User-Centered Refinement of a Digital Tool for Tuberculosis Treatment Support: Iterative Mixed Methods Study

Autores
Iribarren, Sarah; Aguilar Vidrio, Omar Alfonso; Roberti, Javier Eugenio; Goodwin, Kyle; Chirico, Cristina; Telles, Hugo; Lutz, Barry; Bornengo, Fernanda; Rubinstein, Fernando Adrian
Año de publicación
2025
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background: Despite the potential of digital adherence technologies to support patient-centered monitoring for tuberculosis (TB), there is limited research on incorporating indirect and direct adherence monitoring or assessing patients´ experiences with these technologies. The TB Treatment Support Tools (TB-TST) includes a comprehensive mobile app for patients and health care providers and a direct adherence metabolite test to report and monitor adherence.Objective: This paper describes the iterative refinement process of the TB-TST intervention.Methods: To refine the TB-TST intervention, we used an iterative approach involving multiple embedded mixed methods studies guided by the Information Systems Research framework and Design Thinking Process. Embedded studies included a randomized controlled pilot study, interviews, usability testing, and surveys with patients and experts to inform ongoing refinements. The project consisted of interface evaluation, high-level system design, and iterative redesign.Results: The TB-TST intervention was refined through 3 iterative phases. In Phase 1, based on feedback from pilot study participants and 4 experts in TB, improvements included an in-app discussion board, submission confirmations, and enhanced account recovery. Cultural adaptation was based on Hofstede´s dimensions. Phase 2 involved 4 Directed Research Groups and 19 stakeholders to redesign user flows, simplify reporting, and transition the app to a progressive web app, improving device compatibility. Phase 3 included usability testing cycles with 48 participants (26 patients and 22 health care professionals), yielding high satisfaction scores: patient app Mobile Health App Usability Questionnaire, mean 5.96 (SD 0.46); provider mobile dashboard IT Usability Evaluation Scale scores ranged from 5.83 to 6.23 out of 7, and optimization of interface and dashboard. Refinements included larger icons, streamlined onboarding, symptom summary enhancements, and a new cohort-level adherence graph. These modifications improved navigation, usability, and remote monitoring for patients with TB and providers in preparation for a multisite clinical trial.Conclusions: Combining multiple methods guided by the Information Systems Research framework and elements of the Design Thinking Process can help researchers and developers leverage the strengths of mixed methods iterative designs to create highly personalized and effective digital health interventions.
Fil: Iribarren, Sarah. University of Washington; Estados Unidos
Fil: Aguilar Vidrio, Omar Alfonso. University of Washington; Estados Unidos
Fil: Roberti, Javier Eugenio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Goodwin, Kyle. University of Washington; Estados Unidos
Fil: Chirico, Cristina. Programa Nacional Tuberculosis; Argentina
Fil: Telles, Hugo. No especifíca;
Fil: Lutz, Barry. University of Washington; Estados Unidos
Fil: Bornengo, Fernanda. Universidad de Buenos Aires. Facultad de Medicina; Argentina
Fil: Rubinstein, Fernando Adrian. Instituto de Efectividad Clínica y Sanitaria; Argentina
Materia
DIGITAL ADHERENCE
MOBILE HEALTH
MOBILE TELEPHONE
TUBERCULOSIS
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/291238
Acceder
id CONICETDig_ef735ccd4193f585c0a8a305e5018aa6
oai_identifier_str oai:ri.conicet.gov.ar:11336/291238
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling User-Centered Refinement of a Digital Tool for Tuberculosis Treatment Support: Iterative Mixed Methods StudyIribarren, SarahAguilar Vidrio, Omar AlfonsoRoberti, Javier EugenioGoodwin, KyleChirico, CristinaTelles, HugoLutz, BarryBornengo, FernandaRubinstein, Fernando AdrianDIGITAL ADHERENCEMOBILE HEALTHMOBILE TELEPHONETUBERCULOSIShttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Background: Despite the potential of digital adherence technologies to support patient-centered monitoring for tuberculosis (TB), there is limited research on incorporating indirect and direct adherence monitoring or assessing patients´ experiences with these technologies. The TB Treatment Support Tools (TB-TST) includes a comprehensive mobile app for patients and health care providers and a direct adherence metabolite test to report and monitor adherence.Objective: This paper describes the iterative refinement process of the TB-TST intervention.Methods: To refine the TB-TST intervention, we used an iterative approach involving multiple embedded mixed methods studies guided by the Information Systems Research framework and Design Thinking Process. Embedded studies included a randomized controlled pilot study, interviews, usability testing, and surveys with patients and experts to inform ongoing refinements. The project consisted of interface evaluation, high-level system design, and iterative redesign.Results: The TB-TST intervention was refined through 3 iterative phases. In Phase 1, based on feedback from pilot study participants and 4 experts in TB, improvements included an in-app discussion board, submission confirmations, and enhanced account recovery. Cultural adaptation was based on Hofstede´s dimensions. Phase 2 involved 4 Directed Research Groups and 19 stakeholders to redesign user flows, simplify reporting, and transition the app to a progressive web app, improving device compatibility. Phase 3 included usability testing cycles with 48 participants (26 patients and 22 health care professionals), yielding high satisfaction scores: patient app Mobile Health App Usability Questionnaire, mean 5.96 (SD 0.46); provider mobile dashboard IT Usability Evaluation Scale scores ranged from 5.83 to 6.23 out of 7, and optimization of interface and dashboard. Refinements included larger icons, streamlined onboarding, symptom summary enhancements, and a new cohort-level adherence graph. These modifications improved navigation, usability, and remote monitoring for patients with TB and providers in preparation for a multisite clinical trial.Conclusions: Combining multiple methods guided by the Information Systems Research framework and elements of the Design Thinking Process can help researchers and developers leverage the strengths of mixed methods iterative designs to create highly personalized and effective digital health interventions.Fil: Iribarren, Sarah. University of Washington; Estados UnidosFil: Aguilar Vidrio, Omar Alfonso. University of Washington; Estados UnidosFil: Roberti, Javier Eugenio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Goodwin, Kyle. University of Washington; Estados UnidosFil: Chirico, Cristina. Programa Nacional Tuberculosis; ArgentinaFil: Telles, Hugo. No especifíca;Fil: Lutz, Barry. University of Washington; Estados UnidosFil: Bornengo, Fernanda. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Rubinstein, Fernando Adrian. Instituto de Efectividad Clínica y Sanitaria; ArgentinaJournal Medical Internet Research2025-07info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/291238Iribarren, Sarah; Aguilar Vidrio, Omar Alfonso; Roberti, Javier Eugenio; Goodwin, Kyle; Chirico, Cristina; et al.; User-Centered Refinement of a Digital Tool for Tuberculosis Treatment Support: Iterative Mixed Methods Study; Journal Medical Internet Research; Journal Of Medical Internet Research; 27; 7-2025; 1-111438-8871CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://www.jmir.org/2025/1/e76742info:eu-repo/semantics/altIdentifier/doi/10.2196/76742info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2026-08-25T14:33:13Zoai:ri.conicet.gov.ar:11336/291238instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982026-08-25 14:33:13.53CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv User-Centered Refinement of a Digital Tool for Tuberculosis Treatment Support: Iterative Mixed Methods Study
title User-Centered Refinement of a Digital Tool for Tuberculosis Treatment Support: Iterative Mixed Methods Study
spellingShingle User-Centered Refinement of a Digital Tool for Tuberculosis Treatment Support: Iterative Mixed Methods Study
Iribarren, Sarah
DIGITAL ADHERENCE
MOBILE HEALTH
MOBILE TELEPHONE
TUBERCULOSIS
title_short User-Centered Refinement of a Digital Tool for Tuberculosis Treatment Support: Iterative Mixed Methods Study
title_full User-Centered Refinement of a Digital Tool for Tuberculosis Treatment Support: Iterative Mixed Methods Study
title_fullStr User-Centered Refinement of a Digital Tool for Tuberculosis Treatment Support: Iterative Mixed Methods Study
title_full_unstemmed User-Centered Refinement of a Digital Tool for Tuberculosis Treatment Support: Iterative Mixed Methods Study
title_sort User-Centered Refinement of a Digital Tool for Tuberculosis Treatment Support: Iterative Mixed Methods Study
dc.creator.none.fl_str_mv Iribarren, Sarah
Aguilar Vidrio, Omar Alfonso
Roberti, Javier Eugenio
Goodwin, Kyle
Chirico, Cristina
Telles, Hugo
Lutz, Barry
Bornengo, Fernanda
Rubinstein, Fernando Adrian
author Iribarren, Sarah
author_facet Iribarren, Sarah
Aguilar Vidrio, Omar Alfonso
Roberti, Javier Eugenio
Goodwin, Kyle
Chirico, Cristina
Telles, Hugo
Lutz, Barry
Bornengo, Fernanda
Rubinstein, Fernando Adrian
author_role author
author2 Aguilar Vidrio, Omar Alfonso
Roberti, Javier Eugenio
Goodwin, Kyle
Chirico, Cristina
Telles, Hugo
Lutz, Barry
Bornengo, Fernanda
Rubinstein, Fernando Adrian
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv DIGITAL ADHERENCE
MOBILE HEALTH
MOBILE TELEPHONE
TUBERCULOSIS
topic DIGITAL ADHERENCE
MOBILE HEALTH
MOBILE TELEPHONE
TUBERCULOSIS
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Background: Despite the potential of digital adherence technologies to support patient-centered monitoring for tuberculosis (TB), there is limited research on incorporating indirect and direct adherence monitoring or assessing patients´ experiences with these technologies. The TB Treatment Support Tools (TB-TST) includes a comprehensive mobile app for patients and health care providers and a direct adherence metabolite test to report and monitor adherence.Objective: This paper describes the iterative refinement process of the TB-TST intervention.Methods: To refine the TB-TST intervention, we used an iterative approach involving multiple embedded mixed methods studies guided by the Information Systems Research framework and Design Thinking Process. Embedded studies included a randomized controlled pilot study, interviews, usability testing, and surveys with patients and experts to inform ongoing refinements. The project consisted of interface evaluation, high-level system design, and iterative redesign.Results: The TB-TST intervention was refined through 3 iterative phases. In Phase 1, based on feedback from pilot study participants and 4 experts in TB, improvements included an in-app discussion board, submission confirmations, and enhanced account recovery. Cultural adaptation was based on Hofstede´s dimensions. Phase 2 involved 4 Directed Research Groups and 19 stakeholders to redesign user flows, simplify reporting, and transition the app to a progressive web app, improving device compatibility. Phase 3 included usability testing cycles with 48 participants (26 patients and 22 health care professionals), yielding high satisfaction scores: patient app Mobile Health App Usability Questionnaire, mean 5.96 (SD 0.46); provider mobile dashboard IT Usability Evaluation Scale scores ranged from 5.83 to 6.23 out of 7, and optimization of interface and dashboard. Refinements included larger icons, streamlined onboarding, symptom summary enhancements, and a new cohort-level adherence graph. These modifications improved navigation, usability, and remote monitoring for patients with TB and providers in preparation for a multisite clinical trial.Conclusions: Combining multiple methods guided by the Information Systems Research framework and elements of the Design Thinking Process can help researchers and developers leverage the strengths of mixed methods iterative designs to create highly personalized and effective digital health interventions.
Fil: Iribarren, Sarah. University of Washington; Estados Unidos
Fil: Aguilar Vidrio, Omar Alfonso. University of Washington; Estados Unidos
Fil: Roberti, Javier Eugenio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Goodwin, Kyle. University of Washington; Estados Unidos
Fil: Chirico, Cristina. Programa Nacional Tuberculosis; Argentina
Fil: Telles, Hugo. No especifíca;
Fil: Lutz, Barry. University of Washington; Estados Unidos
Fil: Bornengo, Fernanda. Universidad de Buenos Aires. Facultad de Medicina; Argentina
Fil: Rubinstein, Fernando Adrian. Instituto de Efectividad Clínica y Sanitaria; Argentina
description Background: Despite the potential of digital adherence technologies to support patient-centered monitoring for tuberculosis (TB), there is limited research on incorporating indirect and direct adherence monitoring or assessing patients´ experiences with these technologies. The TB Treatment Support Tools (TB-TST) includes a comprehensive mobile app for patients and health care providers and a direct adherence metabolite test to report and monitor adherence.Objective: This paper describes the iterative refinement process of the TB-TST intervention.Methods: To refine the TB-TST intervention, we used an iterative approach involving multiple embedded mixed methods studies guided by the Information Systems Research framework and Design Thinking Process. Embedded studies included a randomized controlled pilot study, interviews, usability testing, and surveys with patients and experts to inform ongoing refinements. The project consisted of interface evaluation, high-level system design, and iterative redesign.Results: The TB-TST intervention was refined through 3 iterative phases. In Phase 1, based on feedback from pilot study participants and 4 experts in TB, improvements included an in-app discussion board, submission confirmations, and enhanced account recovery. Cultural adaptation was based on Hofstede´s dimensions. Phase 2 involved 4 Directed Research Groups and 19 stakeholders to redesign user flows, simplify reporting, and transition the app to a progressive web app, improving device compatibility. Phase 3 included usability testing cycles with 48 participants (26 patients and 22 health care professionals), yielding high satisfaction scores: patient app Mobile Health App Usability Questionnaire, mean 5.96 (SD 0.46); provider mobile dashboard IT Usability Evaluation Scale scores ranged from 5.83 to 6.23 out of 7, and optimization of interface and dashboard. Refinements included larger icons, streamlined onboarding, symptom summary enhancements, and a new cohort-level adherence graph. These modifications improved navigation, usability, and remote monitoring for patients with TB and providers in preparation for a multisite clinical trial.Conclusions: Combining multiple methods guided by the Information Systems Research framework and elements of the Design Thinking Process can help researchers and developers leverage the strengths of mixed methods iterative designs to create highly personalized and effective digital health interventions.
publishDate 2025
dc.date.none.fl_str_mv 2025-07
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/291238
Iribarren, Sarah; Aguilar Vidrio, Omar Alfonso; Roberti, Javier Eugenio; Goodwin, Kyle; Chirico, Cristina; et al.; User-Centered Refinement of a Digital Tool for Tuberculosis Treatment Support: Iterative Mixed Methods Study; Journal Medical Internet Research; Journal Of Medical Internet Research; 27; 7-2025; 1-11
1438-8871
CONICET Digital
CONICET
url http://hdl.handle.net/11336/291238
identifier_str_mv Iribarren, Sarah; Aguilar Vidrio, Omar Alfonso; Roberti, Javier Eugenio; Goodwin, Kyle; Chirico, Cristina; et al.; User-Centered Refinement of a Digital Tool for Tuberculosis Treatment Support: Iterative Mixed Methods Study; Journal Medical Internet Research; Journal Of Medical Internet Research; 27; 7-2025; 1-11
1438-8871
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://www.jmir.org/2025/1/e76742
info:eu-repo/semantics/altIdentifier/doi/10.2196/76742
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Journal Medical Internet Research
publisher.none.fl_str_mv Journal Medical Internet Research
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
_version_ 1874774152793030656
score 13.365483

Publicaciones similares