamed-Syarif Mohamed-Yassin; Siti Fatimah Badlishah-Sham; Azlina Wati Nikmat; Mohamad Rodi Isa; Nursuriati Jamil; Hapizah Nawawi; Anis Safura Ramli

doi:10.1177/20552076231176645

Design, development, utility and usability testing of the EMPOWER-SUSTAIN Self-Management Mobile App^© among primary care physicians and patients with metabolic syndrome

Digit Health. 2023 May 31:9:20552076231176645. doi: 10.1177/20552076231176645. eCollection 2023 Jan-Dec.

Authors

Affiliations

¹ Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh, Selangor, Malaysia.
² Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh, Selangor, Malaysia.
³ KaitNow Tech, Klang, Selangor, Malaysia.
⁴ Cardio Vascular and Lungs Research Institute (CaVaLRI), Hospital Al-Sultan Abdullah (HASA), Universiti Teknologi MARA, Puncak Alam, Selangor, Malaysia.
⁵ Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia.
⁶ Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia.
⁷ Computing Centre of Studies, College of Computing, Informatics and Media, Universiti Teknologi MARA, Shah Alam, Selangor, Malaysia.

Abstract

Objective: This study aimed to design, develop, assess and refine the EMPOWER-SUSTAIN Self-Management Mobile App^© among primary care physicians (PCP) and patients with metabolic syndrome (MetS) in primary care.

Methodology: Using the software-development-life-cycle (SDLC) iterative model, storyboard and wireframe were drafted; and a mock prototype was designed to illustrate the content and function graphically. Subsequently, a working prototype was developed. Qualitative studies using the 'think-aloud' and cognitive-task-analysis methods were conducted for the utility and usability testing. Topic guide was based on the 10-Nielsen's-Heuristic-Principles. Utility testing was conducted among PCP in which they 'thought-aloud' while performing tasks using the mobile app. Usability testing was conducted among MetS patients after they were given the app for 3 weeks. They 'thought-aloud' while performing tasks using the app. Interviews were audio- and video-recorded, and transcribed verbatim. Thematic content analysis was performed.

Result: Seven PCP and nine patients participated in the utility and usability testing, respectively. Six themes (efficiency of use, user control and freedom, appearance and aesthetic features, clinical content, error prevention, and help and documentation) emerged. PCP found the mobile app attractive and relevant sections were easy to find. They suggested adding 'zoom/swipe' functions and some parts needed bigger fonts. Patients commented that the app was user-friendly, has nice interface, and straightforward language. It helped them understand their health better. Based on these findings, the mobile app was refined.

Conclusion: This app was produced using a robust SDLC method to increase users' satisfaction and sustainability of its use. It could potentially improve self-management behaviour among MetS patients in primary care.

Keywords: cognitive task analysis; mobile health app development; primary care; utility and usability testing; ‘think-aloud’ method.