Abstract
Background: Mobile health (mHealth) has the potential to bring preventive healthcare within reach of populations with limited access to preventive services, by delivering personalized support at low cost. Although numerous mHealth interventions are available, very few have been developed following an evidence-based rationale or have been tested for efficacy. This article describes the systematic development of a coach-supported mHealth application to improve healthy lifestyles for the prevention of dementia and cardiovascular disease in the United Kingdom (UK) and China.Methods: Development of the Prevention of Dementia by Mobile Phone applications (PRODEMOS) platform built upon the experiences with the Healthy Aging Through Internet Counseling in the Elderly (HATICE) eHealth platform. In the conceptualization phase, experiences from the HATICE trial and needs and wishes of the PRODEMOS target population were assessed through semi-structured interviews and focus group sessions. Initial technical development of the platform was based on these findings and took place in consecutive sprint sessions. Finally, during the evaluation and adaptation phase, functionality and usability of the platform were evaluated during pilot studies in UK and China.Results: The PRODEMOS mHealth platform facilitates self-management of a healthy lifestyle by goal setting, progress monitoring, and educational materials on healthy lifestyles. Participants receive remote coaching through a chat functionality. Based on lessons learned from the HATICE study and end-users, we made the intervention easy-to-use and included features to personalize the intervention. Following the pilot studies, in which in total 77 people used the mobile application for 6 weeks, the application was made more intuitive, and we improved its functionalities.Conclusion: Early involvement of end-users in the development process and during evaluation phases improved acceptability of the mHealth intervention. The actual use and usability of the PRODEMOS intervention will be assessed during the ongoing PRODEMOS randomized controlled trial, taking a dual focus on effectiveness and implementation outcomes.
Highlights
The projected worldwide increase in dementia prevalence is expected to largely occur in low- and middle-income countries and amongst hard-to-reach populations in highincome countries [1, 2]
Mobile health applications can contribute to personalized care and remote delivery of health messaging and services, at low cost and on a global scale [7, 8]
We describe the development of the PRODEMOS Mobile health (mHealth) intervention, from general idea to platform design, and from prototype to pilot study
Summary
The projected worldwide increase in dementia prevalence is expected to largely occur in low- and middle-income countries and amongst hard-to-reach populations in highincome countries [1, 2]. An estimated 30–40% of late-life dementia appears to be attributable to potentially modifiable risk factors, including smoking, insufficient physical activity, and unhealthy diet [3]. Interventions targeting these risk factors may have the potential to delay or prevent dementia onset and could be especially beneficial for vulnerable populations, given their high exposure to high risk of these behaviors [4, 5]. Mobile health (mHealth) has the potential to bring preventive healthcare within reach of populations with limited access to preventive services, by delivering personalized support at low cost. Numerous mHealth interventions are available, very few have been developed following an evidence-based rationale or have been tested for efficacy. This article describes the systematic development of a coach-supported mHealth application to improve healthy lifestyles for the prevention of dementia and cardiovascular disease in the United Kingdom (UK) and China
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