Background: Remote patient management (RPM) using smartphone-enabled health monitoring devices (SHMDs) can be an effective, value-added part of cardiovascular care. However, cardiac patients’ adherence to RPM is variable. Personas are fictional representations of users with common behaviors, needs, and motivation and can thereby help guide tailoring of interventions to be meaningful and possibly more effective. Personas can be used to understand the needs of the patient group and guide tailoring toward more personalized and effective eHealth intervention. Objective: The aim of this study was to develop data-driven personas for patients with myocardial infarction (MI) based on both quantitative and qualitative results. Methods: This study used a mixed methods design involving (1) database analysis of patients with MI (N=261) SHMD usage data (blood pressure [BP], weight, step count) over the course of a one-year care track and (2) semistructured interviews with patients with MI (N=16) currently using SHMDs. Overall, 12-month adherence rates were calculated based on the number of weeks patients performed the prescribed home measurements with the SHMDs. Results: A cluster analysis was conducted on the self-monitoring data resulting in four distinctive usage patterns labeled as stiff starting (low adherent in first 6 weeks: 13%, 34/261 of users), temporary persisting (decreasing adherence: 24%, 62/261), loyally persisting (continuously adherent: 26%, 68/261), and negligent quitting (nonadherent: 37%, 97/261). Health outcomes (BP, step count, and weight) were analyzed based on these patterns. More adherent usage patterns show better controlled BP when compared to less adherent usage patterns, suggesting that adherence is associated with health outcomes. Patient experiences regarding adherence or nonadherence to the RPM relating to the four distinctive usage patterns were uncovered by means of semistructured interviews, providing insight into adherence factors most relevant for each of the clusters. Thus, 4 distinct personas were developed by data collection (database analysis and semistructured interviews), persona segmentation, and persona creation, named Tamara, Sam, Peter, and Kim. Conclusions: This study identified 4 personas regarding adherence experiences and usage patterns of patients within an RPM care track. Adherent usage patterns were characterized by improved BP and step count. These personas can guide future tailoring of eHealth interventions to maximize patient adherence.

Background: Risk-based breast cancer (BC) screening raises new questions regarding information provision and risk communication. This study aimed to: 1) investigate women’s beliefs and knowledge (i.e., mental models) regarding BC risk and (risk-based) BC screening in view of implications for information development; 2) develop novel informational materials to communicate the screening result in risk-based BC screening, including risk visualizations of both quantitative and qualitative information, from a Human-Centered Design perspective. Methods: Phase 1: Interviews were conducted (n = 15, 40–50 years, 5 lower health literate) on women’s beliefs about BC risk and (risk-based) BC screening. Phase 2: In three participatory design sessions, women (n = 4–6 across sessions, 40–50 years, 2–3 lower health literate) made assignments and created and evaluated visualizations of risk information central to the screening result. Prototypes were evaluated in two additional sessions (n = 2, 54–62 years, 0–1 lower health literate). Phase 3: Experts (n = 5) and women (n = 9, 40–74 years) evaluated the resulting materials. Two other experts were consulted throughout the development process to ensure that the content of the information materials was accurate. Interviews were transcribed literally and analysed using qualitative thematic analysis, focusing on implications for information development. Notes, assignments and materials from the participatory design sessions were summarized and main themes were identified. Results: Women in both interviews and design sessions were positive about risk-based BC screening, especially because personal risk factors would be taken into account. However, they emphasized that the rationale of risk-based screening and classification into a risk category should be clearly stated and visualized, especially for higher- and lower-risk categories (which may cause anxiety or feelings of unfairness due to a lower screening frequency). Women wanted to know their personal risk, preferably visualized in an icon array, and wanted advice on risk reduction and breast self-examination. However, most risk factors were considered modifiable by women, and the risk factor breast density was not known, implying that information should emphasize that BC risk depends on multiple factors, including breast density. Conclusions: The information materials, including risk visualizations of both quantitative and qualitative information, developed from a Human-Centered Design perspective and a mental model approach, were positively evaluated by the target group.