Feasibility of the "OA Coach" Mobile App to Support Individuals with Osteoarthritis: Development and Usability Testing.

Abstract

Background: The OA Coach mobile app was developed to support individuals with knee osteoarthritis in self-managing their condition. The app aims to fill a current gap in the osteoarthritis mobile app field by combining key features such as symptom tracking, objective activity tracking, educational modules, and encouragement notifications underpinned by behavior change theory.

Objective: The aim of this study was to describe the development of the OA Coach mobile app and assess its usability in a 6-week feasibility study.

Methods: The app was designed in consultation with consumers, rheumatologists, physiotherapists, and osteoarthritis researchers. The app prototype contained four screens: (1) a home screen to track goals and activities, (2) a progress page, (3) a learning page with self-directed modules, and (4) an inbox for communication with the study team. For the feasibility study, 30 participants were recruited between March and April 2024 from a database of osteoarthritis trial participants or through the Osteoarthritis Chronic Care Program at Royal North Shore Hospital, Sydney, Australia. Participants were eligible if they were aged 45 years or older, had knee pain ≥4 on an 11-point numerical pain rating scale and knee stiffness lasting <30 minutes in duration, or stiffness >30 minutes and diagnosed with knee osteoarthritis through a health care provider or radiographs. Participants were provided access to the app and asked to interact with it daily for 6 weeks. Outcomes were assessed through online questionnaires or through mobile app data. The primary outcome was usability, assessed using the mHealth App Usability Questionnaire (MAUQ). Secondary outcomes included computer self-efficacy and osteoarthritis knowledge. The quantitative data were summarized descriptively. Qualitative feedback was collected through open-ended survey responses and discussed within the research team to improve the app.

Results: A total of 30 participants completed the study. There was a 1:1 ratio of male to female participants, with an average age of 66.9 (SD 9.1) years and a mean pain level of 6.0 (IQR 5.0-6.8) on an 11-point numerical pain rating scale. Twenty-nine responses from the MAUQ were available for analysis. Most statements scored >5 out of 7 ("somewhat agree"), indicating that the app was easy to use. The mean satisfaction score for the app on the MAUQ was 4.7 (SD 2.0) out of 7. Qualitative feedback from participants indicated the need for clear instructions on how to use and navigate the app, improved structure and integration of the exercise program, and improved tailoring of osteoarthritis education and support.

Conclusions: Overall, the OA Coach app was well accepted by participants. Based on participant feedback, the app will be revised to improve aspects of clarity, ease of use, and personalization. The updated app will be tested against other methods of care delivery in a randomized controlled trial.