Evaluation of a Tailored Mobile Application for Self-Management of Low Back Pain: Towards a Metamodel for Designing Behavior Change Technologies

The mobile health market is rapidly developing, but few apps follow evidence-based guidelines. Literature recommends personalized systems grounded in behavioral science, involving healthcare professionals in design to maximize effectiveness. To address this, we propose a metamodel to guide designers. This article discusses its application to low back pain self-management, focusing on four patient profiles: Unmotivated, Cautious, Depressed, and Confident. We evaluated the app over one month with 60 users. Of these, 32 users received a version of the application tailored to their profile, and 28 users received a version of the application without tailoring (no recommendations or motivational messages). We assessed user experience, engagement and psychological characteristics involved in the behavior change process. Results showed satisfactory user experience, impact of tailoring on user behavior and features to reduce fears and false beliefs and increase self-efficacy. Further efforts are needed to increase user engagement and observe an impact on long-term behavior.