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Lessons and Reflections From an Extended Co-design Process Developing an mHealth App With and for Older Adults: Multiphase, Mixed Methods Study
BACKGROUND: There are many mobile health (mHealth) apps for older adult patients, but research has found that broadly speaking, mHealth still fails to meet the specific needs of older adult users. Others have highlighted the need to embed users in the mHealth design process in a fulsome and meaningf...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
JMIR Publications
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9652733/ https://www.ncbi.nlm.nih.gov/pubmed/36306166 http://dx.doi.org/10.2196/39189 |
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author | Tong, Catherine Kernoghan, Alison Lemmon, Kassandra Fernandes, Paige Elliott, Jacobi Sacco, Veronica Bodemer, Sheila Stolee, Paul |
author_facet | Tong, Catherine Kernoghan, Alison Lemmon, Kassandra Fernandes, Paige Elliott, Jacobi Sacco, Veronica Bodemer, Sheila Stolee, Paul |
author_sort | Tong, Catherine |
collection | PubMed |
description | BACKGROUND: There are many mobile health (mHealth) apps for older adult patients, but research has found that broadly speaking, mHealth still fails to meet the specific needs of older adult users. Others have highlighted the need to embed users in the mHealth design process in a fulsome and meaningful way. Co-design has been widely used in the development of mHealth apps and involves stakeholders in each phase of the design and development process. The involvement of older adults in the co-design processes is variable. To date, co-design approaches have tended toward embedding the stakeholders in early phases (eg, predesign and generative) but not throughout. OBJECTIVE: The aim of this study was to reflect on the processes and lessons learned from engaging in an extended co-design process to develop an mHealth app for older adults, with older users contributing at each phase. This study aimed to design an mHealth tool to assist older adults in coordinating their care with health care professionals and caregivers. METHODS: Our work to conceptualize, develop, and test the mHealth app consisted of 4 phases: phase 1, consulting stakeholders; phase 2, app development and co-designing with older adults; phase 3, field-testing with a smaller sample of older adult volunteer testers; and phase 4, reflecting, internally, on lessons learned from this process. In each phase, we drew on qualitative methods, including in-depth interviews and focus groups, all of which were analyzed in NVivo 11, using team-based thematic analysis. RESULTS: In phase 1, we identified key features that older adults and primary care providers wanted in an app, and each user group identified different priority features (older adults principally sought support to use the mHealth app, whereas primary care providers prioritized recoding illnesses, immunizations, and appointments). Phases 2 and 3 revealed significant mismatches between what the older adult users wanted and what our developers were able and willing to deliver. We were unable to craft the app that our consultations recommended, which the older adult field testers asked for. In phase 4, we reflected on our abilities to embed the voices and perspectives of older adults throughout the project when working with a developer not familiar with or committed to the core principles of co-design. We draw on this challenging experience to highlight several recommendations for those embarking on a co-design process that includes developers and IT vendors, researchers, and older adult users. CONCLUSIONS: Although our final mHealth app did not reflect all the needs and wishes of our older adult testers, our consultation process identified key features and contextual information essential for those developing apps to support older adults in managing their health and health care. |
format | Online Article Text |
id | pubmed-9652733 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | JMIR Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-96527332022-11-15 Lessons and Reflections From an Extended Co-design Process Developing an mHealth App With and for Older Adults: Multiphase, Mixed Methods Study Tong, Catherine Kernoghan, Alison Lemmon, Kassandra Fernandes, Paige Elliott, Jacobi Sacco, Veronica Bodemer, Sheila Stolee, Paul JMIR Aging Original Paper BACKGROUND: There are many mobile health (mHealth) apps for older adult patients, but research has found that broadly speaking, mHealth still fails to meet the specific needs of older adult users. Others have highlighted the need to embed users in the mHealth design process in a fulsome and meaningful way. Co-design has been widely used in the development of mHealth apps and involves stakeholders in each phase of the design and development process. The involvement of older adults in the co-design processes is variable. To date, co-design approaches have tended toward embedding the stakeholders in early phases (eg, predesign and generative) but not throughout. OBJECTIVE: The aim of this study was to reflect on the processes and lessons learned from engaging in an extended co-design process to develop an mHealth app for older adults, with older users contributing at each phase. This study aimed to design an mHealth tool to assist older adults in coordinating their care with health care professionals and caregivers. METHODS: Our work to conceptualize, develop, and test the mHealth app consisted of 4 phases: phase 1, consulting stakeholders; phase 2, app development and co-designing with older adults; phase 3, field-testing with a smaller sample of older adult volunteer testers; and phase 4, reflecting, internally, on lessons learned from this process. In each phase, we drew on qualitative methods, including in-depth interviews and focus groups, all of which were analyzed in NVivo 11, using team-based thematic analysis. RESULTS: In phase 1, we identified key features that older adults and primary care providers wanted in an app, and each user group identified different priority features (older adults principally sought support to use the mHealth app, whereas primary care providers prioritized recoding illnesses, immunizations, and appointments). Phases 2 and 3 revealed significant mismatches between what the older adult users wanted and what our developers were able and willing to deliver. We were unable to craft the app that our consultations recommended, which the older adult field testers asked for. In phase 4, we reflected on our abilities to embed the voices and perspectives of older adults throughout the project when working with a developer not familiar with or committed to the core principles of co-design. We draw on this challenging experience to highlight several recommendations for those embarking on a co-design process that includes developers and IT vendors, researchers, and older adult users. CONCLUSIONS: Although our final mHealth app did not reflect all the needs and wishes of our older adult testers, our consultation process identified key features and contextual information essential for those developing apps to support older adults in managing their health and health care. JMIR Publications 2022-10-28 /pmc/articles/PMC9652733/ /pubmed/36306166 http://dx.doi.org/10.2196/39189 Text en ©Catherine Tong, Alison Kernoghan, Kassandra Lemmon, Paige Fernandes, Jacobi Elliott, Veronica Sacco, Sheila Bodemer, Paul Stolee. Originally published in JMIR Aging (https://aging.jmir.org), 28.10.2022. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Aging, is properly cited. The complete bibliographic information, a link to the original publication on https://aging.jmir.org, as well as this copyright and license information must be included. |
spellingShingle | Original Paper Tong, Catherine Kernoghan, Alison Lemmon, Kassandra Fernandes, Paige Elliott, Jacobi Sacco, Veronica Bodemer, Sheila Stolee, Paul Lessons and Reflections From an Extended Co-design Process Developing an mHealth App With and for Older Adults: Multiphase, Mixed Methods Study |
title | Lessons and Reflections From an Extended Co-design Process Developing an mHealth App With and for Older Adults: Multiphase, Mixed Methods Study |
title_full | Lessons and Reflections From an Extended Co-design Process Developing an mHealth App With and for Older Adults: Multiphase, Mixed Methods Study |
title_fullStr | Lessons and Reflections From an Extended Co-design Process Developing an mHealth App With and for Older Adults: Multiphase, Mixed Methods Study |
title_full_unstemmed | Lessons and Reflections From an Extended Co-design Process Developing an mHealth App With and for Older Adults: Multiphase, Mixed Methods Study |
title_short | Lessons and Reflections From an Extended Co-design Process Developing an mHealth App With and for Older Adults: Multiphase, Mixed Methods Study |
title_sort | lessons and reflections from an extended co-design process developing an mhealth app with and for older adults: multiphase, mixed methods study |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9652733/ https://www.ncbi.nlm.nih.gov/pubmed/36306166 http://dx.doi.org/10.2196/39189 |
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