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. 2024 May 20:10:20552076241249269.
doi: 10.1177/20552076241249269. eCollection 2024 Jan-Dec.

User-centered development of an mHealth app for cardiovascular prevention

Lara Marie Reimer  1   2 , Leon Nissen  2 , Moritz von Scheidt  3   4 , Benedikt Perl  5 , Jens Wiehler  6 , Sinann Al Najem  7 , Florian P Limbourg  8   9 , Theodora Tacke  10 , Angelina Müller  10 , Stephan Jonas  2 , Heribert Schunkert  3   4   7   11 , Fabian Starnecker  3   4
Affiliations

User-centered development of an mHealth app for cardiovascular prevention

Lara Marie Reimer et al. Digit Health. .

Abstract

Background: Mobile health (mHealth) apps can be used for cardiovascular disease (CVD) prevention. User-centered design, evidence-based content and user testing can be applied to ensure a high level of usability and adequate app access.

Objective: To develop and evaluate an mHealth app (HerzFit) for CVD prevention.

Methods: HerzFit´s development included a user-centered design approach and guideline-based content creation based on the identified requirements of the target group. Beta testing and a preliminary usability evaluation of the HerzFit prototype were performed. For evaluation, German versions of the System Usability Scale (SUS) and the mHealth App Usability Questionnaire (GER-MAUQ) as well as free text feedback were applied.

Results: User-centered design thinking led to the definition of four personas. Based on their requirements, HerzFit enables users to individually assess, monitor, and optimize their cardiovascular risk profile. Users are also provided with a variety of evidence-based information on CVD and their risk factors. The user interface and system design followed the identified functional requirements. Beta-testers provided feedback on the structure and functionality and rated the usability of HerzFit´s prototype as slightly above average both in SUS and GER-MAUQ rating. Participants positively noted the variety of functions and information presented in HerzFit, while negative feedback mostly concerned wearable synchronization.

Conclusions: The present study demonstrates the user-centered development of a guideline-based mHealth app for CVD prevention. Beta-testing and a preliminary usability study were used to further improve the HerzFit app until its official release.

Keywords: Cardiovascular disease; HerzFit; cardiovascular risk assessment; lifestyle; mHealth app; mHealth app usability questionnaire; personas; prevention; system usability scale; usability.

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Conflict of interest statement

The authors have nothing to disclose.

Figures

Figure 1.
Figure 1.
Personas and their potential requirements identified during HerzFit´s design thinking phase.
Figure 2.
Figure 2.
Connecting HerzFit with Apple Health/HealthKit for automatic synchronization of sensor data.
Figure 3.
Figure 3.
Core modules of the HerzFit app. The HerzFit app is divided into four core modules: two modules for assessing cardiovascular risk and monitoring health parameters (“Measure”), one module for lifestyle modification (“Improve”), and one module for information about cardiovascular health and disease (“Learn”). The profile area allows users to manage their profile settings and upload documents.
Figure 4.
Figure 4.
Top-level design of the HerzFit system. The HerzFit app gathers health and lifestyle data and receives content and information from the content management system.
Figure 5.
Figure 5.
Herzfit usability testing. Boxplots of the results of the HerzFit usability testing, representing the two used questionnaires System Usability Scale (SUS) and German mHealth App Usability Questionnaire (GER-MAUQ) including its three subscales Ease of Use (GER-MAUQ_Q), Interface and Satisfaction (GER-MAUQ_I), and Usefulness (GER-MAUQ_U). With an average SUS score of 68.1 (median 70.0 ± 18.8) and an average GER-MAUQ score of 4.5 (median 4.6 ± 1.4) HerzFit´s usability was rated as above average. In the subscale analysis, HerzFit showed an above-average performance in Ease of Use (GER-MAUQ_E) and Interface and Satisfaction (GER-MAUQ_I), and an average performance in Usefulness (GER-MAUQ_U). The average ratings for both scales are represented by the red lines.
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