Use and User Experience of a Preconception Lifestyle App for Couples Undergoing in Vitro Fertilization: Mixed Methods Study (Preprint)

BACKGROUND Mobile apps are a promising way to improve healthy lifestyle behavior among people with infertility. However, sufficient engagement with mobile health apps is crucial to influence health outcomes, and identifying features to create more effective interventions is urgently needed. OBJECTIVE This study conducted a process evaluation focusing on the use and user experience of the PreLiFe app, a mobile lifestyle app for couples undergoing in vitro fertilization (IVF). METHODS A mixed methods approach was used among heterosexual couples with infertility undergoing IVF. An objective quantitative study using a tracking-based system assessed the actual use of the PreLiFe app over time in relation to partner use and in relation to the specific fertility treatment. A subjective quantitative study using online questionnaires assessed the acceptability (using the Mobile App Rating Scale) and partner support (based on the Social Support for Diet and Exercise Scale) experienced while using the PreLiFe app. A subjective qualitative study using semistructured interviews evaluated in-depth user experiences with the PreLiFe app. RESULTS A total of 106 couples used the PreLiFe app for 2 to 365 days. Overall use was low; 18.9% (20/106) of the men and 49.1% (52/106) of the women used all the modules of the PreLiFe app. Mixed-model analyses revealed that higher app use was observed when a partner used the app as well and during fertility treatment. The average acceptability score was 6 (SD 1) of 10, and patients felt supported by their partners while using the app. Semistructured interviews with 10 patients indicated that the PreLiFe app was easy to use. CONCLUSIONS Our findings showed good acceptability and user experiences but low actual objective use of a preconception lifestyle app for couples undergoing IVF. To increase use of and engagement with such apps, future studies should further focus on personalization and interaction with partners, health care providers, and other patient data systems.