People living with long-term health conditions have helped design an innovative mobile app that advises when and where to exercise based on real-time air pollution levels.
Researchers funded by the NIHR Leicester Biomedical Research Centre report how public contributors directly shaped the development of the Personalised Space Technology Exercise Platform (P-STEP) in the journal Research Involvement and Engagement in February 2026.
P-STEP is a digital health innovation funded by the European Space Agency (ESA) that supports people with cardiovascular disease, respiratory conditions and type 2 diabetes to exercise more safely outdoors. While physical activity improves outcomes in long-term conditions, air pollution can worsen symptoms and discourage outdoor exercise. The app combines personalised exercise guidance with real-time, location-specific air quality data to help users plan safer routes and timings to reduce exposure.
The study describes a locally developed involvement model called FUN: Feedback User Needs. Through regular online discussion groups and interactive workshops, people living with long-term conditions worked alongside researchers and app developers to influence features such as how health recommendations were presented, how pollution data should be visualised, and what would motivate sustained engagement.
While earlier feasibility work demonstrated that the Android version of the app was usable and acceptable in a 12-week pilot study in Leicestershire, the newly published paper focuses on how people with lived experience were involved from the earliest design stages.
Professor André Ng, Principal Investigator for P-STEP and Consultant Cardiologist and Professor of Cardiac Electrophysiology at the University of Leicester, said: “Digital health tools will only succeed if they genuinely meet the needs of the people they are designed for. This publication shows that involving people with long-term conditions in a meaningful way strengthened the design of P-STEP and improved its usability.”
The P-STEP User Team was led by Professor Umesh Kadam, supported by Dr Michelle Hadjiconstantinou, Behavioural Scientist and co-investigator on P-STEP.
Dr Michelle Hadjiconstantinou said, “Our FUN approach ensured that user contributions were not simply collected but acted upon. Participants could see the impact of their feedback on the evolving design, which built trust and improved the overall quality of the app.”
Project manager Rachel Hobson shared, “Development of the iOS version of P-STEP is now progressing well, and a representative from the European Space Agency visited Leicester on 3 March 2026 to test the updated app. The team will use insights from both the feasibility study and the involvement evaluation to inform further refinement of the app.”
Dr David Clayton, Research Associate in the P-STEP User Team added: “The impact of the project is also extending beyond research. In February 2026, members of the P-STEP team and user group contributed to teaching on the University of Leicester’s MSc in Healthcare Management, sharing the FUN involvement model with students studying digital health and innovation. The session offered a real-world example of co-design in practice, with a joint presentation from researcher and public contributor demonstrating co-production in action.”
Rather than being treated as research subjects, contributors were positioned as collaborators in the design process. Their feedback was formally documented and fed back into iterative development cycles, enabling users to see how their suggestions changed the app. The paper also includes reflections from user group members on their experience of involvement, highlighting the importance of transparency, respect and shared ownership in digital health innovation.
By placing patient involvement at the centre of digital innovation, the researchers hope P-STEP can provide a scalable model for supporting safer physical activity among people living with long-term conditions.
Find out more about the app on the P-STEP website.
Click here to read the full paper published in Research Involvement and Engagement journal.