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BackgroundThe Portfolio Diet, or Dietary Portfolio, is a therapeutic dietary pattern that combines cholesterol-lowering foods to manage dyslipidemia for the prevention of cardiovascular disease. To translate the Portfolio Diet for primary care, we developed the as a patient and physician educational and engagement tool for PCs and smartphones. The is currently being used as an add-on therapy to the standard of care (usual care) for the prevention of cardiovascular disease in primary care. To enhance the adoption of this tool, it is important to ensure that the meets the needs of its target end users.ObjectiveThe main objective of this project is to undertake user testing to inform modifications to the as part of ongoing engagement in quality improvement (QI).MethodsWe undertook a 2-phase QI project from February 2021 to September 2021. We recruited users by convenience sampling. Users included patients, family physicians, and dietitians, as well as nutrition and medical students. For both phases, users were asked to use the daily for 7 days. In phase 1, a mixed-form questionnaire was administered to evaluate the users' perceived acceptability, knowledge acquisition, and engagement with the The questionnaire collected both quantitative and qualitative data, including 2 open-ended questions. The responses were used to inform modifications to the In phase 2, the System Usability Scale was used to assess the usability of the updated, with a score higher than 70 being considered acceptable.ResultsA total of 30 and 19 users were recruited for phase 1 and phase 2, respectively. In phase 1, the increased users' perceived knowledge of the Portfolio Diet and influenced their perceived food choices. Limitations identified by users included challenges navigating to resources and profile settings, limited information on plant sterols, inaccuracies in points, timed-logout frustration, request for step-by-step pop-up windows, and request for a mobile app version; when looking at positive feedback, the recipe section was the most commonly praised feature. Between the project phases, 6 modifications were made to the to incorporate and address user feedback. At phase 2, the average System Usability Scale score was 85.39 (SD 11.47), with 100 being the best possible.ConclusionsBy undertaking user testing of the, its limitations and strengths were able to be identified, informing modifications to the application, which resulted in a clinical tool that better meets users' needs. The educates users on the Portfolio Diet and is considered acceptable by users. Although further refinements to the will continue to be made before its evaluation in a clinical trial, the result of this QI project is an improved clinical tool.

Original publication




Journal article


JMIR human factors

Publication Date





Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.