Design and development of a smartphone app for hypertension management: An intervention mapping approach

Frontiers in Public Health · 10 authors, 5 centres

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TL;DR

This paper describes the design and development process of a smartphone app for hypertension self-management using a systematic, theory-based intervention mapping approach. The central result is the creation of an mHealth prototype integrating a wearable blood pressure device, which will be evaluated in a future study.

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The development was informed by a literature review and stakeholder consultation to identify user preferences (e.g., education, medication adherence) and establish objectives. Theoretical models (Information, Motivation, and Behavior Skills Model; Patient Health Engagement Model) guided the integration of features like health education, wearable-based blood pressure monitoring, clinician portals for medication titration, and push notifications. The app aims to address gaps in existing mHealth apps, such as lack of theoretical basis and clinician support. The study is limited to the design phase; clinical effectiveness and usability will be evaluated in a planned future trial. Technical limitations include potential data loss from Bluetooth connectivity issues.

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other

SPECIALTY

cardiology

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ORIGINAL PAPER

PMC10050573

Design and development of a smartphone app for hypertension management: An intervention mapping approach

Frontiers in Public Health

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ABSTRACT

Abstract Background Several research studies have demonstrated the potential of mobile health apps in supporting health management. However, the design and development process of these apps are rarely presented. Objective We present the design and development of a smartphone-based lifestyle app integrating a wearable device for hypertension management. Methods We used an intervention mapping approach for the development of theory- and evidence-based intervention in hypertension management. This consisted of six fundamental steps: needs assessment, matrices, theoretical methods and practical strategies, program design, adoption and implementation plan, and evaluation plan. To design the contents of the intervention, we performed a literature review to determine the preferences of people with hypertension (Step 1) and necessary objectives toward the promotion of self-management behaviors (Step 2). Based on these findings, we implemented theoretical and practical strategies in consultation with stakeholders and researchers (Steps 3), which was used to identify the functionality and develop an mHealth app (Step 4). The adoption (Step 5) and evaluation (Step 6) of the mHealth app will be conducted in a future study. Results Through the needs analysis, we identified that people with hypertension preferred having education, medication or treatment adherence, lifestyle modification, alcohol and smoking cessation and blood pressure monitoring support. We utilized MoSCoW analysis to consider four key elements, i.e., education, medication or treatment adherence, lifestyle modification and blood pressure support based on past experiences, and its potential benefits in hypertension management. Theoretical models such as (i) the information, motivation, and behavior skills model, and (ii) the patient health engagement model was implemented in the intervention development to ensure positive engagement and health behavior. Our app provides health education to people with hypertension related to their condition, while utilizing wearable devices to promote lifestyle modification and blood pressure management. The app also contains a clinician portal with rules and medication lists titrated by the clinician to ensure treatment adherence, with regular push notifications to prompt behavioral change. In addition, the app data can be reviewed by patients and clinicians as needed. Conclusions This is the first study describing the design and development of an app that integrates a wearable blood pressure device and provides lifestyle support and hypertension management. Our theory-driven intervention for hypertension management is founded on the critical needs of people with hypertension to ensure treatment adherence and supports medication review and titration by clinicians. The intervention will be clinically evaluated in future studies to determine its effectiveness and usability. Keywords: blood pressure, smartphone, mobile phone, applications, digital health

CITATION EXPORT

Elton H Lobo, Chandan Karmakar, Mohamed Abdelrazek et al.. Design and development of a smartphone app for hypertension management: An intervention mapping approach. Frontiers in Public Health. (2023). https://doi.org/10.3389/fpubh.2023.1092755

AUTHORS

10 · 5 CENTRES

Elton H Lobo, Chandan Karmakar, Mohamed Abdelrazek, Jemal Abawajy, Clara K Chow, Yuxin Zhang, Muhammad Ashad Kabir, Reza Daryabeygi, Ralph Maddison, Sheikh Mohammed Shariful Islam

1Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, VIC, Australia
2Department of General Practice, The University of Melbourne, Melbourne, VIC, Australia
3School of Information Technology, Deakin University, Geelong, VIC, Australia
4Westmead Applied Research Centre, University of Sydney, Sydney, NSW, Australia
5School of Computing, Mathematics and Engineering, Charles Sturt University, Bathurst, NSW, Australia