Only very few educational mobile health applications (MHAs) on oral cancer exists. Based on existing literature, only one of such MHAs (application name: Prayaas) was created specifically for lay persons; unfortunately, the application has been critiqued to be non-inclusive and non-comprehensive. Hence, this study aimed to co-create a more comprehensive and inclusive educational MHA prototype on oral cancer through a participatory action research approach. A three-round modified Delphi technique was employed to engage stakeholders in a participatory action research process. Digital communication experts and individuals with oral cancer risk factors ( n = 17) from five countries participated. Round one utilised focus group discussions to define essential application features. Rounds two and three involved iterative evaluations of successive prototypes using a validated questionnaire (Mobile Application Rating Scale). Quantitative data were analysed using descriptive statistics, with consensus defined a priori as a mean score > 2.5 on a 5-point Likert scale—indicating majority agreement on each evaluated item. Stakeholder input across three iterative rounds led to the co-creation of the “Beat Oral Cancer” prototype. Quantitative consensus was achieved across all evaluated domains, including usability, aesthetics, information quality, and perceived impact. The final prototype showed significant improvements: the second version was rated higher than the first in entertainment (+ 0.68), interactivity (+ 0.32), customizability (+ 0.64), and ease of use (+ 0.33). Key inclusive features, such as adjustable text size, were incorporated based on stakeholder feedback. This study successfully co-created a highly comprehensive, stakeholder-informed MHA prototype for oral cancer education via a modified Delphi process. The results demonstrate the value of iterative participatory design in creating digital health tools with high potential for acceptability and usability. This work establishes a methodological precedent for applying the Delphi technique in mobile health co-creation and provides a foundation for future efficacy testing and public deployment.
Kanmodi et al. (Sat,) studied this question.