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

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. This study identifies key factors influencing user preferences and trade-offs in mHealth adaptation design. 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. 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. 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.