Design and Development of a Smartphone Application for Hypertension Management: An Intervention Mapping Approach (Preprint)

Abstract

Several research studies have demonstrated the potential of mobile health applications (apps) in supporting health management. However, the design and development process of these apps are rarely presented.

We present the design and development of a smartphone-based lifestyle app integrating a wearable device for hypertension management.

We used an intervention mapping approach for the development of theory- and evidence-based interventions for problem identification, problem-solving and mitigation strategies. This consisted of six fundamental steps of the intervention mapping approach: needs assessment, matrices, theoretical methods and practical strategies, program design, adoption and implementation plan, and evaluation plan. To design the contents of the intervention, we performed a literature review to determine the opinions and preferences of people with hypertension and implemented theoretical and practical strategies to support these needs in consultation with stakeholders and researchers.

Through the needs analysis, we identified that people with hypertension preferred having education, medication or treatment adherence, lifestyle modification, alcohol and smoking cessation and blood pressure monitoring support to manage their condition. Out of which, the authors utilized MoSCoW analysis to focus on four key elements, i.e., education, medication or treatment adherence, lifestyle modification and blood pressure support due to past experiences in developing interventions for hypertension, and its potential benefits in hypertension management. Theoretical models such as (i) the information, motivation, and behaviour skills (IMB) model, and (ii) the patient health engagement (PHE) model was implemented in the intervention development to ensure positive engagement and health behaviour. The app developed provides education to people with hypertension related to their condition, while utilizing wearable devices to promote lifestyle modification and blood pressure support. The app also contains rules and medication lists titrated by the clinician to ensure treatment adherence, with regular push notifications to prompt behavioural change. In addition, the app data can be reviewed by patients and clinicians as needed.

This is the first study describing the development of an app that integrates a wearable blood pressure device and provides lifestyle support and hypertension management. Our theory-driven intervention for self-management of hypertension is founded on the critical needs of people with hypertension to ensure treatment adherence and supports medication review and titration by clinicians. The intervention will be evaluated clinically in future studies to determine its effectiveness and usability.