Development and Content Validation of a Web-Based Educational App for Mental Health Self-Monitoring After Bariatric Surgery: A Formative Research Study.
Despite the effectiveness of bariatric surgery in the treatment of severe obesity, a substantial proportion of patients experience insufficient weight loss or weight regain over time. Evidence indicates that behavioral factors and mental health conditions play a central role in these outcomes, representing strategic targets for educational and technology-based self-monitoring interventions.
This study aimed to develop and validate the content of a web-based application designed to support mental health self-monitoring and behavioral change among patients undergoing bariatric surgery.
This is a formative research study focused on the development and content validation of a digital health educational intervention, conducted in accordance with the Systematic Instructional Design (SID) model, encompassing the phases of analysis, design/development, and validation. Content validation was performed by a panel of 13 experts, based on Pasquali's criteria. Interrater agreement was quantitatively assessed using the Content Validity Index (CVI), considering the domains of clarity and relevance, with a minimum acceptable agreement threshold of ≥0.80.
The application was developed with 11 screens and integrates validated psychometric instruments for the self-monitoring of key mental health conditions, including the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), the Modified Yale Food Addiction Scale 2.0 (mYFAS 2.0), and the Alcohol Use Disorders Identification Test (AUDIT). In addition, the platform includes body weight monitoring, physical activity tracking, and access to educational content on healthy eating and mental health. The application incorporates motivational strategies such as goal setting, automated alerts, and encouragement of multidisciplinary follow-up. All screens demonstrated content validity in terms of relevance (I-CVI=1.00; S-CVI=1.00). For the clarity domain, only one screen presented an index below the predefined cutoff in the initial evaluation. After revision and adjustments, this screen was re-evaluated and achieved satisfactory agreement (I-CVI=0.92).
The results indicate that the developed application demonstrates adequate content validity as a digital tool to support mental health care in the postoperative period of patients undergoing bariatric surgery. Although this study was limited to content validation, the findings support the formative development of Mcare as a tool for mental health self-monitoring and behavioral support in this population. Future studies should evaluate usability, acceptability, and clinical effectiveness in real-world settings.
This study aimed to develop and validate the content of a web-based application designed to support mental health self-monitoring and behavioral change among patients undergoing bariatric surgery.
This is a formative research study focused on the development and content validation of a digital health educational intervention, conducted in accordance with the Systematic Instructional Design (SID) model, encompassing the phases of analysis, design/development, and validation. Content validation was performed by a panel of 13 experts, based on Pasquali's criteria. Interrater agreement was quantitatively assessed using the Content Validity Index (CVI), considering the domains of clarity and relevance, with a minimum acceptable agreement threshold of ≥0.80.
The application was developed with 11 screens and integrates validated psychometric instruments for the self-monitoring of key mental health conditions, including the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), the Modified Yale Food Addiction Scale 2.0 (mYFAS 2.0), and the Alcohol Use Disorders Identification Test (AUDIT). In addition, the platform includes body weight monitoring, physical activity tracking, and access to educational content on healthy eating and mental health. The application incorporates motivational strategies such as goal setting, automated alerts, and encouragement of multidisciplinary follow-up. All screens demonstrated content validity in terms of relevance (I-CVI=1.00; S-CVI=1.00). For the clarity domain, only one screen presented an index below the predefined cutoff in the initial evaluation. After revision and adjustments, this screen was re-evaluated and achieved satisfactory agreement (I-CVI=0.92).
The results indicate that the developed application demonstrates adequate content validity as a digital tool to support mental health care in the postoperative period of patients undergoing bariatric surgery. Although this study was limited to content validation, the findings support the formative development of Mcare as a tool for mental health self-monitoring and behavioral support in this population. Future studies should evaluate usability, acceptability, and clinical effectiveness in real-world settings.