User-centred design of ChestCare: mHealth app for pulmonary rehabilitation for patients with COPD; a mixed-methods sequential approach

Devinder Singh, Arimi Fitri Mat Ludin, Nazlena Ali, Suad Ghaben
Purpose:

This study aimed to design and develop the ChestCare mHealth app using a user-centred design (UCD) approach. Thus, it provided PTR for patients with COPD, enhancing their self-management of symptoms and improving their compliance with PR programs. which would provide solutions to the PR challenges.

Methods:

In this mixed-methods sequential research, we deployed the UCD iterative design through the prototype app design and development sequence. The first phase was built based on the results of a previous needs assessment study and an analysis of related apps. This produced the initial mock-up, the foundation for the focus group discussions with potential users. The research team prepared the FGD moderator guide based on published literature on similar projects and verified it. Five physiotherapists and three patients with COPD participated in three sequential FGDs to provide their perspectives on the proposed mock-ups. We used a framework and deductive analysis to analyze the qualitative data from the sequential FGDs. In parallel, we made changes to the initial mock-up, resulting in three more versions. We developed and piloted the content validity document. Six physiotherapists with cardiorespiratory specialisation evaluated each app module and item of the latest mock-up on a 1-4 scale. The I-CVI, (S-CVI/Ave) and (S-CVI/UA) were computed. Qualitative and quantitative data were integrated, and decisions were made by comparing their results.

Results:

The UCD iterative design through sequential MMR has generated four mock-up app versions. The latest version identified 13 modules through 150 items validated by six experts using a CVI document. The I-CVI calculation of 145 items was 1, while 0.83 was calculated for the remaining items, which was within accepted values. The S-CVI scored 99.4, indicating the overall validity of the ChestCare app as a PTR system for patients with COPD.

Conclusion(s):

The development and validation of the ChestCare app resulted from conducting UCD iterative design and sequential MMR, which identified 13 functionalities, including symptom assessment, tracking lung volume, functional capacity test, action plan, intervention program, COPD education, COPD community, monitoring, and reminders.

Implications:

We expect that developing the ChestCare app would facilitate the delivery of the PR programs, and overcome the mentioned challenges. It would also enhance the establishment of the PTR programs. Additionally, deploying the mHealth app in rehabilitation programs would enhance the performance of healthcare services. 


Funding acknowledgements:
The author(s) received no financial support for this article's research, authorship, and/or publication.
Keywords:
UCD
COPD
telerehabilitation
Primary topic:
Cardiorespiratory
Second topic:
Innovative technology: information management, big data and artificial intelligence
Third topic:
Service delivery/emerging roles
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
This study was approved by the Research Ethics Committee, Universiti Kebangsaan Malaysia
Provide the ethics approval number:
(UKM PP1/111/8/JEP-2022-561)
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
Yes

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