Co-creation of an educational mobile health application prototype on oral cancer using modified delphi technique

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.