A multi-level usability evaluation of mobile health applications: A case study

Hwayoung Cho, Po Yin Yen, Dawn Dowding, Jacqueline A. Merrill, Rebecca Schnall

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


Objective: To report a methodological approach for the development of a usable mHealth application (app). Materials and methods: This work was guided by a 3-level stratified view of health information technology (IT) usability evaluation framework. We first describe a number of methodologies for operationalizing each level of the framework. Following the description of each methodology, we present a case study which illustrates the use of our preferred methodologies for the development of a mHealth app. At level 1 (user-task), we applied a card sorting technique to guide the information architecture of a mobile HIV symptom self-management app, entitled mVIP. At level 2 (user-task-system), we conducted a usability evaluation of mVIP in a laboratory setting through end-user usability testing and heuristic evaluation with informatics experts. At level 3 (user-task-system-environment), usability of mVIP was evaluated in a real-world setting following the use of the app during a 3-month trial. Results: The 3-level usability evaluation guided our work exploring in-depth interactions between the user, task, system, and environment. Integral to the findings from the 3-level usability evaluation, we iteratively refined the app's content, functionality, and interface to meet the needs of our intended end-users. Discussion and conclusion: The stratified view of the health IT usability evaluation framework is a useful methodological approach for the design, development, and evaluation of mHealth apps. The methodological recommendations for using the theoretical framework can inform future usability studies of mHealth apps.

Original languageEnglish
Pages (from-to)79-89
Number of pages11
JournalJournal of Biomedical Informatics
StatePublished - Oct 2018


  • Case study
  • Health information technology
  • Information systems
  • Mobile Health
  • Mobile applications
  • Usability evaluation


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