ArticlePLOS digital health2026
Designing user-centered evaluations: Leveraging beta-testing results to develop process evaluation interview questions for the AMPLIFY program.
Article in PLOS digital health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
15 authors.
Funding
Abstract
Refining digital health programs with end-user feedback is essential throughout program lifecycles to ensure user-centered perspectives are incorporated during all program development. Results from beta-testing "think aloud" interviews exploring program engagement, satisfaction, motivation, and usefulness may be leveraged to support development of interview questions for a subsequent user-centered process evaluation implemented during program efficacy testing. We describe how results from beta-testing "think aloud" interviews were utilized to inform the design of user-centered process evaluation interview questions for implementation during program efficacy testing of AMPLIFY, a web-based diet and exercise program for older cancer survivors. Beta-testers (n = 15) were asked to complete three "think aloud" interviews via a videoconference platform over a 6-month period; 40 interviews were completed, accounting for early dropouts. Transcripts were analyzed using a multi-step process: 1) suggested refinements from beta-testing "think aloud" interview results were catalogued and organized according to whether the program feature was liked, disliked, or confusing to the beta-tester; and 2) suggestions for refinements were categorized based on feasibility to adopt (feasible/not feasible), the type of recommended change (formatting/content), and underlying improvement goal (engagement, satisfaction, motivation, usefulness). Refinements considered feasible to adopt were categorized into formatting refinements (changes to the presentation/organization of the program) and content refinements (additions, deletions, or changes to the information provided in the program). Refinements were also categorized by relationship to four process evaluation constructs: engagement, satisfaction, motivation, and usefulness. Results informed user-centered process evaluation interview questions for implementation during program efficacy testing; such that, subsequent semi-structured interview questions were developed based on these evaluation constructs and underlying improvement goals. The application of beta-testing results to refinements and process evaluation provide a potential guide for other researchers developing and evaluating digital health interventions.
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Registered trials
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