Design and content validation of an instrument measuring user perception of the persuasive design principles in a breastfeeding mHealth app : A modified Delphi study

Journal article

Almohanna, Alaa Ali S., Win, Khin Than, Meedya, Shahla and Vlahu-Gjorgievska, Elena. (2022). Design and content validation of an instrument measuring user perception of the persuasive design principles in a breastfeeding mHealth app : A modified Delphi study. International Journal of Medical Informatics. 164, p. Article 104789. https://doi.org/10.1016/j.ijmedinf.2022.104789
AuthorsAlmohanna, Alaa Ali S., Win, Khin Than, Meedya, Shahla and Vlahu-Gjorgievska, Elena
Abstract

Background
Persuasive design principles are increasingly employed in mHealth apps for motivating users and promoting healthy behaviours among individuals. However, how the persuasive design principles are perceived by the mHealth app users remains unclear.

Aim
To develop and validate the content validity of an instrument designed to measure the user’s perceptions of the persuasive design principles assimilated in a breastfeeding mHealth app.

Methods
A critical review of the literature guided the development of the research instrument. The developed instrument was refined and validated through a two-round modified Delphi process. Ten experts drawn from academic and clinical settings evaluated the items through two content validity indicators, relevance, and clarity and provided narrative feedback. The content validity of the instrument was determined by calculating the Content Validity Index (CVI). Content validity indicators at the scale-level (S-CVI) and item-level (I-CVI) were calculated.

Results
The results demonstrated high content validity index of individual items in the instrument. All items in the instrument reached an excellent I-CVI ≥ 0.78 for both relevance and clarity except one item. The overall content validity index of the instrument using the average approach was moderate to high (S-CVI/Ave was 0.89 and 0.92 for relevance and clarity, respectively). The developed research instrument is composed of 5 constructs representing 24 items: (1) primary task support, (2) dialogue support, (3) system credibility support, (4) social support and (5) perceived persuasiveness.

Conclusions
Using a modified Delphi approach, the development and validation of the research instrument demonstrated moderate to high content validity for measuring users’ perceptions of the persuasive design principles assimilated in a breastfeeding mHealth app. The evidence from this study supports that the research instrument is valid, relevant, and clear.

Keywordspersuasive technology; mHealth app; breastfeeding; instrument development; instrument validation; content validity; Delphi
Year2022
JournalInternational Journal of Medical Informatics
Journal citation164, p. Article 104789
PublisherElsevier B.V.
ISSN1386-5056
Digital Object Identifier (DOI)https://doi.org/10.1016/j.ijmedinf.2022.104789
PubMed ID35597101
Scopus EID2-s2.0-85130867401
Page range1-10
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online10 May 2022
Publication process dates
Accepted28 Apr 2022
Deposited15 Apr 2025
Additional information

© 2022 Elsevier B.V. All rights reserved.

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Sufficient exercise for Australians living with dementia in residential aged care facilities is lacking : An exploration of policy incoherence [Commentary]
Brett, Lindsey, Stapley, Paul, Meedya, Shahla and Traynor, Victoria. (2018). Sufficient exercise for Australians living with dementia in residential aged care facilities is lacking : An exploration of policy incoherence [Commentary] John Wiley & Sons, Inc.. https://doi.org/10.1111/1753-6405.12800
Association between maternal sense of competence and self-efficacy in primiparouswomen during postpartum period
Bagherinia, Marzieh, Meedya, Shahla and Mirghafourvand, Mojgan. (2018). Association between maternal sense of competence and self-efficacy in primiparouswomen during postpartum period. Shiraz E-Medical Journal. 19(3), p. Article e59286. https://doi.org/10.5812/semj.59286
Effect of educational and support interventions on long-term breastfeeding rates in primiparous women : A systematic review and meta-analysis
Meedya, Shahla, Fernandez, Ritin and Fahy, Kathleen. (2017). Effect of educational and support interventions on long-term breastfeeding rates in primiparous women : A systematic review and meta-analysis. JBI Evidence Synthesis. 15(9), pp. 2307-2332. https://doi.org/10.11124/JBISRIR-2016-002955
Effect of educational and support interventions to increase long-term breastfeeding rates in primiparous women : A systematic review protocol
Meedya, Shahla, Fernandez, Ritin and Fahy, Kathleen. (2017). Effect of educational and support interventions to increase long-term breastfeeding rates in primiparous women : A systematic review protocol. JBI Evidence Synthesis. 15(3), pp. 594-602. https://doi.org/10.11124/JBISRIR-2016-003132
Effects and feasibility of an exercise intervention for individuals living with dementia in nursing homes : Study protocol
Brett, Lindsey, Traynor, Victoria, Stapley, Paul and Meedya, Shahla. (2017). Effects and feasibility of an exercise intervention for individuals living with dementia in nursing homes : Study protocol. International Psychogeriatrics. 29(9), pp. 1565-1577. https://doi.org/10.1017/S1041610217000138
The health and health preparation of long-term Australian travellers
Halcomb, Elizabeth, Stephens, Moira, Smyth, Elizabeth, Meedya, Shahla and Tillott, Sarah. (2017). The health and health preparation of long-term Australian travellers. Australian Journal of Primary Health. 23(4), pp. 386-390. https://doi.org/10.1071/PY16138
The Milky Way educational and support programme : Structure, content and strategies
Meedya, Shahla, Fahy, Kathleen and Parratt, Jenny A.. (2016). The Milky Way educational and support programme : Structure, content and strategies. Women and Birth. 29(4), pp. 388-393. https://doi.org/10.1016/j.wombi.2016.01.006