Development of a mobile application to provide targeted nutritional support to head and neck cancer patients undergoing radiotherapy

Abstract

Head and neck cancer (HNC) patients frequently experience severe side effects during radiotherapy, including pain, mucositis, and dysphagia, which can compromise nutritional intake and quality of life. Despite clinical support, digital tools addressing nutrition during treatment remain limited. This study aimed to develop and evaluate NutriRT, a mobile application designed to provide side-effect-based dietary advice to HNC patients undergoing radiotherapy. A mixed-methods approach was employed across three phases. Phase 1 involved semi-structured interviews with healthcare professionals (HCPs) and patients to identify needs and app features. Phase 2 focused on prototype development using Thunkable, guided by insights from Phase 1 and literature. Phase 3 consisted of a usability study involving 10 participants (5 HCPs, 4 patients, and 1 informal carer) using the System Usability Scale (SUS), Single Ease Question (SEQ), and open-ended feedback. The NutriRT prototype incorporated tailored features including symptom reporting, fluid and food intake monitoring, dietary advice, educational content, weight monitoring, a contact list, a question submission feature, and frequently asked questions. SUS scores averaged 88 for patients and 97 for HCPs, well above the usability benchmark of 68. Average SEQ scores ranged between 6 and 7, indicating high ease of use across all functionalities. Qualitative feedback reinforced the value of the app’s simplicity, clarity, and clinical relevance. Key suggestions included adding post-treatment guidance and offering language localisation. NutriRT demonstrated strong usability and user satisfaction, offering an innovative, patient-centred tool that can complement existing nutritional care for HNC patients. The study highlighted the value of user-centred design in mHealth, especially in oncology settings, and set the foundation for broader implementation and further development.