Development of Goal-Achievement Support App to Assist Children and Families in Participating in Meaningful Occupations: Content Validation Using Delphi Method.

Background: Occupational therapy has highlighted the necessity for planning and executing interventions in collaboration with clients, families, and caregivers to facilitate their progress. Thus, in pediatric occupational therapy, it is essential to position the family as a primary client and to actively involve them in the intervention process. These interventions often incorporate tools that facilitate parental engagement in home-based activities. However, no tools have been specifically designed to support parents comprehensively in achieving their parenting goals in everyday situations. To address this gap, we developed a mobile app called the Children's Occupation Support Mobile System (COSMO) to support occupational therapists, children, and parents in a collaborative manner to achieve intervention goals in daily life. Objective: The aim of the study is to develop the COSMO and validate its content in terms of legibility, visibility, and accessibility. Methods: This study was conducted in two stages: (1) designing a prototype of COSMO and (2) validating its content using the Delphi method. The prototype was developed based on a conceptual model of parenting strategies, which was derived from interviews with mothers raising children with developmental disabilities. This study included 10 Japanese pediatric occupational therapists, who were selected using convenience sampling to ensure diversity and heterogeneity in attributes. The Delphi survey was conducted entirely through a web-based questionnaire emailed to the experts. Participants rated their agreement with each item on a 5-point Likert scale. A mean item score of ≥3.75 (75%) indicated consensus. Results: The prototype was designed through a series of 13 one-hour meetings held monthly. The functional framework of COSMO was structured into four core components based on previous research: (1) collaborative goal setting, (2) home strategy-an action plan to achieve goals, (3) self-reflection-a record of implemented strategies, and (4) progress reports-data storage for tracking outcomes. For validating the content, the 2 Delphi rounds resulted in a total mean score of 4.44 for legibility, 4.86 for visibility, and 4.84 for accessibility. In the free-text responses, there were references to improvements in the wording and to the burden of writing the reflections. Therefore, the wording was revised to avoid jargon and use plain language. The burden of COSMO use was reduced by simplifying the use process by incorporating optional inputs for some of its functions. Conclusions: COSMO was developed as a comprehensive tool to integrate functions while aiming to reduce the burden on parents. This may reduce resistance to app use and make it easier for more parents to use it. Future studies should evaluate the generalizability and effectiveness of the prototype as an intervention. Limitations of this study include the absence of end-user testing, a geographically limited expert panel, and a limited discussion of implementation challenges across diverse health care settings.