Content Development & Testing

© 2013 Sarah V. Harlan/JHU•CCP, Courtesy of Photoshare

As you explore technology and design choices for your mHealth solution, you can also develop and test content. Insights from formative research can directly inform content development. For example, interviews with prospective end users provide an understanding of:

  • how they interact with their mobile phones;
  • how they perceive and talk about the health issue in focus; and
  • their relevant literacy, numeracy, and technology skills.

When you set out to develop content, be aware of the specifications of your mode of mobile communication. For example, if the mHealth solution will use...

  • Short messaging service (SMS)--tailor your content to messages of 160 characters or fewer.
  • Video--check the typical bandwidth capabilities of the devices and networks that will be used.
  • A mobile survey or form--ensure that you know the character limits and how many survey questions are permitted.
  • Interactive voice recording (IVR)--find out how many menu options can be built into the service (for example, users are given an option to press 1, 2, or 3 for more information).

The discussion paper Designing Health Literate Mobile Apps provides insights about how to build health literate apps by applying usability and health literacy strategies throughout the development process. The authors focus on the following steps:

  • learn about your users,
  • write actionable content,
  • display content clearly,
  • organize and simplify,
  • engage users, and
  • revise and evaluate.

Just as with print materials, content development and testing is an ongoing process. Experienced mHealth implementers attest that you can expect to make changes to content throughout the course of the project. Organize your content in an easily readable, adaptable format, which might vary depending on your program’s content needs. For example, Microsoft Word works well to keep track of SMS content because of the “word count” functionality in the program, which Microsoft Excel does not have. Also ensure that you have a naming convention policy with your team to ensure version control—for example, name files according to project title, date, and initials of the last person to edit the content, such as “m4RH_Messages_6.30.201_HV.”    

Also note that some mHealth programs, such as Mobile Alliance for Maternal Action (MAMA) and CommCare, have made content available for adaptation by other programs. The Resources section of the Guide includes a comprehensive list of mHealth Content Repositories. MAMA has also developed MAMA Content Learning Modules, which are short online learning courses designed to assist organizations as they work on their own projects to localize the messages. 



“It is recommended to work with technical experts to approve content and ensure that it meets standards of care.” – Berhane Gerbu, Uganda Health Information Network, Mozambique Health Information Network, Mobile Health Information System (South Africa)

“If you are asking a lot of questions [via SMS], people stop responding. We found that four questions worked well. We saw that with every extra question beyond that the respondents dropped off.”  - Bhupendra Sheoran, YTH (formerly ISIS), SexInfo and The Hookup, USA

“We included the target audience in program design and content development. Our initial strategy was to hold focus groups in schools and community clinics to discuss the main sexual health issues. After warming up the groups, we asked questions, to which participants texted their answers. It helped the program designers see how the youth used texting, and what words they used. Then the program staff wrote messages. Now [as of July 2012], we have partnerships with high schools to work with students to write messages and give feedback on messages. This has produced more appropriate language for the messages. It’s been invaluable: it would be a wasted investment if we didn’t include the audience. We are constantly trying to figure out how to reach the youth. They are excited to participate as soon as we give them voice.” – Rebecca Braun, California Family Health Council (CFHC), The HookUp, USA