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.