Development of the Web App ‘MUCO_BALAD’ to Enhance Physical Activity in People with Cystic Fibrosis: Co-design and Acceptability Evaluation by patients and health professionals (Preprint)

Abstract

Cystic fibrosis (CF) is a genetic disease affecting the respiratory and digestive systems, with recent treatment advances improving life expectancy. However, many people with cystic fibrosis (pwCF) lack adequate physical activity (PA). PA can enhance lung function and quality of life, but barriers exist. The CF-DB-PA questionnaire assesses decisional balance for PA in pwCF, but it is not optimal for clinical use. Developing a digital app can overcome these limitations, improving efficiency in administration, results’ interpretation, and communication between patients and healthcare professionals.

This paper aims to present the development process and to assess the acceptability of a web app designed to measure and monitor the decisional balance for PA in pwCF.

The study comprised two stages: (a) co-designing a digital app, and (b) evaluating its acceptability among healthcare professionals and pwCF. A participatory approach engaged stakeholders in the app's creation. The app's acceptability, based on factors outlined in the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2), is vital for successful adoption. Participants volunteered, gave informed consent, were over 18, and fluent in French. Data collection employed qualitative interviews, video presentations, surveys, and individual semi-structured interviews, with quantitative and qualitative data analyses.

A total of 11 healthcare professionals, 6 pwCF, and 5 researchers were involved in the co-design phase. Healthcare professionals encompassed various roles. Findings revealed early promotion of physical activity by healthcare professionals, personalized recommendations, and perceptions of CF-DB-PA scale benefits and limitations. Regarding the CF-DB-PA scale, healthcare professionals reported benefits such as providing specific information about facilitators and barriers, evaluating motivation for PA, and challenging their own assumptions. They also emphasized the time-consuming aspect of processing results and the limitations of the paper-and-pencil format. In evaluating the digital tool, participants highlighted the need for a simple interface and secure data storage. Most participants expressed intention to use the digital format, with a few exceptions. In the acceptability evaluation phase, the sample included 47 healthcare professionals, 44 pwCF, and 12 researchers. The analysis revealed that the acceptability measures were positive, and that the app acceptability did not differ according to user profiles. Semi-structured interviews allowed to identify positive and negative perceptions of the app and the interface, as well as missing functionalities.

This study assessed the acceptability of the MUCO_BALAD app and demonstrated promising qualitative and quantitative results. The digital tool for measuring the decisional balance in physical activity for pwCF is encouraging for healthcare professionals, pwCF, and researchers, with valuable insights gained from the study's perspectives.