A User-Centric Approach to the Development of a Mobile Yoga App for Patients With Thoracic Cancer and Their Family Caregivers

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Abstract
Background: We recently completed the efficacy testing of an instructor-led yoga program for patients with thoracic cancer undergoing radiotherapy and their family caregivers. Translating an instructor-led intervention to a mobile app–based delivery model may facilitate the implementation of this yoga program in routine oncological clinical care. Objective: The current study seeks to develop a prototype of the app-based yoga program using a user-centric approach. Methods: Ten patients with a primary diagnosis of lung or esophageal cancer and their family caregivers (N=20) participated in structured interviews. Half of the sample had previously participated in the instructor-led yoga program, whereas half of the sample did not. Participants provided feedback on various mock-ups, wireframes, and yoga videos to guide the development of the app’s content, features, and workflow. Results: All patients (60% male; 70% non–Hispanic White; age: mean 62 years; 90% stage III) and their caregivers (90% female; 50% non–Hispanic White; age: mean 52 years) indicated that developing an app-based program is important and useful. Of the 20 participants, 95% mentioned that having an initial orientation with a yoga interventionist is important, and 90% stated that at least 1 check-in should be available (65% desired weekly check-ins). Participants provided feedback on characteristics of the instructor and instruction preferences. Other desired features included scheduling sessions on a calendar (95%), monitoring progress (95%), receiving practice reminders (90%), providing education on yoga as symptom management (90%), and providing daily inspiration (85%). All participants indicated the importance of including practices of various lengths. Conclusions: Both patients and caregivers deemed an app-based yoga program useful. Regardless of their level of yoga experience, almost all participants desired at least some contact with a live yoga instructor, although the desired frequency varied. These data have informed the development of a prototype that we are currently field-testing to ensure feasibility and acceptability.

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