Development and Usability of the “FORTEe Get Strong” App: Mixed Methods Study

The FORTEe Get Strong mobile application serves as a gamified health intervention designed to improve physical activity levels and health literacy among pediatric and adolescent cancer patients. By integrating a virtual village environment with customizable avatars and interactive exercise modules, the platform aims to bolster patient self-efficacy during intensive treatment. The primary objective of this evaluation is to determine the usability and acceptability of the intervention across a diverse age range of 5 to 19 years, providing a foundation for future clinical applications in pediatric oncology.

Quantitative and qualitative data from a multicenter trial involving 53 participants indicate high user satisfaction, with the app achieving a mean rating of 4.14 out of 5. Users consistently praised the intuitive design, user-friendly interface, and the motivational impact of the gamified elements. Engagement levels remained stable across various demographics, including age, sex, and specific cancer diagnoses, suggesting that the core mechanics of the application are broadly appealing to the pediatric oncology population.

Despite these successes, the study identifies critical areas for refinement to ensure long-term engagement. Participants noted a disparity in age-appropriateness, with older adolescents finding certain content better suited for younger children. Furthermore, strict data protection regulations currently limit the inclusion of real-time social features, which users identified as a significant gap. Future development must prioritize more personalized, age-differentiated exercise content and privacy-compliant social interaction to enhance the app’s clinical utility. While the current findings validate the app as a viable tool for hospital-based support, further research with larger, more diverse cohorts is necessary to confirm its long-term behavioral impact and effectiveness in promoting sustained physical activity.