Abstract
BackgroundPhysical inactivity is a major contributor to the development and persistence of chronic diseases. Mobile health apps that foster physical activity have the potential to assist in behavior change. However, the quality of the mobile health apps available in app stores is hard to assess for making informed decisions by end users and health care providers.ObjectiveThis study aimed at systematically reviewing and analyzing the content and quality of physical activity apps available in the 2 major app stores (Google Play and App Store) by using the German version of the Mobile App Rating Scale (MARS-G). Moreover, the privacy and security measures were assessed.MethodsA web crawler was used to systematically search for apps promoting physical activity in the Google Play store and App Store. Two independent raters used the MARS-G to assess app quality. Further, app characteristics, content and functions, and privacy and security measures were assessed. The correlation between user star ratings and MARS was calculated. Exploratory regression analysis was conducted to determine relevant predictors for the overall quality of physical activity apps.ResultsOf the 2231 identified apps, 312 met the inclusion criteria. The results indicated that the overall quality was moderate (mean 3.60 [SD 0.59], range 1-4.75). The scores of the subscales, that is, information (mean 3.24 [SD 0.56], range 1.17-4.4), engagement (mean 3.19 [SD 0.82], range 1.2-5), aesthetics (mean 3.65 [SD 0.79], range 1-5), and functionality (mean 4.35 [SD 0.58], range 1.88-5) were obtained. An efficacy study could not be identified for any of the included apps. The features of data security and privacy were mainly not applied. Average user ratings showed significant small correlations with the MARS ratings (r=0.22, 95% CI 0.08-0.35; P<.001). The amount of content and number of functions were predictive of the overall quality of these physical activity apps, whereas app store and price were not.ConclusionsApps for physical activity showed a broad range of quality ratings, with moderate overall quality ratings. Given the present privacy, security, and evidence concerns inherent to most rated apps, their medical use is questionable. There is a need for open-source databases of expert quality ratings to foster informed health care decisions by users and health care providers.
Highlights
Physical inactivity is a significant risk factor for noncommunicable diseases such as cancer, diabetes, cardiovascular diseases, or chronic respiratory diseases and is estimated to cause 6%-10% of these diseases worldwide [1,2]
The results indicated that the overall quality was moderate
The amount of content and number of functions were predictive of the overall quality of these physical activity apps, whereas app store and price were not
Summary
Physical inactivity is a significant risk factor for noncommunicable diseases such as cancer, diabetes, cardiovascular diseases, or chronic respiratory diseases and is estimated to cause 6%-10% of these diseases worldwide [1,2]. Health app users were more likely to meet the World Health Organization recommendations concerning physical activity [3,11] and apps were found to be efficacious in promoting physical activity with moderate effect sizes [12]. In 2 recent meta-analyses of apps for increasing physical activity, there was an increase in objectively measured physical activity in the app groups compared to that in the control groups [13,14] Regarding the content and quality of apps promoting physical activity, previous reviews focused mainly on the use of behavioral change techniques (BCTs) developed by Abraham and Michie [15,16,17,18,19,20,21]. Mobile health apps that foster physical activity have the potential to assist in behavior change. The quality of the mobile health apps available in app stores is hard to assess for making informed decisions by end users and health care providers
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