Put on your thinking app: Involving end-users in the development of mHealth technology


Mobile phone applications (apps) are being continually used to supplement diabetes prevention programs; however, apps are rarely grounded in evidence, highlighting a need for more rigorous development and evaluation. The purpose of this study was to develop and test an app prototype to support diet and physical activity behaviour change among participants in the Small Steps for Big Changes diabetes prevention program. Based on a previous needs assessment and literature review, 14 potential app components were identified. This study consisted of: 1) end-user evaluations of wireframes for these 14 components; 2) development of a minimal viable product (MVP) and; 3) a heuristic evaluation in which an expert completed 6 pre-specified tasks within the app to identify usability errors. Based on end-user evaluations, the MVP was designed to include the following features: an exercise timer, exercise videos, goal setting feature, heart rate calculator, progress tracker, and self-reported exercise feature. During the heuristic evaluation of the MVP, 18 errors were identified and reported back to the app developer. Through rapid prototyping and testing, we were able to iteratively improve upon our mHealth intervention and refine the app requirements with end-users. Understanding end-user perspectives and accommodating their priorities in the development of an app will maximize the acceptability and future uptake of the resulting app by Small Steps for Big Changes participants. This approach of rapid development, prototyping, and iteration with end-users can be used by future mHealth developers to ensure the timely development of implementable and evidence-based apps.