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PreprintCited by 1Usability and User Interface DesignMobile Health and mHealth ApplicationsInnovative Human-Technology Interaction

USER-CENTERED DESIGN AND USABILITY EVALUATION OF A CANCER PREVENTION WEB APPLICATION: AN ITERATIVE APPROACH IN GERMANY

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Carrera, Pricivel, Elias, Odile, Zhang, Ruidong, Norajitra, Tobias, Goncalves, Angela, Maier-Hein, Klaus·2025·medRxiv
DOI 10.1101/2025.04.29.25326679
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Abstract

Objectives: Limited public awareness of cancer risk factors necessitates effective dissemination of cancer prevention information. Digital technologies offer an opportunity to address this gap, yet there is scant information on tools for communicating cancer prevention evidence. This article describes the user-centered design, development and usability evaluation of a web application for personalized cancer prevention tailored to the German population. Materials and Methods: Prototypes of the web-app were developed through early and continuous formative evaluations. These prototypes integrated validated cancer risk prediction models and recommendations using an evidence-based risk communication approach. In a graphical user interface (GUI) test usability was assessed using the system usability scale (SUS), deriving scores for overall usability, usefulness, and learnability. Qualitative data on user experience (UX) and user interface (UI) issues were also collected through think-aloud protocols, interviews, and questionnaires. Findings: The GUI test showed a SUS score of 69.7/100 and a usefulness score of 75.8, indicating acceptable usability, while the learnability score was 48.4. Eight categories of UX/UI problems were identified, including one severe and three moderate issues related to data input, user guidance and risk visualization. Qualitative feedback highlighted strengths in navigation, information presentation, and interactive features such as the risk simulation tool. Discussion: The iterative development and early user testing yielded valuable feedback, identifying key usability concerns during prototyping. The usability score was within an acceptable range, and the usefulness score was above average. However, the lower learnability score indicated potential challenges in user understanding and satisfaction. Identified usability issues highlight areas for improvement while positive feedback supports the design choices, particularly the use of visual aids, numerical data, and personalized feedback to improve risk comprehension and motivate behavior change. Conclusion: The NCPC cancer prevention web application represents a significant step towards effective digital health promotion in Germany. Addressing identified usability concerns through continued iterative refinement and user involvement is crucial for enhancing the tool’s effectiveness. The integration of evidence-based risk communication strategies shows promise in improving risk comprehension and motivating behavior change among users.

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  • An iterative development process of a cancer prevention web application by Carrera et al [45] and the prevention-focused web application described by Anders et al [32] incorporated repeated cycles of feedback that shaped tutorials and interactive features.

    “Similarly, an iterative development process of a cancer prevention web application by Carrera et al [45] and the prevention-focused web application described by Anders et al [32] incorporated repeated cycles of feedback that shaped tutorials and interactive features, supporting its potential to enhance risk understanding and healthy behavior.”

    From User-Centered Design for Digital Patient-Navigation Tools in Oncology: Scoping Review (2026) · cites this paper as [45]

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  • The iterative development of the prevention web applications supports their potential to enhance risk understanding and healthy behavior.

    “Similarly, an iterative development process of a cancer prevention web application by Carrera et al [45] and the prevention-focused web application described by Anders et al [32] incorporated repeated cycles of feedback that shaped tutorials and interactive features, supporting its potential to enhance risk understanding and healthy behavior.”

    From User-Centered Design for Digital Patient-Navigation Tools in Oncology: Scoping Review (2026) · cites this paper as [45]

    The Iterative development section describes repeated formative evaluations whose feedback refined the cancer-prevention app’s content, functionality, and risk visualizations. The Conclusion says its risk-communication features show promise for improving risk comprehension and motivating behavior change. However, the Discussion describes tutorials as a user recommendation, not a feature already shaped or incorporated through those cycles. (LLM, conf=0.84)

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Cited by

Sorted by citations

  • User-Centered Design for Digital Patient-Navigation Tools in Oncology: Scoping Review

    Kheirinejad, S., White, B. M., Kheirkhah Rahimabad, P., Zink, J. A., Hashtarkhani, S., Kumsa, F. A., Rashid, R., Chinthala, L., Brett, C. L., Davis, R. L., et al. (2026) · JMIR Human Factors · doi:10.2196/87686

    “Similarly, an iterative development process of a cancer prevention web application by Carrera et al [45] and the prevention-focused web application described by Anders et al [32] incorporated repeated cycles of feedback that shaped tutorials and interactive features, supporting its potential to…”

Authors
Carrera, P., Elias, O., Zhang, R., Norajitra, T., Goncalves, A., & Maier-Hein, K.
Affiliations
  • Cochrane (GB)
  • German Cancer Research Center (DE)
Corresponding author
Carrera, Pricivel
ORCID
Venue
medRxiv
Publisher
openRxiv
Published
2025-04-30
DOI
10.1101/2025.04.29.25326679
OpenAlex
W4410016867
Cited by
1
References
1
Citations by year
2026: 1
Type
posted content
Language
en
Open access
Licence
Locations
medRxiv (acceptedVersion, cc-by-nc)
Funders
  • Deutsches Krebsforschungszentrum
  • North Carolina Pork Council
  • Deutsche Krebshilfe
Topics
  • Physical Sciences › Computer Science › Human-Computer Interaction › Usability and User Interface Design
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Physical Sciences › Computer Science › Human-Computer Interaction › Innovative Human-Technology Interaction
Keywords
cancer prevention, web application, usability evaluation, user-centered design, cancer risk prediction, digital health promotion, user experience, learnability, risk visualization, behavior change

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