Developing Dietary Self-Management Personas for mHealth Tools Among Patients with Kidney Failure Undergoing Hemodialysis: A Multi-Method Study.

BACKGROUND

Dietary management remains a widespread challenge among patients with kidney failure undergoing hemodialysis. Although mobile health (mHealth) is considered a promising approach for providing self-management support, most existing tools lack the specificity to effectively address patients' diverse behavioral patterns.

OBJECTIVE

To develop user personas for dietary self-management among Chinese patients on hemodialysis and explore the needs of these personas regarding mHealth tools.

METHODS

A sequential multi-method design was employed. In-depth qualitative interviews were conducted with 28 patients on hemodialysis recruited from a university-affiliated hospital between March and July 2025 to explore their dietary self-management experiences. Transcripts were analyzed using Colaizzi's method, and dietary self-management personas were derived through manual thematic synthesis and iterative consensus among researchers. These personas were then presented with descriptive labels. In a subsequent quantitative phase, a cross-sectional survey was administered to a separate cohort of 167 patients on hemodialysis between October 2025 and February 2026. Participants were asked to self-identify with up to two personas that best reflected their current dietary behaviors, in order to assess the coverage and distribution of the developed personas.

RESULTS

Qualitative analysis identified six distinct personas: (A) Proactive; (B) Occupation-Driven Maladaptive; (C) Family Care-Prioritizing Maladaptive; (D) Knowledge-Deficient; (E) Instant Gratification-Driven; and (F) Poor Execution Ability. Quantitative results showed that all participants identified with at least one of the six personas, with no patients reporting behaviors outside this classification. Persona A was the most prevalent (35.93%), and 19.76% of participants identified two personas.

CONCLUSION

The six personas reflect significant diversity in dietary self-management among patients undergoing hemodialysis and provide a preliminary, comprehensive typology that can inform the design of stratified, user-centered mHealth interventions. Future studies are needed to validate the feasibility and effectiveness of these personas.