Abstract
BackgroundAdolescent and young adult (AYA) cancer patients are seldom involved in the process of testing cancer-related apps. As such, knowledge about youth-specific content, functionalities, and design is sparse. As a part of a co-creation process of developing the mobile phone app Kræftværket, AYAs in treatment for cancer and in follow-up participated in a usability think-aloud test of a prototype of the app. Thus, the app was initiated, created, and evaluated by AYAs with cancer experience.ObjectiveThe aim of this study was to explore the results of a think-aloud test administered to see how the prototype of the app Kræftværket was used by AYAs in treatment for cancer and in follow-up, and to investigate the strengths and weaknesses of the app.MethodsA total of 20 AYA cancer patients aged 16 to 29 years (n=10 on treatment, n=10 in follow-up) were provided with the first version of the co-created mobile phone app Kræftværket during a 6-week test period (April-May 2018). After the test period, 15 participated in individual usability think-aloud tests. The tests were video-recorded, transcribed verbatim, and analyzed using a thematic analysis approach.ResultsThe thematic analysis led to the following themes and subthemes: navigation (subthemes: intuition, features, buttons, home page, profile), visual and graphic design (subthemes: overview, text and colors, photos, videos, YouTube), and usefulness (subthemes: notifications, posts, adding). The analysis identified gender differences in app utilization—female participants seemed to be more familiar with parts of the app. The app seemed to be more relevant to AYAs receiving treatment due to app functions such as tracking symptoms and searching for relevant information. Lack of notifications and incorrect counting of posts were perceived as barriers to using the app.ConclusionsUsability testing is crucial to meet the needs of the AYA target audience. AYA cancer apps should preferably be relevant, targeted, and unique, and include a tracking function and AYA-produced videos. Notifications and correct marking and ordering of posts are critical to make apps engaging and dynamic. Further research is recommended to evaluate the Kræftværket app with the input of more AYAs.
Highlights
In Denmark, approximately 500 adolescents and young adults (AYAs) aged 15 to 29 years are diagnosed with cancer each year
For AYA cancer patients, networking with peers, information seeking, and tracking of symptoms are found to be most relevant at diagnosis onset and during the initial treatment period [6,7], and the motivation to use health apps often decreases over time [8,9]
Several apps have been developed for AYAs with cancer, but AYAs have rarely been involved in the development process [11,12] despite research indicating that user involvement in the development of Mobile health (mHealth) solutions is necessary to ensure relevant content and functionality [13,14]
Summary
In Denmark, approximately 500 adolescents and young adults (AYAs) aged 15 to 29 years are diagnosed with cancer each year. There has been an increased focus on AYA cancer patients as a group with special treatment and support needs, addressing problems such as social maturity, identity-forming, health concerns, romantic relationships, friendships, fertility, mood changes, and risk of depression and anxiety [1,2]. Mobile health (mHealth) apps have demonstrated benefits in addressing some of these needs of AYAs, including connecting with peers and health care teams, accessing information, and health care tracking [3,4,5]. For AYA cancer patients, networking with peers, information seeking, and tracking of symptoms are found to be most relevant at diagnosis onset and during the initial treatment period [6,7], and the motivation to use health apps often decreases over time [8,9]. Adolescent and young adult (AYA) cancer patients are seldom involved in the process of testing cancer-related apps. The app was initiated, created, and evaluated by AYAs with cancer experience
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