Table_2_Design and Development of a Mobile Health (mHealth) Platform for Dementia Prevention in the Prevention of Dementia by Mobile Phone Applications (PRODEMOS) Project.DOCX

Background: Mobile health (mHealth) has the potential to bring preventive healthcare within reach of populations with limited access to preventive services, by delivering personalized support at low cost. Although numerous mHealth interventions are available, very few have been developed following an evidence-based rationale or have been tested for efficacy. This article describes the systematic development of a coach-supported mHealth application to improve healthy lifestyles for the prevention of dementia and cardiovascular disease in the United Kingdom (UK) and China.
Methods: Development of the Prevention of Dementia by Mobile Phone applications (PRODEMOS) platform built upon the experiences with the Healthy Aging Through Internet Counseling in the Elderly (HATICE) eHealth platform. In the conceptualization phase, experiences from the HATICE trial and needs and wishes of the PRODEMOS target population were assessed through semi-structured interviews and focus group sessions. Initial technical development of the platform was based on these findings and took place in consecutive sprint sessions. Finally, during the evaluation and adaptation phase, functionality and usability of the platform were evaluated during pilot studies in UK and China.
Results: The PRODEMOS mHealth platform facilitates self-management of a healthy lifestyle by goal setting, progress monitoring, and educational materials on healthy lifestyles. Participants receive remote coaching through a chat functionality. Based on lessons learned from the HATICE study and end-users, we made the intervention easy-to-use and included features to personalize the intervention. Following the pilot studies, in which in total 77 people used the mobile application for 6 weeks, the application was made more intuitive, and we improved its functionalities.
Conclusion: Early involvement of end-users in the development process and during evaluation phases improved acceptability of the mHealth intervention. The actual use and usability of the PRODEMOS intervention will be assessed during the ongoing PRODEMOS randomized controlled trial, taking a dual focus on effectiveness and implementation outcomes.

背景：移动医疗（Mobile health, mHealth）可通过低成本提供个性化支持，让难以获得预防服务的人群也能享受到预防医疗服务。尽管现有多款移动医疗干预方案，但极少有基于循证依据研发，或经过疗效验证。本文介绍了一款教练辅助型移动医疗应用的系统性研发历程，该应用面向英国（United Kingdom, UK）与中国两地人群，旨在通过改善健康生活方式预防痴呆与心血管疾病。
方法：手机应用预防痴呆（Prevention of Dementia by Mobile Phone applications, PRODEMOS）平台的研发，基于老年互联网咨询健康老龄化（Healthy Aging Through Internet Counseling in the Elderly, HATICE）电子健康（eHealth）平台的研发经验。在概念设计阶段，本研究通过半结构化访谈与焦点小组会议，评估了HATICE试验的相关经验，以及PRODEMOS目标人群的需求与期望。平台的初始技术开发基于上述研究结果，通过连续的迭代冲刺阶段完成。最后，在评估与适配阶段，本研究于英国与中国开展试点研究，对平台的功能与易用性进行了评估。
结果：PRODEMOS移动医疗平台可通过目标设定、进度追踪以及健康生活方式科普材料，帮助用户自主管理健康生活方式。参与者可通过聊天功能获取远程教练指导。基于HATICE研究与终端用户的反馈经验，本研究将干预方案设计得易于操作，并加入了个性化定制干预方案的功能。在总计77名用户使用该移动应用达6周的试点研究结束后，本研究对应用进行了优化，使其操作更直观，并完善了各项功能。
结论：终端用户早期参与研发过程与评估阶段，有效提升了该移动医疗干预方案的可接受度。PRODEMOS干预方案的实际使用情况与易用性，将在正在进行的PRODEMOS随机对照试验中进行评估，同时兼顾干预效果与实施结局。