Development And Usability Evaluation Of Risk Prevention And Control Platform For Maternal Urinary Incontinence Based On APP

BackgroundPregnancy is a high-risk factor for urinary incontinence(UI),and the prevalence during pregnancy is about 15.4-72%.The first-line treatment of female urinary incontinence is pelvic floor muscle training and lifestyle adjustment,while accuracy and compliance were the key point of effect.Mobile health(m-Health)is gradually applied to disease management and has achieved effective results in UI management,especially pelvic floor muscle training.It can improve the patient's self-management ability and reduce disease symptoms.However,the application of UI during pregnancy needs to be explored.ObjectivesFocused on the behavior change theory and the principle of user-centered,this study develops a scheme to manage UI during pregnancy,design and establish the mobile application for preventing and controlling this condition and conduct a usability evaluation.Methods1.Requirements analysis of prevention and control platform for urinary incontinence during pregnancy(1)Preliminary framework and contents:To know the current management methods of UI during pregnancy,and then provide a theoretical basis and framework for the development of the platform.(2)Investigation on medical staff:We will investigate medical staffs to understand the status of clinical UI management during pregnancy and their views on this platform.(3)User needs analysis:This part is a cross-sectional study,combined with questionnaire surveys and interview to analyze the user's needs for the platform.2.Development and testing of urinary incontinence risk prevention and control platform during pregnancy(1)Expert Group MeetingAccording to user needs analysis,the framework,content,and functions of the platform were initially established.Expert working group meetings were held to adjust and modifications to determine the content and functions of the platform.(2)Development and testing of the platformWe adopted the rapid prototype interaction model to establish the APP.After completing the prototype,we will select pregnant women,clinical researchers,and engineers by convenience sampling to test the usability of the platform prototype.3.Usability evaluation of UI risk prevention and control platform during pregnancyThe usability evaluation study includes two sub-studies each using a unique method.We will conduct "Think-aloud test",Remote usability test and interviews to collected users' experience with APP.Results1.Design of prevention and control platform for urinary incontinence during pregnancyBased on the results of literature review and our previous research,we made a preliminary design.After conducting a clinical status and user need analysis,we formed a draft content which divided into six modules:weight management,prevention of constipation,avoidance of tobacco,liquid management,behavior training and prenatal care.2.Development and testing of urinary incontinence prevention and control platform during pregnancyThe contents and functions of the platform were finally determined by an expert working meeting.The platform content consists of four major modules:risk assessment,health knowledge,pelvic floor muscle training and online assessment.After testing by engineers,researchers,and users,we performed the IOS system,Android system and PC segment background data management system.The APP client needs to have the following functions:registration and login,information entry,satisfaction evaluation,interactive circle,message reminder and "punch-in",etc.Meanwhile the medical care terminal has the management functions of column,push information,regular reminder,and interactive circle,user rights,and statistical analysis and so on.The APP called "Youaiwu",the homophone of urinary incontinence of women(UIW),was put on the APP store,which has the interface of registration login,informed consent,basic information collection,and five home pages.3.Usability evaluation of urinary incontinence risk prevention and control platform during pregnancyThis section adopts a think-aloud test,remote usability test,scale survey and semi-structured interview to evaluate the usability of UIW.Three users participated in the think-aloud test,and the effectiveness was 93.33%,93.33%,86.67%,and the efficiency was 1.57min per item,2.14min per item,and 2min per item,respectively.20 participants conducted a 4-week remote usability test,11 completed a system availability scale survey,and the average score of the SUS was 70.23.Five users participated in the telephone interview,and the user's overall evaluation of the APP was high,which was considered helpful.ConclusionsThis study uses literature review,user needs analysis and expert groups meeting to construct a UI management program based on mobile application which promotes changes behaviors in UI management and improves its training compliance.Conducting usability evaluation by "think-aloud" and "remote usability test",the UIW app shows high acceptance,ease of use,and usability.