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Topic

Usability Testing of a Mobile Health Physical Activity Application for People with an Inflammatory Bowel Disease: Mixed Methods Study

School of Exercise Science, Physical and Health Education

Date & location

• Monday, May 5, 2025

• 11:00 A.M.

• McKinnon Building

• Room 092

Reviewers

Supervisory Committee

• Dr. Sam Liu, School of Exercise Science, Physical and Health Education, University of Victoria (Supervisor)

• Dr. Kirsten Lane, School of Exercise Science, Physical and Health Education, UVic (Member)

• Dr. Helen Monkman, School of Health Information Science, UVic (Non-unit Member) 

External Examiner

• Dr. Jean Buckler, School of Exercise Science, Physical and Health Education, University of Victoria 

Chair of Oral Examination

• Dr. Ibrahim Numanagic, Department of Computer Science, UVic 

Abstract

Background: Living with an Inflammatory Bowel Disease (IBD) implies a lifelong burden of physical and mental health complications to diagnosed individuals, even when in a quiescent disease state. The prevalence of IBD within industrialized nations is increasing worldwide, and the associated economic cost is substantial. Physical Activity (PA) has the potential to improve systemic symptoms for people with an IBD without risk of exacerbating disease activity. Despite this, the recommended amount of PA is often not met within the IBD population. Fatigue is a common systemic symptom of IBD which can affect participation in PA. Just-in-time adaptive interventions (JITAI) can be delivered using mobile health (mHealth) apps and can provide tailored support for behaviour change. These types of intervention have the potential to offer an scalable solution to help increase PA levels for people with an IBD while tailoring to person’s fatigue level. Thus, IBD-Move is a mHealth JITAI app that was developed with the aim of increasing PA levels while tailoring to their current fatigue level.

Objective: This study aims to evaluate the usability and acceptability of a JITAI-IBD app, IBD Move, among individuals living with an IBD.

Methods: Usability testing, involving two cycles of 4 participants (n = 8), was conducted at the University of Victoria. Participants were asked to complete five tasks, 1) login and read through the introductory module, 2) read through the Chapter 1 module, 3) add a PA goal, 4) complete a PA session, and 5) track the PA using the app. During the study, participants 1) completed the baseline questionnaire on demographics (e.g., age, sex, social economic status) and experience with smartphones, 2) attempted to complete the five goal-oriented tasks, listed above, while performing the Think-Aloud protocol, and 3) provided usability and acceptability feedback following testing. Data collection included task completion rates, efficiency (e.g., completing a task with minimal steps), and qualitative use feedback. The Framework Analysis method and Usability Problem Taxonomy (UPT) was used to identify themes of usability problems, as identified from Think-Aloud task completion and interview.

Results: Quantitative results showed that task completion rates improved from Cycle 1 to Cycle 2, though Tasks 3 (Add Goal) and 4 (complete PA Session) sustained errors in completion in Cycle 2 and demonstrated the highest inefficiencies of screen transitions. Usability scores improved in both Ease of Use (MAUQ: Cycle 1 = 1.93 (0.52), Cycle 2 = 1.45 (0.21)) and Interface and Satisfaction (MAUQ: Cycle 1 = 1.98 (0.42) to Cycle 2 = 1.15 (0.14)). Usefulness scores, used to measure acceptability, also improved (MAUQ: Cycle 1 = 2.88 (0.82) to Cycle 2 = 1.67 (0.85)). Constructs of the Theoretical Framework of Acceptability were met with unanimous agreement in Cycle 1, however the constructs Perceived Effectiveness and Self efficacy were not fully agreed with in Cycle 2. Qualitative analysis identified 12 consolidated usability problems for Cycle 1 and 13 for Cycle 2, with the most severe problems in Tasks 2 (read Chapter 1), Task 3 (Add Goal), and Task 4 (complete PA Session), primarily related to Visualness and Task-mapping classifications of UPT.

Conclusion: IBD-Move demonstrated high usability and acceptability, with its tailored approach to physical activity and content well-received. Key refinements were made from Cycle 1 to Cycle 2, including adjusted text, added instructions, and fixed technical errors enhancing usability, though challenges in Tasks 3 and 4 remained. Further adjustments to the app will be made in preparation for a future feasibility study, evaluating IBD-Move’s effectiveness for improving physical activity levels and health outcomes.