Get moving: the practice nurse is watching you! A case study of the user-centred design process and testing of a web-based coaching system to stimulate the physical activity of chronically ill patients in primary care.

Background: The system informs the nurse about levels of physical activity in the daily living of patients who are using the It's LiFe! tool. The tool consists of an accelerometer that transfers data to a smartphone, which is subsequently connected to a server. Nurses can monitor patients' physical activity via a secured website. Physical activity levels are measured in minutes per day compared with pre-set activity goals, which are set in dialogue with the patient.

Objective: To examine user requirements and to evaluate the usability of the secured website, in order to increase the probability of effective use by nurses.

Method: The needs and preferences of nurses towards the system were determined through qualitative research. The usability of the system was evaluated in a laboratory situation and during a three-month pilot study.

Results: A monitoring and feedback system to support patients in their intention to be more active was developed in a systematic way. Automatically generated feedback messages were defined based on the requirements of nurses. The results from the usability tests gave insights into how to improve the structure and quality of the information provided. Nurses were positive about the features and ease of use of the system, but made critical remarks about the time that its use entails.

Conclusion: The system supports nurses when performing physical activity counselling in a structured and profound way. The opportunity to support self-management of patients in between regular consultations needs further investigation, and adaptation into the clinical workflow of the nurses.