Exploring Stroke Survivors’ Experiences and Perspectives of mHealth Applications to Inform Guidelines for Good UX Design

Abstract

This inquiry looked at the use of mobile health (mHealth) applications among stroke survivors (survivors). Literature shows that mHealth applications have the potential to support self-management following stroke. Despite this, the acceptability rate by survivors is currently deemed low. This inquiry sought to understand why this is so to inform a set of actionable guidelines to support the design and development of mHealth applications for survivors.

Social constructionism guided this inquiry, revealing the views and perceptions of participants in their unique situations. Along with this, an interpretivist approach underpinned the decision to use action research to collaboratively undertake this doctoral work. Data was collected by examining current literature and conducting interviews with survivors, application (app) designers, and health care professionals (HCPs). The interviews, undertaken in three cycles, were aligned with Coghlan and Brannick’s (2014) action research cycle model including phases of constructing and planning action, taking action, and evaluating action.

The outcome of cycles one and two were applied in the creation of a proposed prototype called ‘A Comfortable Communication Environment for Stroke Survivors’ (ACCESS) to test the user experience (UX) of a proposed user interface to provide insights into the usefulness of the proposed guidelines in practice.

Findings indicated that three main themes with 17 supporting categories were of value to the stroke community. Themes included: 1) qualities promoting acceptance of mHealth - desired applications, which included four categories: connecting, reminding, monitoring, and being informed; 2) post-stroke capability of survivors, which is related to the capability of stroke survivors with regard to the use of mHealth applications, and produced four categories: physical, emotional, psychological and medical complications; and 3) qualities influencing survivors' possibilities for access to mHealth applications, which are supported by nine categories: digital literacy, social support, technological support, language barriers, affordability, design of interface, engagement, motivation, and security.

The process of undertaking this inquiry led to actionable knowledge – guidelines that contribute to the human-computer interface field and demonstrate the value of finding solutions through action research. The guidelines that were created and evaluated are now available for app designers to use.

This doctoral work contributes to mHealth technology acceptance literature by: 1) examining the factors that affect mHealth application acceptance; and 2) exploring participants' insights into mHealth services from different perspectives to identify the key factors relevant to human decision-making in the context of mHealth applications and survivors. To the best of the writer’s knowledge, this inquiry is among the first to explore survivors' experiences of the acceptance of mHealth applications, and certainly the first to propose guidelines for developing stroke-related mHealth applications with good UX.