Web-Based Educational Application for Mental Health Self-Monitoring After Bariatric Surgery: Development and Content Validation Study

Abstract

Background Despite the effectiveness of bariatric surgery in the treatment of severe obesity, a substantial proportion of patients experience insufficient weight loss or weight regain over time. Evidence indicates that behavioral factors and mental health conditions play a central role in these outcomes, representing strategic targets for educational and technology-based self-monitoring interventions. Objective This study aimed to develop and validate the content of a web-based application designed to support mental health self-monitoring and behavioral change among patients undergoing bariatric surgery. Methods This is a formative research study focused on the development and content validation of a digital health educational intervention conducted in accordance with the systematic instructional design model, encompassing the phases of analysis, design/development, and validation. Content validation was performed by a panel of 13 experts using the Pasquali criteria. Interrater agreement was quantitatively assessed using the content validity index (CVI), considering the domains of clarity and relevance, with a minimum acceptable agreement threshold of ≥0.80. Results The application was developed with 11 screens; it integrates validated psychometric instruments for the self-monitoring of key mental health conditions, including the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, the modified Yale Food Addiction Scale 2.0, and the Alcohol Use Disorders Identification Test. In addition, the platform includes body weight monitoring, physical activity tracking, and access to educational content on healthy eating and mental health. The application incorporates motivational strategies such as goal setting, automated alerts, and encouragement of multidisciplinary follow-up. All screens demonstrated content validity in terms of relevance (item-level CVI [I-CVI]=1.00; scale-level CVI=1.00). For the clarity domain, only 1 screen presented an index below the predefined cutoff in the initial evaluation. After revision and adjustments, this screen was re-evaluated and achieved satisfactory agreement (I-CVI=0.92). Conclusions The results indicate that the developed application demonstrates adequate content validity as a digital tool to support mental health care in the postoperative period of patients undergoing bariatric surgery. Although this study was limited to content validation, the findings support the formative development of a web-based platform for mental health self-monitoring and behavioral support in this population. Future studies should evaluate usability, acceptability, and clinical effectiveness in real-world settings.