Peer-reviewed article

Evaluation and Implementation of the Gamified Jooay Mobile Health App: Protocol for a Hybrid Implementation-Effectiveness Study.

Mahmoudi E, Szydlowski G, Movahed M, Majnemer A, Shikako K · 4 Sept 2026

Abstract

Background Leisure participation is essential for children's health and well-being and is also a fundamental human right; however, children and youth with disabilities face significant barriers to participation compared with their peers without disabilities. The Jooay App was developed to address gaps in information and access to adaptive and inclusive leisure activities. A new gamification-based version of the Jooay App was co-designed with users, including youth with disabilities, parents, and health care professionals. Objective This study aims to describe a study protocol to implement and evaluate the gamified version of the Jooay App using a patient-oriented approach to increase awareness about adaptive and inclusive leisure activities and promote participation in leisure among children and youth with disabilities. Methods A hybrid type II effectiveness-implementation study will be conducted. The Consolidated Framework for Implementation Research (CFIR) will guide implementation strategies, including the expansion of knowledge broker (KB) networks to raise the profile of adaptive and inclusive leisure activities in Canada. An interrupted time series (ITS) design will be used to evaluate implementation outcomes across 5 provinces in Canada. Process evaluation will analyze inner and outer setting characteristics, KB strategies, and community resource mobilization. Effectiveness outcomes will be assessed through two phases: (1) a nonrandomized mixed methods pilot feasibility study of the app, where acceptability, engagement, implementation, and potential benefits will be measured, and (2) an ITS at the population level, where overall app usage (eg, clicks, logins, and time spent), individual gamification feature metrics, and user feedback will assess effectiveness outcomes. Results The project was funded by the CHILD-BRIGHT (Child Health Initiatives Limiting Disability-Brain Research Improving Growth and Health Trajectories) Network through the Strategy for Patient-Oriented Research, Canadian Institutes of Health Research, in September 2025, and data collection is expected to occur from March 2026 to June 2027. As of manuscript submission, 12 KBs have been recruited, the ITS study and data analysis have not yet begun, and the study results for the implementation and effectiveness components are expected to be published in fall 2027. Findings will be disseminated via peer-reviewed publications, conference presentations, educational materials, social media, community events, and reports. Outputs will include a summary of findings in lay language, in both French and English, including short videos, infographics, and posters for various social media platforms. Community organizations will assist in further dissemination through their networks. Conclusions This study will evaluate both the effectiveness and the implementation of the gamified Jooay mobile app to promote participation in leisure among children and youth with disabilities using a hybrid effectiveness-implementation design. By applying the CFIR framework, this study aims to generate evidence about how the Jooay App can be effectively implemented across Canada and expand scholarship on the implementation of technology for equity-deserving groups.