University of Oulu

Giunti G, Kool J, Rivera Romero O, Dorronzoro Zubiete E. Exploring the Specific Needs of Persons with Multiple Sclerosis for mHealth Solutions for Physical Activity: Mixed-Methods Study. JMIR Mhealth Uhealth 2018;6(2):e37. DOI: 10.2196/mhealth.8996. PMID: 29426814

Exploring the specific needs of persons with multiple sclerosis for mHealth solutions for physical activity : mixed-methods study

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Author: Giunti, Guido1,2; Kool, Jan3; Rivera Romero, Octavio4;
Organizations: 1Salumedia Tecnologias
2University of Oulu
3Kliniken Valens
4Universidad de Sevilla
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.7 MB)
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Language: English
Published: JMIR Publications, 2018
Publish Date: 2018-03-01


Background: Multiple sclerosis (MS) is one of the world’s most common neurologic disorders, with symptoms such as fatigue, cognitive problems, and issues with mobility. Evidence suggests that physical activity (PA) helps people with MS reduce fatigue and improve quality of life. The use of mobile technologies for health has grown in recent years with little involvement from relevant stakeholders. User-centered design (UCD) is a design philosophy with the goal of creating solutions specific to the needs and tasks of the intended users. UCD involves stakeholders early and often in the design process. In a preliminary study, we assessed the landscape of commercially available MS mobile health (mHealth) apps; to our knowledge, no study has explored what persons with MS and their formal care providers think of mHealth solutions for PA.

Objective: The aim of this study was to (1) explore MS-specific needs for MS mHealth solutions for PA, (2) detect perceived obstacles and facilitators for mHealth solutions from persons with MS and health care professionals, and (3) understand the motivational aspects behind adoption of mHealth solutions for MS.

Methods: A mixed-methods design study was conducted in Kliniken Valens, Switzerland, a clinic specializing in neurological rehabilitation. We explored persons with MS and health care professionals who work with them separately. The study had a qualitative part comprising focus groups and interviews, and a quantitative part with standardized tools such as satisfaction with life scale and electronic health (eHealth) literacy.

Results: A total of 12 persons with relapsing-remitting MS and 12 health care professionals from different backgrounds participated in the study. Participants were well-educated with an even distribution between genders. Themes identified during analysis were MS-related barriers and facilitators, mHealth design considerations, and general motivational aspects. The insights generated were used to create MS personas for design purposes. Desired mHealth features were as follows: (1) activity tracking, (2) incentives for completing tasks and objectives, (3) customizable goal setting, (4) optional sociability, and (5) game-like attitude among others. Potential barriers to mHealth apps adoption were as follows: (1) rough on-boarding experiences, (2) lack of clear use benefits, and (3) disruption of the health care provider-patient relationship. Potential facilitators were identified: (1) endorsements from experts, (2) playfulness, and (3) tailored to specific persons with MS needs. A total of 4 MS personas were developed to provide designers and computer scientists means to help in the creation of future mHealth solutions for MS.

Conclusions: mHealth solutions for increasing PA in persons with MS hold promise. Allowing for realistic goal setting and positive feedback, while minimizing usability burdens, seems to be critical for the adoption of such apps. Fatigue management is especially important in this population; more attention should be brought to this area.

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Series: JMIR mHealth and uHealth
ISSN: 2291-5222
ISSN-E: 2291-5222
ISSN-L: 2291-5222
Volume: 6
Issue: 2
Article number: e37
DOI: 10.2196/mhealth.8996
Type of Publication: A1 Journal article – refereed
Field of Science: 113 Computer and information sciences
217 Medical engineering
222 Other engineering and technologies
3111 Biomedicine
3112 Neurosciences
3124 Neurology and psychiatry
3141 Health care science
Funding: GG gratefully acknowledges the grant number 676201 for the Connected Health Early Stage Researcher Support System (CHESS ITN) from the Horizon 2020 Framework Programme of the European Commission.
EU Grant Number: (676201) CHESS - Connected Health Early Stage Researcher Support System
Copyright information: ©Guido Giunti, Jan Kool, Octavio Rivera Romero, Enrique Dorronzoro Zubiete. Originally published in JMIR Mhealth and Uhealth (, 09.02.2018. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.