Usability and feasibility of PreventS-MD web app for stroke prevention
Authors: Feigin Valery L , Krishnamurthi Rita , Medvedev Oleg , Merkin Alexander , Nair Balakrishnan , Kravchenko Michael , Jalili-Moghaddam Shabnam , Barker-Collo Suzanne , Ratnasabapathy Yogini , Skinner Luke , Owolabi Mayowa , Norrving Bo , Sachdev Perminder S , Arroll Bruce , Brainin Michael , Thrift Amanda , Hankey Graeme J , Abd-Allah Foad , Akinyemi Rufus , Azarpazhooh Reza , Bhatia Anjali , Bath Philip M , Brayne Carol , Budincevic Hrvoje , Child Nicholas , Chwojnicki Kamil , Correia Manuel , Davis Alan , Devlin Gerry , Demarin Vida , Dhamija Rajinder K , Ding Ding , Dokova Klara , Dudley Makarena , Dyer Jesse , Edmonds Misty , Ely Marcela , Farhoudi Mehdi , Feigin Svetlana , Fornolles Caroline , Firzah Abdul Aziz Aznida , Gabriel Denis , Gall Seana , Gil Artyom , Gnedovskaya Elena , George Ann , Haršány Michal , Harwood Matire , Hillis Argye , Hou Zeng-Guang , Hwang Kevin , Ibrahim Norlinah , Ka’ai Tania , Kalra Nidhi , Katzenellenbogen Judith , Zhe Kang Law , Kar Arindam , Karaszewski Bartosz , Kazin Vitalij , Kivipelto Miia , Kamenova Saltanat , Kondybaeva Aida , Lavados Pablo , Lee Tsong-Hai , Liu Liping , Mahawish Karim , Maluchnik Michal , Martins Sheila , Mateen Farrah , Mavaddat Nahal , Mohan Mehndiratta Man , Mikulik Robert , Oliver Angela , Özturk Serefnur , Patel Nikhil , Piradov Michael , Prakash Binita , Purvis Tara , Reips Ulf-Dietrich , Roos Kev , Rosand Jonathan , Sahathevan Ramesh , Sekaran Lakshmanan , Shamalov Nikolay , Anne De Silva Deidre , Singh Vinod , Solomon Alina , Srivastava Padma , Suwanwela Nijasri C , Taylor Denise , Truelsen Thomas , Venketasubramanian Narayanaswamy , Volevach Ekaterina , Volný Ondřej , Wan Joyce , Withanapathirana Katila , Welte Tamara , Wiebers David , Winkler Andrea S , Wijeratne Tissa , Wu Teddy , Asyraf Wan Zaidi Wan 
Published: July 2023

Background: Most strokes and cardiovascular diseases (CVDs) are potentially preventable if their risk factors are identified and well controlled. Digital platforms, such as the PreventS-MD web app (PreventS-MD) may aid health care professionals (HCPs) in assessing and managing risk factors and promoting lifestyle changes for their patients. Methods: This is a mixed-methods cross-sectional two-phase survey using a largely positivist (quantitative and qualitative) framework. During Phase 1, a prototype of PreventS-MD was tested internationally by 59 of 69 consenting HCPs of different backgrounds, age, sex, working experience, and specialties using hypothetical data. Collected comments/suggestions from the study HCPs in Phase 1 were reviewed and implemented. In Phase 2, a near-final version of PreventS-MD was developed and tested by 58 of 72 consenting HCPs using both hypothetical and real patient (n = 10) data. Qualitative semi-structured interviews with real patients (n = 10) were conducted, and 1 month adherence to the preventive recommendations was assessed by self-reporting. The four System Usability Scale (SUS) groups of scores (0–50 unacceptable; 51–68 poor; 68–80.3 good; >80.3 excellent) were used to determine usability of PreventS-MD. Findings: Ninety-nine HCPs from 27 countries (45% from low- to middle-income countries) participated in the study, and out of them, 10 HCPs were involved in the development of PreventS before the study, and therefore were not involved in the survey. Of the remaining 89 HCPs, 69 consented to the first phase of the survey, and 59 of them completed the first phase of the survey (response rate 86%), and 58 completed the second phase of the survey (response rate 84%). The SUS scores supported good usability of the prototype (mean score = 80.2; 95% CI [77.0–84.0]) and excellent usability of the final version of PreventS-MD (mean score = 81.7; 95% CI [79.1–84.3]) in the field. Scores were not affected by the age, sex, working experience, or specialty of the HCPs. One-month follow-up of the patients confirmed the high level of satisfaction/acceptability of PreventS-MD and (100%) adherence to the recommendations. Interpretation: The PreventS-MD web app has a high level of usability, feasibility, and satisfaction by HCPs and individuals at risk of stroke/CVD. Individuals at risk of stroke/CVD demonstrated a high level of confidence and motivation in following and adhering to preventive recommendations generated by PreventS-MD.