Date of Award

Spring 3-2023

Document Type


Degree Name

Doctor of Philosophy in Information Systems (PhDIS)


Business and Information Systems

First Advisor

Omar El-Gayar

Second Advisor

Ronghua Shan

Third Advisor

Nevine Nawar

Fourth Advisor

Renae Spohn


Despite the ubiquity of mobile health applications (apps), the practical use and success of the apps have been questionable. Design Principles (DP) can affect chronic health app user satisfaction and have been studied for ensuring favorable app usage. However, there is no consensual definition of DP within the preceding literature, which has a technical rather than an end-user-centric focus and lacks a rigorous theoretical basis. Moreover, different levels of DPs’ application can lead to differential user satisfaction as influenced by the user-contextual environment, warranting a quantitative assessment. Accordingly, the overarching question to be addressed is which DP for the self-management of chronic conditions contributes to better user satisfaction outcomes. The research focuses on Multiple Sclerosis (MS) as a representative condition. This research uses a mixed methods, with a qualitative approach for DP identification and a quantitative approach for the studying the DP-Satisfaction relationship. The DP identification is achieved through - 1) An in depth review of foundational theory for greater validity, 2) A Systematic Literature Review (SLR), for DP themes grounded in theory, and 3) Manually coded user reviews for MS apps. The theoretical underpinnings of the empirical approach are established through a composite theoretical lens, based on technologically, behaviorally, and cognitively oriented frameworks. The DP extracted from theory, SLR, and manual coding methods are found to be largely consistent with each other, namely ‘Communication with Clinicians’, ‘Compatibility, ‘Education’, ‘Notifications’, ‘Tracking’, ‘Social Support’, ‘Ease of Use’, ‘Technical Support’, ‘Usefulness’, ‘Privacy and Security’, and Quality. An ordinal logistic regression analysis is conducted to understand the relationship between DP and User Satisfaction outcomes based on the manually coded DP scores of the user reviews. All DP have a significant impact on User Satisfaction. From a theoretical perspective, the research improves our understanding of key design principles for the self-management of chronic conditions such as MS and the impact of such principles on user satisfaction. From a practical perspective, the findings provide guidance to the user requirement elicitation process, potentially leading to the development of more successful, sustainable, and responsive healthcare interventions.