Building a web-based app for persons with physical disabilities: A collaboration between game developers and rehabilitation researchers (Preprint)

BACKGROUND Individuals with disability and their partners, who often provide care, are both at risk for depression and lower quality of life. Mobile health (mHealth) interventions are promising to address barriers for mental health care. Rehabilitation researchers and software development researchers must collaborate effectively with each other, and with clinical and patient stakeholders to ensure successful mHealth development. OBJECTIVE To aid researchers interested in mHealth software development by describing the collaborative process between a team of rehabilitation researchers, software development researchers, and stakeholders. Thus, we provide a framework (conceptual model) for other teams to replicate in order to build a web-based mHealth app for individuals with physical disability. METHODS Rehabilitation researchers, software development researchers, and stakeholders (people with physical disabilities and clinicians) are involved in an iterative software development process. The overall process to develop an mHealth intervention includes initial development meetings and a co-design method called “designbox”, in which the needs and key elements of the app are discussed. Based on the objectives outlined, a prototype is developed and goes through scoping iterations with feedback from stakeholders and end-users. The prototype is then tested by users to identify technical errors and gather feedback on usability and accessibility. RESULTS Illustrating the overall development process, we present a case study based on our experience developing an app (SupportGroove) for couples coping with spinal cord injury. Examples of how we addressed specific challenges are also included. For example, feedback from stakeholders resulted in development of app features for individuals with limited functional ability. Initial designs lacked accessibility design principles made visible by end-users. Solutions included large text, single-click, and minimal scrolling to facilitate menu navigation for individuals using eye-gaze technology. Prototype testing allowed further refinement and demonstrated high usability and engagement with activities in the app. Qualitative feedback indicated high levels of satisfaction, accessibility, and confidence in potential utility. We also present key lessons learned about working in a collaborative interdisciplinary team. CONCLUSIONS mHealth promises to help overcome barriers to mental health intervention access. However, the development of these interventions can be challenging because of the disparate and often siloed expertise required. By describing the mHealth software development process and illustrating it with a successful case study of rehabilitation researchers, software development researchers, and stakeholders collaborating effectively, our goal is to help other teams avoid challenges we faced and benefit from our lessons learned. Ultimately, good interdisciplinary collaboration will benefit individuals with disabilities and their families. CLINICALTRIAL n/a