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Cited by 84Mobile Health and mHealth ApplicationsDigital Mental Health InterventionsHIV/AIDS Research and Interventions

Development of an mHealth platform for HIV Care: Gathering User Perspectives Through Co-Design Workshops and Interviews

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Marent, Benjamin, Henwood, Flis, Darking, Mary, EmERGE Consortium·2018·JMIR mHealth and uHealth
DOI 10.2196/mhealth.9856PMC PMC6231792

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Abstract

BACKGROUND: Despite advances in testing and treatment, HIV incidence rates within European countries are at best stable or else increasing. mHealth technology has been advocated to increase quality and cost-effectiveness of health services while dealing with growing patient numbers. However, studies suggested that mHealth apps are rarely adopted and often considered to be of low quality by users. Only a few studies (conducted in the United States) have involved people living with HIV (PLWH) in the design of mHealth. OBJECTIVE: The goal of this study was to facilitate a co-design process among PLWH and clinicians across 5 clinical sites in the European Union to inform the development of an mHealth platform to be integrated into clinical care pathways. We aimed to (1) elicit experiences of living with HIV and of working in HIV care, (2) identify mHealth functionalities that are considered useful for HIV care, and (3) identify potential benefits as well as concerns about mHealth. METHODS: Between January and June 2016, 14 co-design workshops and 22 semistructured interviews were conducted, involving 97 PLWH and 63 clinicians. Data were analyzed thematically and iteratively, drawing on grounded theory techniques. RESULTS: Findings were established into 3 thematic clusters: (1) approaching the mHealth platform, (2) imagining the mHealth platform, and (3) anticipating the mHealth platform's implications. Co-design participants approached the mHealth platform with pre-existing concerns arising from their experiences of receiving or providing care. PLWH particularly addressed issues of stigma and questioned how mHealth could enable them to manage their HIV. Clinicians problematized the compatibility of mHealth with existing information technology systems and questioned which patients should be targeted by mHealth. Imagining the potential of mHealth for HIV care, co-design participants suggested medical functionalities (accessing test results, managing medicines and appointments, and digital communication channels), social functionalities (peer support network, international travel, etc), and general features (security and privacy, credibility, language, etc). Co-design participants also anticipated potential implications of mHealth for self-management and the provision of care. CONCLUSIONS: Our approach to co-design enabled us to facilitate early engagement in the mHealth platform, enabling patient and clinician feedback to become embedded in the development process at a preprototype phase. Although the technologies in question were not yet present, understanding how users approach, imagine, and anticipate technology formed an important source of knowledge and proved highly significant within the technology design and development process.

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  • Other reported methodological limitations included a lack of stakeholder involvement that might result in missing important evaluation criteria and perspectives.

    “Other reported methodological limitations included a lack of stakeholder involvement that might result in missing important evaluation criteria and perspectives [90].”

    From Security and Privacy of mHealth Applications: A Scoping Review (2020) · cites this paper as [90]

    The Discussion > Limitations section reports that some patient and clinician groups were underrepresented, restricting how far the findings can be generalized. But the Methods > Facilitating Co-Design section describes substantial patient and clinician involvement; the paper does not report a general lack of stakeholder involvement or say that evaluation criteria were missed. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Two studies provided guidelines based on co-design sessions that included e-Health experts, clinicians, and cancer survivors or HIV patients.

    “Two studies provided guidelines based on co-design sessions that included e-Health experts, clinicians, and cancer survivors [3] or HIV patients [99].”

    From Security and Privacy of mHealth Applications: A Scoping Review (2020) · cites this paper as [99]

    The Methods sections ‘Facilitating Co-Design’ and ‘Design Specification and Priorities’ describe workshops with people living with HIV and clinicians, whose findings informed a design specification. Technology developers participated in subsequent consortium meetings and a technical co-design group; the copy does not establish that e-Health experts attended the workshops themselves. The cancer-survivor portion is attached to a different citation and is not assessed here. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Three remaining studies applied existing frameworks to evaluate mHealth applications, including ORCHA-24, APA App Evaluation Model and PsyberGuide 10, and the GeoHealth PIA framework.

    “Three remaining studies applied existing frameworks to evaluate mHealth applications, which included ''The Organisation for the Review of Care and Health Applications 24 Question Assessment (ORCHA-24) framework'' [88], IEEEAccess American Psychiatric Association (APA) App Evaluation Model and PsyberGuide 10 [5], and the GeoHealth Privacy Impact Assessment (PIA) framework [90].”

    From Security and Privacy of mHealth Applications: A Scoping Review (2020) · cites this paper as [90]

    The Methods and Results passages describe co-design workshops and interviews for an HIV-care mHealth platform, not an evaluation using an existing app-assessment framework. Searches for ORCHA-24, the APA App Evaluation Model, PsyberGuide 10, and GeoHealth PIA found no passage in our copy addressing those frameworks or their application. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

  • The final type of framework consists of checklists or sets of evaluation criteria or principles.

    “The nal type of framework consists of checklists or sets of evaluation criteria or principles [5], [87] [90].”

    From Security and Privacy of mHealth Applications: A Scoping Review (2020) · cites this paper as [90]

    The Methods section, ‘Design Specification and Priorities’ (page unavailable), describes a co-design group outlining specifications for an HIV-care platform, not a type of framework consisting of checklists or evaluation criteria. Searches for ‘checklists or sets of evaluation criteria or principles’ and ‘framework evaluation criteria checklist principles’ found no passage in our copy addressing that classification. (LLM, conf=0.72)

    Experimental — accuracy not yet measured

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Authors
Marent, B., Henwood, F., Darking, M., & EmERGE Consortium
Affiliations
University of Brighton (GB)
Corresponding author
Marent, Benjamin
ORCID
Venue
JMIR mHealth and uHealth
Publisher
JMIR Publications Inc.
Published
2018-10-19
Volume
6
Issue
10
Pages
e184
ISSN
2291-5222 (ISSN-L)
DOI
10.2196/mhealth.9856
PMC
PMC6231792
OpenAlex
W2891458167
Cited by
84
References
38
Citations by year
2026: 7 · 2025: 12 · 2024: 12 · 2023: 12 · 2022: 10 · 2021: 12 · 2020: 15 · 2019: 3 · 2018: 1
FWCI
11.84
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JMIR mhealth and uhealth (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • University of Brighton Repository (University of Brighton) (publishedVersion, cc-by)
  • Sussex Research Online (University of Sussex) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
  • Zenodo (CERN European Organization for Nuclear Research) (submittedVersion, cc-by)
Topics
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Keywords
mobile health, HIV care, people living with HIV, co-design, user perspective, clinician perspectives, HIV stigma, self-management, peer support, care pathways, information technology integration, privacy and security

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