Have you recently looked for an app to help improve your health or the health of your family or patients? If you have, you won’t be surprised to learn that the number of mobile health (mHealth) apps has doubled in the last few years, with over 100,000 available for download in the AppStore. And, that number doesn’t include interactive, mobile health websites. Predominantly targeting chronically ill or injured patients and health/fitness-minded people, these apps aim to change behavior, manage health care issues, and improve health. The challenge is that many of them are developed outside of health care organizations, and although well-meaning, may not have much of an evidence-base or may not have been evaluated to show whether they truly change behavior and improve health.
Digital health developers need to make sure that they are starting with building the evidence in, as well as getting the evidence out. This has been our mantra, both in our own research and in the tools we have developed or are developing, including AfterTheInjury.org and Coping Coach. Digital health developers need to make sure that their tools are built on solid theory, as well as evidence from previous research and that they are being shared in a way that resonates with users to drive behavioral change for optimum health results.
As more and more apps and mobile sites are available to educate and motivate us on a wide variety of health issues and as more of us in the health arena develop these tools, it’s important to remember some basic tenets of health education and behavior change. Whether it’s a brochure, a self-guided printed manual, a website, or an mHealth app, the following best practice approaches and developmental steps serve as a guide for developing tools with the best chance of improving health:
Step 1. Understand the problem and your audience. What are you trying to solve? Why is it a problem? Who is your specific audience? What is age appropriate? Are there cultural, language or health literacy issues in addressing the problem?
Step 2. Use theory and evidence to guide app development. Review the literature to see what has worked in the past, with similar issues or audiences. Has anything been done using mHealth tools or will you need to adapt existing interventions to a technology-based approach? What well-grounded behavior change theory will guide your app development?
Step 3. Talk to representatives of your target audience and stakeholders. Are there gaps between the literature and the views and needs of the audience and stakeholders?
Step 4. Design your app / intervention. What is the best communication channel? Is mHealth the right approach? Develop concepts and early stage renderings to get user and stakeholder input. Then apply user-centered design principles.
Step 5. Build a Minimal Viable Product (MVP). Build just enough to allow you to get early feedback and then refine the app.
So, if you are developing an mHealth tool, think carefully about how you will integrate this best practice approach. If you are using an mHealth tool or recommending one to a patient, think critically and find out whether it was developed based on these best practices.
Over the next few months, we will have a series of blog posts focusing on using health communication best practices (health literacy, culturally-tailored development, content validity assessment, usability testing) in the development of mHealth apps and ways to evaluate their impact. Check back to learn more!
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