Abstract
Only very few educational mobile health applications (MHAs) on oral cancer exists. Based on existing literature, only one of such MHAs (application name: Prayaas) was created specifically for lay persons; unfortunately, the application has been critiqued to be non-inclusive and non-comprehensive. Hence, this study aimed to co-create a more comprehensive and inclusive educational MHA prototype on oral cancer through a participatory action research approach. A three-round modified Delphi technique was employed to engage stakeholders in a participatory action research process. Digital communication experts and individuals with oral cancer risk factors (n = 17) from five countries participated. Round one utilised focus group discussions to define essential application features. Rounds two and three involved iterative evaluations of successive prototypes using a validated questionnaire (Mobile Application Rating Scale). Quantitative data were analysed using descriptive statistics, with consensus defined a priori as a mean score > 2.5 on a 5-point Likert scale—indicating majority agreement on each evaluated item. Stakeholder input across three iterative rounds led to the co-creation of the “Beat Oral Cancer” prototype. Quantitative consensus was achieved across all evaluated domains, including usability, aesthetics, information quality, and perceived impact. The final prototype showed significant improvements: the second version was rated higher than the first in entertainment (+ 0.68), interactivity (+ 0.32), customizability (+ 0.64), and ease of use (+ 0.33). Key inclusive features, such as adjustable text size, were incorporated based on stakeholder feedback. This study successfully co-created a highly comprehensive, stakeholder-informed MHA prototype for oral cancer education via a modified Delphi process. The results demonstrate the value of iterative participatory design in creating digital health tools with high potential for acceptability and usability. This work establishes a methodological precedent for applying the Delphi technique in mobile health co-creation and provides a foundation for future efficacy testing and public deployment.
Data availability
The data that support the findings of this study are available from the authors, but restrictions apply to the availability of these data, and they are not publicly available. Data are, however, available from the corresponding author (KKK) upon reasonable request.
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Funding
This study was funded by Teesside University. The funder played no influential role in the study design, collection, analysis, and interpretation of data, writing of the report, and the decision to submit the report for publication.
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Study conceptualization: KKK and LAN. Study protocol and design: KKK, JA, and LAN. Data collection: KKK, YAJ, RDJ, and SO. Data analysis and interpretation: KKK. Writing original manuscript: KKK. Reviewing and editing of manuscript: YAJ, RDJ, JA, AAS, MN, and LAN. Publication funding acquisition: KKK. Reading and approval of the manuscript: all authors.
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Ruwan Duminda Jayasinghe is an editorial board member of Scientific Reports and a co-author of this article. To minimize bias, they were excluded from all editorial decision-making related to the acceptance of this article for publication. All other authors declare that they have no competing interest involved with their work in this study.
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This study was done in strict compliance with the 1964 Helsinki Declaration on health research involving human subjects. Ethical clearance to conduct this study was obtained from the School of Health and Life Science Research Sub-Committee of Teesside University (Ref: 2024 Mar 20233 Kanmodi). Participation in this study was completely voluntary and confidential.
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Kanmodi, K.K., Jayasinghe, R.D., Jayasinghe, Y.A. et al. Co-creation of an educational mobile health application prototype on oral cancer using modified delphi technique. Sci Rep (2026). https://doi.org/10.1038/s41598-026-41276-x
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DOI: https://doi.org/10.1038/s41598-026-41276-x
