Development and usability evaluation of a patient journey-based mHealth intervention for esophageal cancer patients: a three-phase protocol

Introduction: Esophageal cancer (EC) patients face significant challenges in health management across different disease stages, including symptom monitoring, treatment adherence, and long-term self-care. Digital health interventions, particularly mobile health (mHealth) applications, hold promise for providing personalized support and improving patient engagement. However, many existing mHealth tools for esophageal cancer lack a strong theoretical foundation and fail to fully incorporate patient-centered considerations, which may limit their long-term effectiveness. This study aims to develop and evaluate a WeChat-based mini-program that integrates Patient Journey Mapping (PJM) and the Integrated Theory of Health Behavior Change (ITHBC) to support personalized health management for esophageal cancer patients. Methods: This study will adopt a single-arm, exploratory design. Semi-structured interviews with esophageal cancer patients will first be conducted to identify their health management needs. Based on these findings, a WeChat-based mini-program will be developed and iteratively refined through Delphi expert consultation. In the evaluation phase, a mixed-method usability assessment will be performed, incorporating the mHealth App Usability Questionnaire (MAUQ), task-based performance metrics, and backend interaction analytics. To supplement these quantitative measures, brief post-test interviews will be conducted to capture user experiences and contextual factors. The primary outcome is system usability. Secondary outcomes include task completion performance, while backend interaction data will serve as process indicators of user engagement. Discussion: The findings of this study will provide insights into the user experience and system functionality of a WeChat-based mini-program designed for esophageal cancer patients. The results will inform refinements to the intervention, ensuring better alignment with patient needs and enhancing the feasibility of digital health solutions in oncology care. Furthermore, by integrating patient journey insights, this study helps establish a more patient-centered approach to mHealth design. This approach may serve as a foundation for future digital health tools supporting cancer care and long-term health management. Clinical trial registration: https://www.chictr.org.cn, Chinese Clinical Trial Registry: ChiCTR2500098611.