A Mobile App (Joint Effort) to Support Cannabis Use Self-Management and Reinforce the Use of Protective Behavioral Strategies: Development Process and Usability Testing (Preprint)

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Abstract
BACKGROUND Canada’s legalization of recreational cannabis use (CU) has further highlighted the need for innovative interventions that promote lower-risk CU. Young adults aged 18-25 years represent the age group with the highest prevalence of CU. Protective behavioral strategies (PBSs) have been shown to help manage CU and reduce its negative consequences. To date, only a few interventions have focused on PBSs. To address this gap, a mobile app prototype using PBSs to influence CU was developed with and for young adults. OBJECTIVE This study aims to describe the development process and usability testing of Joint Effort, a CU self-management mobile app prototype centered on promoting the use of PBSs among young adults with any past 30-day CU. METHODS Intervention mapping (IM) and a co-design approach were used. Six steps were followed: (1) focus groups were conducted to identify needs and preferences regarding CU interventions; (2) a matrix of change objectives was used to select target behaviors and determinants; (3) theory-based intervention methods and practical applications were selected; (4) focus groups were held to validate the intervention structure and examples of tailored messages; (5) preliminary intervention content was created; and (6) the intervention content was transposed into a mobile app prototype. Usability was assessed through qualitative semistructured interviews and the User Version of the Mobile Application Rating Scale (uMARS), completed by a sample of 20 university students with a mean age of 21.8 (median 22) years, 14 (70%) of whom were women and 15 (75%) were undergraduates. Qualitative data were analyzed using thematic analysis. RESULTS Four themes were identified from the interviews: Joint Effort was visually pleasing and easy to use; the content was well-adapted to the target audience and nonjudgmental; customization functions were appreciated; and the app was perceived as helpful and relevant for initiating behavior change. The prototype received a mean quality score of 4.43/5.0 (SD 0.53) per item on the uMARS. The mean scores on the 5 subscales were as follows: engagement (4.14, SD 0.53), functionality (4.60, SD 0.47), aesthetics (4.53, SD 0.52), information quality (4.44, SD 0.61), and subjective quality (3.36, SD 0.53). CONCLUSIONS Our findings highlight the added value of IM and a co-design approach, underscoring the importance of incorporating user feedback in the development of mobile apps. Building on the strong usability results, the Joint Effort prototype has since been developed into an iOS mobile app, and larger-scale evaluations are currently underway to assess its acceptability, feasibility, and efficacy.
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