Development and content validation of a patient-centered and digitally inclusive mobile application for chronic heart failure: A Delphi study

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Background Chronic heart failure (CHF) necessitates ongoing self-management to reduce hospital admissions and enhance clinical outcomes. Mobile health (mHealth) applications are promising tools. However, most lack validated content and user-centered design. This study aimed to identify and validate core content for a CHF-focused mHealth application through expert consensus. Methods A two-round Delphi study was conducted with 24 experts, including physicians, nurses, and patients with CHF. In round one, 39 self-management items were evaluated. Based on quantitative scores and qualitative feedback, 5 items were excluded, and 13 new ones were added. In round two, 44 of 47 items (93.6%) achieved consensus ( x ̄ ≥ 7.5). Psychometric indicators included standard deviation, Content Validity Ratio (CVR), Content Validity Index (CVI), and Intraclass Correlation Coefficient (ICC). Results Validated content was categorized into two domains. Domain 1: Recording Functionalities included Signs and Symptoms ( x ̄ = 8.23 ± 0.88) and Medication Management ( x ̄ = 8.52 ± 0.94). Domain 2: Therapeutic Education included five classes: Basic Concepts ( x ̄ = 7.90), Self-care and Disease Management ( x ̄ = 8.27), Recognition of Signs and Symptoms ( x ̄ = 8.03), Psychosocial Support ( x ̄ = 8.15), and Lifestyle Management ( x ̄ = 8.06). Inter-rater reliability demonstrated variable but generally moderate to good agreement across items (ICC range 0.31–1.00), with statistical significance (p < 0.05). The overall CVI reached 0.82. Conclusions This study validated 44 items for CHF self-management via mHealth. The participatory, evidence-based approach ensures clinical relevance and usability. Implementation may improve adherence, decrease readmissions, and support quality of life.

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