Development of 'My Retainers' mobile application: Triangulation of two qualitative methods

Diligent wear of removable orthodontic retainers requires prolonged adherence and is invariably necessary to preserve optimal results. Patient-informed behaviour-change interventions represent a promising and novel means of enhancing adherence to removable retainer wear. The aim of this study was to describe the development of a patient-informed mobile application designed to enhance retainer wear.

App development encompassed consideration of participant preferences, social media posts, available interventions and behaviour change theories. Qualitative methods including analysis of publicly-available retainer-related posts on Twitter (n = 827) and one-to-one interviews were undertaken. Audio-recorded one-to-one interviews were undertaken to identify patient preferences in relation to features, content and design of the application. A criterion-based purposive sample of participants wearing vacuum-formed retainers for at least 4 years was used (n = 15). Thematic analysis of transcribed data was undertaken. These data were triangulated to inform design and content of the application.

The need to facilitate communication with the treating clinician, responsive reminder and tracking systems, and access to useful and engaging written and visual information, in addition to other personalised and interactive features were considered important. Concerns related to retainer wear shared on Twitter informed an exhaustive list of frequently-asked questions. Application features were mapped to relevant theoretical constructs. Determinants of existing behavioural change theories were also used to link application features to retainer wear and maintenance.

A holistic process involving both patient and professional input can be useful in informing the development of mobile applications. The orthodontic application ("My Retainers") will undergo further scrutiny in relation to its effectiveness in inducing behavioural change and concerning patient experiences prior to finalisation.