Development and content validation of a patient-centered and digitally inclusive mobile application for chronic heart...

Chronic heart failure (CHF) necessitates ongoing self-management to reduce hospital admissions and enhance clinical outcomes. Mobile health (mHealth) applications are promising tools. However, most lack validated content and user-centered design. This study aimed to identify and validate core content for a CHF-focused mHealth application through expert consensus.

A two-round Delphi study was conducted with 24 experts, including physicians, nurses, and patients with CHF. In round one, 39 self-management items were evaluated. Based on quantitative scores and qualitative feedback, 5 items were excluded, and 13 new ones were added. In round two, 44 of 47 items (93.6%) achieved consensus (x̄ ≥ 7.5). Psychometric indicators included standard deviation, Content Validity Ratio (CVR), Content Validity Index (CVI), and Intraclass Correlation Coefficient (ICC).

Validated content was categorized into two domains. Domain 1: Recording Functionalities included Signs and Symptoms (x̄ = 8.23 ± 0.88) and Medication Management (x̄ = 8.52 ± 0.94). Domain 2: Therapeutic Education included five classes: Basic Concepts (x̄ = 7.90), Self-care and Disease Management (x̄ = 8.27), Recognition of Signs and Symptoms (x̄ = 8.03), Psychosocial Support (x̄ = 8.15), and Lifestyle Management (x̄ = 8.06). Inter-rater reliability demonstrated variable but generally moderate to good agreement across items (ICC range 0.31-1.00), with statistical significance (p < 0.05). The overall CVI reached 0.82.

This study validated 44 items for CHF self-management via mHealth. The participatory, evidence-based approach ensures clinical relevance and usability. Implementation may improve adherence, decrease readmissions, and support quality of life.