Table 3.

Recommendations for future app development.

Challenges	Experiences	Recommendations	Suggestions for further research
Engaging user subgroups	Participants who are separated in user groups seemed freer to share ideas than they may have been in mixed groups.	Separate participants in user groups in workshops sessions.	What tools and techniques are best suited for different types of end users (ie, young people, parents, health care providers)?
	Young people found it easier to create paper prototypes, compared to parents and health care providers.	Creating paper prototypes is an effective tool for engagement, especially with young people in activities to generate ideas.
Resolving conflicting views on functionality	The IT company and the steering group made the final decisions about the content of the app.		Incorporate eliminated functions in a future version since users wanted them.
	Functions (mentor/mentee-function, customization, and monthly newsfeed) were eliminated due to lack of resources.		How to prioritize and eliminate user ideas?
Meeting requirements for building an mHealth app	A diverse team of experts was crucial to meeting the challenge of building a new technology platform within health care.	Invite end users, designers, and a diverse team of experts (eg, illustrators, journalists) to participate in workshops.
		Collaborate with other educational institutions to meet the need for expertise with minimal cost.
		Establish public-private partnerships to combine resources and ensure engagement from all stakeholders.
		Consider engaging an innovation consultant to guide the PD process.
		Set aside enough time to build the app – it always takes more time than expected.
		Invite users to participate in meetings with the IT company during app building.
Designing and refining technology in a rapid, low-cost way	Main activities resulted in large amounts of data (eg, 46 hours of digital records from workshops).	Prolong the prototype stage before developing complex expensive technology.	Guidelines are needed on how to collect, analyze, and prioritize data.
	Ongoing user input from iterative cycles helped designers understand user needs and refine the app.	Consider workshops as an ongoing iterative activity in which users give feedback and propose new ideas to prototypes.	More efficient methods, tools, and techniques are needed to meet the rapid development within technology to avoid outdated app versions.
	Expensive technology challenged our ability to meet the users input.	Use living labs to simulate hospital or home settings to try out paper prototypes and explore future ways to use the new technology.	How do we reduce resource (money and time) use?
Improving the user interface	The mail panel functioned as a consulting panel and provided feedback in a short time that improved the app content. The think-aloud tests explored how users assessed the app (ie, navigation, technical errors).	We highly recommend both a mail panel and think-aloud tests in future PD studies, given the valuable input and the low cost and speed of conducting these techniques.	Solicit larger panels using social media (eg, Facebook, Twitter) to comment and share ideas.
	Combining mail panel and think-aloud tests resulted in a substantial reduction of user problems.	Add digital videos and screen records in think-aloud tests to register physical actions, supporting the interpretation of the results.	Introduce a panel in an earlier phase to supplement or replace face-to-face workshops.
Implementing technology in health care	Interviews with health care providers helped us understand barriers to introducing new technology.	Include end users in all phases of a PD project to ensure adoption.	How to teach health care providers to use new technology in collaboration with young people and parents?
	Workshops, mail panel, think-aloud tests, and feasibility study helped us to ensure a user-friendly app.	Feasibility test new technology prior to implementation.
	The feasibility study revealed implementation barriers.	Provide a hotline in case of technical difficulties.
		Teach health care providers how to use the technology prior to test.