Utility and usability testing of the FrESH (free from E-Cigarettes and smoking for health) web application: A qualitative study.

Résumé

BACKGROUND: Adolescent tobacco and e-cigarette use remains a major public health concern due to early nicotine dependence. Although digital cessation tools exist, only few have been systematically evaluated. The FrESH (Free from E-Cigarette and Smoking for Health) Web App was developed as part of the Stop Nicotine Addiction Among Secondary School Students (SNAASSS©) peer-led school intervention in Malaysia. This study reports a formative evaluation of the web app through expert utility and adolescent usability testing.METHODS: A qualitative formative evaluation was conducted in two phases. Utility testing involved medical and user experience experts using Cognitive Task Analysis (CTA), think-aloud protocols, and semi-structured interviews. Usability testing was subsequently conducted with adolescent cigarette smokers, vape users, and dual users in a secondary school. Recorded interviews were transcribed verbatim and analyzed via thematic content analysis using NVivo v.14 software.RESULTS: Experts evaluation focused on utility, identifying core strengths in educational content, self-monitoring tools, and motivational feedback mechanisms (e.g., progress tracking, money saved), while recommending simpler language, clearer dashboard outputs, and improved consent readability to enhance value. Usability testing with adolescents found the app learnable, visually appealing, and supportive, with good comprehension when content was structured. However, barriers included text-dense information, unfamiliar terminology, ambiguous tracker values, limited system feedback, navigation uncertainty, alongside concerns regarding data privacy.CONCLUSION: The FrESH Web App shows strong potential as a school-integrated digital cessation support tool for Malaysian adolescents. Findings provide actionable guidance to improve content clarity, feedback interpretability, navigation support, and youth-friendly consent processes. Further mixed-method evaluation across multiple schools is warranted to assess engagement and effectiveness.