title: User Preferences and Design Recommendations for an mHealth App to Promote Cystic Fibrosis Self-Management.
abstract: BACKGROUND
  mHealth apps hold potential to provide automated, tailored support for treatment adherence among individuals with chronic medical conditions. Yet relatively little empirical research has guided app development and end users are infrequently involved in designing the app features or functions that would best suit their needs. Self-management apps may be particularly useful for people with chronic conditions like cystic fibrosis (CF) that have complex, demanding regimens.
  
  
  OBJECTIVE
  The aim of this mixed-methods study was to involve individuals with CF in guiding the development of engaging, effective, user-friendly adherence promotion apps that meet their preferences and self-management needs.
  
  
  METHODS
  Adults with CF (n=16, aged 21-48 years, 50% male) provided quantitative data via a secure Web survey and qualitative data via semi-structured telephone interviews regarding previous experiences using apps in general and for health, and preferred and unwanted features of potential future apps to support CF self-management.
  
  
  RESULTS
  Participants were smartphone users who reported sending or receiving text messages (93%, 14/15) or emails (80%, 12/15) on their smartphone or device every day, and 87% (13/15) said it would be somewhat or very hard to give up their smartphone. Approximately one-half (53%, 8/15) reported having health apps, all diet/weight-related, yet many reported that existing nutrition apps were not well-suited for CF management. Participants wanted apps to support CF self-management with characteristics such as having multiple rather than single functions (eg, simple alarms), being specific to CF, and minimizing user burden. Common themes for desired CF app features were having information at one's fingertips, automation of disease management activities such as pharmacy refills, integration with smartphones' technological capabilities, enhancing communication with health care team, and facilitating socialization within the CF community. Opinions were mixed regarding gamification and earning rewards or prizes. Participants emphasized the need for customization options to meet individual preferences and disease management goals.
  
  
  CONCLUSIONS
  Unique capabilities of emerging smartphone technologies (eg, social networking integration, movement and location detection, integrated sensors, or electronic monitors) make many of these requests possible. Involving end users in all stages of mHealth app development and collaborating with technology experts and the health care system may result in apps that maintain engagement, improve integration and automation, and ultimately impact self-management and health outcomes.
authors.affiliation: Baylor College of Medicine, Department of Pediatrics, Houston, TX, United States.
authors.forename: Marisa E
authors.identifier: http://orcid.org/0000-0002-8813-629X
authors.initials: ME
authors.lastname: Hilliard
authors.forename: Amy
authors.identifier: http://orcid.org/0000-0002-1834-195X
authors.initials: A
authors.lastname: Hahn
authors.forename: Alana K
authors.identifier: http://orcid.org/0000-0002-2019-2981
authors.initials: AK
authors.lastname: Ridge
authors.forename: Michelle N
authors.identifier: http://orcid.org/0000-0002-8587-8343
authors.initials: MN
authors.lastname: Eakin
authors.forename: Kristin A
authors.identifier: http://orcid.org/0000-0001-6892-3512
authors.initials: KA
authors.lastname: Riekert
keywords: cystic fibrosis; mobile health; qualitative research