Abstract
BackgroundUp to 70% of lung cancer survivors are affected by chronic obstructive pulmonary disease (COPD), a common, debilitating, comorbid disease. Lung cancer and COPD are both characterized by symptoms such as breathlessness, fatigue, and psychological distress. These distressing chronic symptoms are exacerbated by stress and detract from an individual’s quality of life.ObjectiveThe aim of this study was to identify and evaluate evidence-based, commercially available apps for promoting mindfulness-based strategies among adults with a COPD or lung cancer history (ie, chronic lung disease).MethodsFor this review, an interdisciplinary research team used 19 keyword combinations in the search engines of Google and iOS app stores in May 2017. Evaluations were conducted on the apps’ (1) content, (2) usability heuristics, (3) grade-level readability, and (4) cultural sensitivity.ResultsThe search resulted in 768 apps (508 in iOS and 260 in Google stores). A total of 9 apps met the inclusion criteria and received further evaluation. Only 1 app had below an eighth-grade reading level; the ninth one did not have enough text to calculate a readability score. None of the 9 apps met the cultural sensitivity evaluation criteria.ConclusionsThis systematic review identified critical design flaws that may affect the ease of using the apps in this study. Few mobile apps promote mindfulness-based strategies among adults with chronic lung disease (ie, COPD or lung cancer or both), but those that exist, overall, do not meet the latest scientific evidence. Recommendations include more stringent regulation of health-related apps, use of evidence-based frameworks and participatory design processes, following evidence-based usability practices, use of culturally sensitive language and images, and ensuring that content is written in plain language.
Highlights
Prevalence of Lung Cancer and Chronic Obstructive Pulmonary DiseaseLung cancer is the second most commonly diagnosed cancer in the United States, accounting for 13.2% of new cases in 2017 [1]
We evaluated the apps for content, usability heuristics, readability, and cultural sensitivity
The 2 apps that somewhat met criteria for having scientific evidence—Lung+ Pioneering Healthcare and chronic obstructive pulmonary disease (COPD)—both contained content linked to a corporation, and neither referenced peer-reviewed literature or other http://mhealth.jmir.org/2018/5/e124/
Summary
Prevalence of Lung Cancer and Chronic Obstructive Pulmonary DiseaseLung cancer is the second most commonly diagnosed cancer in the United States, accounting for 13.2% of new cases in 2017 [1]. Several studies demonstrate strong links between lung cancer and COPD, such as their common environmental, genetic, and epigenetic risk factors and their similar pathogenic mechanisms for activation [4,5,6]. Those with COPD are 5 times more likely to develop lung cancer than those individuals without the disease [7]. Objective: The aim of this study was to identify and evaluate evidence-based, commercially available apps for promoting mindfulness-based strategies among adults with a COPD or lung cancer history (ie, chronic lung disease). Recommendations include more stringent regulation of health-related apps, use of evidence-based frameworks and participatory design processes, following evidence-based usability practices, use of culturally sensitive language and images, and ensuring that content is written in plain language
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