O-086 Co-development of Orchid mobile application for supporting fertility intentions and reproductive choices
Authors: Stewart C , Grace B , Hall J 
Published: June 2023

Abstract

Study question
What does co-development bring to the design of a mobile application (app) for supporting fertility intentions and reproductive choices?

Summary answer
Co-development of the app for supporting fertility intentions and reproductive choices informed the design and content, from expressed preferences, ensuring acceptability by the end user.

What is known already
We sought to develop a digital tool to support people of reproductive age to understand their pregnancy preferences and fertility intentions; helping them to prepare for pregnancy, improving pregnancy outcomes, preventing unplanned pregnancies and reducing inequalities in maternal health. Orchid encourages the person to consider that they have a choice about their fertility intentions and to reflect on their personal reproductive goals and how this may fit with other life goals. We aimed to co-develop a mobile app via a person-centred approach, which draws on behaviour change theory.

Study design, size, duration
The app development was conducted via University College London. Co-development was conducted online over five rounds (four online surveys and one online group discussion) from November 2022 – February 2023. Round 1 – Content mapping, Round 2 – App layout, Round 3 – Online group discussion of content and layout, Round 4 – App design, and Round 5 - Functioning pilot app.

Participants/materials, setting, methods
Participants were invited via a database of potential research participants and were purposefully selected to ensure diversity and inclusion. The co-development group was made up of 10 women from across the UK; aged 19-44 years with a range of relationship status’ (married, divorced, cohabiting and single), ethnicities (White n = 8, Asian n = 1, Mixed n = 1) and family sizes.

Main results and the role of chance
We gained feedback from our co-development group through online surveys, made up of a combination of structured and open text questions. We also held an online group session which allowed us to have an in-depth discussion about the content and look of the app. As a result of the co-development feedback, we redesigned key elements of the app; altering the language used throughout, including the wording of the pregnancy prediction, adding extra information about the reproductive preference groups and including a wider range of resources. The overall look of the app also changed considerably, with feedback from the co-development group helping to make decisions regarding the colour scheme, the number of screens, the layout and presentation of information. Final user testing was also conducted by the co-development group to verify functionality of the app.
We performed multiple iterations of co-development – with a survey at every development stage – and used the feedback to inform our decisions throughout the development process to ensure acceptability to the end user.

Limitations, reasons for caution
There was a limited number of participants involved in this, the first stage of developing a Minimum Viable Product (MVP) of the app. A larger group of even more diverse individuals will be needed for the next stage, which will likely increase the complexity of the co-development process.

Wider implications of the findings
We co-developed an MVP app with a sample population, representative of our end-user. Participants were involved in every stage of the development process and provided a positive evaluation of the product. People must be viewed less as consumers and more as contributing partners in their care.

Trial registration number
not applicable