International ResearchKit App for Women with Menstrual Pain: Development, Access, and Engagement

Jiani Wang, Alizé A Rogge, Mike Armour, Caroline A Smith, Christopher R D'Adamo, Claudia R Pischke, Hung-Rong Yen, Mei-Yao Wu, Ari Ojeda Ocampo Moré, Claudia M Witt, Daniel Pach, Jiani Wang, Alizé A Rogge, Mike Armour, Caroline A Smith, Christopher R D'Adamo, Claudia R Pischke, Hung-Rong Yen, Mei-Yao Wu, Ari Ojeda Ocampo Moré, Claudia M Witt, Daniel Pach

Abstract

Background: Primary dysmenorrhea is a common condition in women of reproductive age. A previous app-based study undertaken by our group demonstrated that a smartphone app supporting self-acupressure introduced by a health care professional can reduce menstrual pain.

Objective: This study aims to evaluate whether a specific smartphone app is effective in reducing menstrual pain in 18- to 34-year-old women with primary dysmenorrhea in a self-care setting. One group of women has access to the full-featured study app and will be compared with 2 control groups who have access to fewer app features. Here, we report the trial design, app development, user access, and engagement.

Methods: On the basis of the practical implications of the previous app-based study, we revised and reengineered the study app and included the ResearchKit (Apple Inc) framework. Behavior change techniques (BCTs) were implemented in the app and validated by expert ratings. User access was estimated by assessing recruitment progress over time. User evolution and baseline survey respondent rate were assessed to evaluate user engagement.

Results: The development of the study app for a 3-armed randomized controlled trial required a multidisciplinary team. The app is accessible for the target population free of charge via the Apple App Store. In Germany, within 9 months, the app was downloaded 1458 times and 328 study participants were recruited using it without external advertising. A total of 98.27% (5157/5248) of the app-based baseline questions were answered. The correct classification of BCTs used in the app required psychological expertise.

Conclusions: Conducting an innovative app study requires multidisciplinary effort. Easy access and engagement with such an app can be achieved by recruitment via the App Store. Future research is needed to investigate the determinants of user engagement, optimal BCT application, and potential clinical and self-care scenarios for app use.

Trial registration: ClinicalTrials.gov NCT03432611; https://ichgcp.net/clinical-trials-registry/NCT03432611 (Archived by WebCite at http://www.webcitation.org/75LLAcnCQ).

Keywords: ResearchKit; acupressure; behavior change techniques (BCTs); dysmenorrhea; mHealth; mobile applications; pain; recruitment.

Conflict of interest statement

Conflicts of Interest: The app has been developed for research purposes and is not a commercial product. The authors do not have any financial stake in the success of the app.

©Jiani Wang, Alizé A Rogge, Mike Armour, Caroline A Smith, Christopher R D’Adamo, Claudia R Pischke, Hung-Rong Yen, Mei-Yao Wu, Ari Ojeda Ocampo Moré, Claudia M Witt, Daniel Pach. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 11.02.2020.

Figures

Figure 1
Figure 1
Study design. ITT: intention to treat; PP: per protocol.
Figure 2
Figure 2
Screenshots of the study app.
Figure 3
Figure 3
PRECIS-2 rating results of the study design.
Figure 4
Figure 4
App downloads and new users per day.
Figure 5
Figure 5
User evolution.

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