Think-Aloud Testing of a Companion App for Colonoscopy Exams: Usability Study (Preprint)

BACKGROUND Colonoscopies are vital for initial screening, follow-ups, surveillance of neoplasia, and assessing symptoms like rectal bleeding. Successful colonoscopies require thorough colon preparation, but up to 33% fail due to poor preparation. This can lead to longer procedures, repeat colonoscopies, inconvenience, poorer health outcomes, and higher costs. eHealth tools can enhance bowel preparation and potentially reduce the need for repeat procedures. OBJECTIVE This usability study aimed to identify strengths and weaknesses in a prototype companion app for colonoscopy exams. The objective was to obtain in-depth insights into the app's usability, ease of use, and content comprehension, with the objective of refining the tool to effectively fulfil its intended purpose, guided by feedback from potential users. METHODS From February to August 2024, we conducted a qualitative study using the think-aloud (TA) procedure. Each session involved 6 tasks and a semi-structured interview to delve deeper into participants' task experiences. All TA sessions and interviews were recorded. Quantitative usability questions were analyzed using Microsoft Excel, while qualitative data underwent coding and analysis based on thematic analysis principles. RESULTS In total, 17 individuals, all smartphone users, participated in this study. Participants were recruited from one hospital, one private clinic, and one patient organization in Switzerland. The study found that participants rated the app's usability metrics positively, with an overall mean rating of ease of use at 4.29 (SD 0.59), usefulness at 4.53 (SD 0.72), and comprehensibility at 4.29 (SD 0.92). Additionally, 100% of participants indicated they will or may use the app if they require a colonoscopy exam. Participants highlighted the need for reminders and alerts in the week leading up to the colonoscopy, along with tailored content, simplified language, and visual aids. CONCLUSIONS The app prototype demonstrated favorable results with the majority of participants, and the testing process enabled the prompt identification and resolution of usability issues. Moving forward, the app has the potential to function effectively as a companion app for colonoscopy exams. To achieve this, further studies with a larger sample in real-world settings will be crucial. CLINICALTRIAL NA