User-centric requirements prioritization in mHealth applications: Insights from a Discrete Choice Experiment

Context: Mobile health (mHealth) applications are widely used for chronic disease management, but usability and accessibility challenges persist due to the diverse needs of users. Adaptive User Interfaces (AUIs) offer a promising approach to personalizing interactions and improving user experience. However, their adoption remains limited, partly due to a lack of understanding of how users perceive and evaluate different adaptation strategies. Addressing this gap is crucial for advancing user-centered design and requirements engineering in software systems for health contexts. Objective: This study identifies key factors influencing user preferences and trade-offs in mHealth adaptation design. Method: A Discrete Choice Experiment (DCE) was conducted with 186 participants living with chronic conditions who regularly use mHealth applications. Each participant completed a series of choice tasks, selecting their preferred adaptation designs from scenarios composed of six attributes with varying levels. A mixed logit model was applied to examine preference heterogeneity. Subgroup analyses were also conducted to explore variations in preferences across age, gender, health condition, and coping mechanism. Results: Participants preferred adaptation designs that preserved usability, offered controllability, introduced changes infrequently, and applied small-scale modifications. Conversely, adaptations affecting frequently used functions and those involving caregiver input were generally viewed less favorably. These findings highlight key trade-offs that influence user acceptance of adaptive mHealth interfaces. Conclusion: This study employs a data-driven approach to quantify user preferences, identify key trade-offs, and reveal variations across demographic and behavioral subgroups through preference heterogeneity modeling. These insights provide actionable guidance for designing more user-centered adaptive interfaces and contribute to advancing requirements prioritization practices in software engineering—particularly in the context of health technologies.