Access To Apps Research Articles

User-centered development of an mHealth app for cardiovascular prevention

Background Mobile health (mHealth) apps can be used for cardiovascular disease (CVD) prevention. User-centered design, evidence-based content and user testing can be applied to ensure a high level of usability and adequate app access. Objective To develop and evaluate an mHealth app ( HerzFit) for CVD prevention. Methods HerzFit´s development included a user-centered design approach and guideline-based content creation based on the identified requirements of the target group. Beta testing and a preliminary usability evaluation of the HerzFit prototype were performed. For evaluation, German versions of the System Usability Scale (SUS) and the mHealth App Usability Questionnaire (GER-MAUQ) as well as free text feedback were applied. Results User-centered design thinking led to the definition of four personas. Based on their requirements, HerzFit enables users to individually assess, monitor, and optimize their cardiovascular risk profile. Users are also provided with a variety of evidence-based information on CVD and their risk factors. The user interface and system design followed the identified functional requirements. Beta-testers provided feedback on the structure and functionality and rated the usability of HerzFit´s prototype as slightly above average both in SUS and GER-MAUQ rating. Participants positively noted the variety of functions and information presented in HerzFit, while negative feedback mostly concerned wearable synchronization. Conclusions The present study demonstrates the user-centered development of a guideline-based mHealth app for CVD prevention. Beta-testing and a preliminary usability study were used to further improve the HerzFit app until its official release.

Appraisal of Mobile Apps for Communication and Collaboration among Construction Project Teams

Purpose: The construction industry faces communication and collaboration challenges, leading to delays, errors, and increased costs. This study investigates the impact and effectiveness of mobile apps in enhancing internal and external communication and collaboration in the construction industry.
 Design/Methodology/Approach: The research design consisted of five phases: familiarisation with the study topic, literature search for construction apps, selection of apps, assessment and categorisation of apps, and validation of app functionality. The selection of apps was based on their versatility, capability to perform multiple tasks, market popularity, relevance to communication and collaboration, readability, and range of functions. Empirical study articles were used to validate and assess the functionalities claimed by the app developers.
 Findings: Out of the 65 mobile apps evaluated, only 12 met the exclusion criteria for assessing the practicality of their functions through empirical evidence. Mobile apps like Slack, Microsoft Teams, SmartBidNet, and Basecamp have the potential to significantly enhance communication, collaboration, and decision-making processes in the construction industry.
 The Research Limitation: The study identified and evaluated only 12 mobile apps out of 65, based on the exclusion criteria established to evaluate the practicality of the applications' functions through empirical evidence. This limited sample size may not fully represent the range of mobile apps available for communication and collaboration in the construction industry.
 Practical Implication: The mobile apps to be used by project team members have the potential to replace traditional methods, particularly for geographically dispersed teams, leading to improved project efficiency and accuracy.
 Social Implication: Mobile apps facilitate real-time communication with local communities, allowing construction projects to address concerns and involve community members in the decision-making process.
 Originality/value: The study contributes to the existing body of knowledge by providing insights into the availability, accessibility, and competencies of mobile apps in improving internal and external communication and collaboration within the construction industry.

Assessing Gait & Balance in Adults with Mild Balance Impairment: G&B App Reliability and Validity.

Smartphone applications (apps) that utilize embedded inertial sensors have the potential to provide valid and reliable estimations of different balance and gait parameters in older adults with mild balance impairment. This study aimed to assess the reliability, validity, and sensitivity of the Gait&Balance smartphone application (G&B App) for measuring gait and balance in a sample of middle- to older-aged adults with mild balance impairment in Pakistan. Community-dwelling adults over 50 years of age (N = 83, 50 female, range 50-75 years) with a Berg Balance Scale (BBS) score between 46/56 and 54/56 were included in the study. Data collection involved securing a smartphone to the participant's lumbosacral spine. Participants performed six standardized balance tasks, including four quiet stance tasks and two gait tasks (walking looking straight ahead and walking with head turns). The G&B App collected accelerometry data during these tasks, and the tasks were repeated twice to assess test-retest reliability. The tasks in quiet stance were also recorded with a force plate, a gold-standard technology for measuring postural sway. Additionally, participants completed three clinical measures, the BBS, the Functional Reach Test (FRT), and the Timed Up and Go Test (TUG). Test-retest reliability within the same session was determined using intraclass correlation coefficients (ICCs) and the standard error of measurement (SEM). Validity was evaluated by correlating the G&B App outcomes against both the force plate data and the clinical measures using Pearson's product-moment correlation coefficients. To assess the G&B App's sensitivity to differences in balance across tasks and repetitions, one-way repeated measures analyses of variance (ANOVAs) were conducted. During quiet stance, the app demonstrated moderate reliability for steadiness on firm (ICC = 0.72) and compliant surfaces (ICC = 0.75) with eyes closed. For gait tasks, the G&B App indicated moderate to excellent reliability when walking looking straight ahead for gait symmetry (ICC = 0.65), walking speed (ICC = 0.93), step length (ICC = 0.94), and step time (ICC = 0.84). The TUG correlated with app measures under both gait conditions for walking speed (r -0.70 and 0.67), step length (r -0.56 and -0.58), and step time (r 0.58 and 0.50). The BBS correlated with app measures of walking speed under both gait conditions (r 0.55 and 0.51) and step length when walking with head turns (r = 0.53). Force plate measures of total distance wandered showed adequate to excellent correlations with G&B App measures of steadiness. Notably, G&B App measures of walking speed, gait symmetry, step length, and step time, were sensitive to detecting differences in performance between standard walking and the more difficult task of walking with head turns. This study demonstrates the G&B App's potential as a reliable and valid tool for assessing some gait and balance parameters in middle-to-older age adults, with promise for application in low-income countries like Pakistan. The app's accessibility and accuracy could enhance healthcare services and support preventive measures related to fall risk.

Abstract A006: A randomized controlled trial of a mobile symptom monitoring app and tailored messages: Differences in outcomes among Black and White women with breast cancer on adjuvant endocrine therapy

Abstract Black women with early-stage, hormone receptor-positive breast cancer have lower adjuvant endocrine therapy (AET) adherence and higher symptom burden than White women. We compared the effects of a symptom monitoring app and tailored messages on treatment-relevant outcomes among Black and White women with breast cancer starting AET. Patients prescribed AET for early-stage breast cancer at a cancer center from November 2018 until June 2021 were randomized into: (1) an “App” group that received instructions and access to the study app and weekly text reminders to use it (n=94); (2) an “App+Feedback (AF)” group that received additional weekly tailored messages about managing symptoms, adherence, and communication (n=100); or (3) a “Usual Care (UC)” group without app access (n=102). The intervention lasted 6-months, and participants completed surveys at enrollment and 12-months. Increasing/severe symptoms and missed doses triggered alerts that prompted follow-ups from the oncology team. Outcomes included AET adherence, captured with an electronically monitored pillbox, app use, alerts, symptom burden (FACT-ES), quality of life (SF-12), self-efficacy for managing symptoms (PROMIS 1.0), and healthcare utilization (6-month count of emergency department visits/urgent care/hospitalizations, and office visits). Analyses stratified by self-reported race. Overall, 102 (34%) Black and 194 (66%) White women were randomized. Retention at 12-months was 88%. Median age was higher among White participants (60 vs. 55 years, p<0.01). Number of weeks with app use was higher among White intervention participants (15.5 vs. 11.8, p<0.01), but resulted in fewer alerts (2.7 vs. 8.1, p<0.01) compared with Black participants. AET adherence over 12-months was lower among Black women (69% vs 76%, p=0.06), and such difference was similar across study arms. Black AF participants had fewer higher cost healthcare encounters compared to UC (0.27 vs. 0.97, p=0.03) but not for App only vs. UC. Black App participants had more office visits 6 to 12-months post enrollment compared to UC (4.4. vs. 2.6, p=0.04). White App participants reported 4.3 points higher physical health scores compared to UC (51.7 vs. 47.4, p=0.04). There were no significant differences by study arm in AET adherence, mental health score, symptom burden, or self-efficacy for managing symptoms among White or Black participants. Although Black intervention participants used the symptom monitoring app less often, they were more likely to report severe symptoms that triggered an alert to their oncology team than White participants. Among Black participants, the app combined with tailored messages resulted in fewer higher cost healthcare encounters, while App only resulted in more frequent office visits compared to UC. White participants did not have any differences in healthcare utilization, but App only participants reported higher physical health compared with UC. Symptom monitoring apps with tailored text messages improved different outcomes among Black and White patients with breast cancer on AET. Citation Format: Ilana Graetz, Xin Hu, Rebecca A. Krukowski, Mehmet Kocak, Janeane N. Anderson, Teresa M. Waters, Andrea N. Curry, Andrew Robles, Andrew Paladino, Edward Stepanski, Gregory A. Vidal, Lee S. Schwartzberg. A randomized controlled trial of a mobile symptom monitoring app and tailored messages: Differences in outcomes among Black and White women with breast cancer on adjuvant endocrine therapy [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A006.

Mixing Meds and Milk: Evaluation of a Performance Gap Intervention for Provider Education in Breastfeeding and Maternal Medication Use.

The need for maternal medications is a known barrier to breastfeeding. Though most medications are compatible with lactation, healthcare providers use abundant caution, often viewing medications and breastfeeding as mutually exclusive. A dual intervention of an educational webinar and access to a mobile app for lactation pharmacology was used to enhance provider familiarity, confidence, and access to knowledge in medication use during breastfeeding. Surveys were administered before, one week after, and three months after the webinar to evaluate performance gap improvement. Usage data of the mobile app was collected over twelve months to monitor topic engagement. Results suggested the interventions temporarily increased provider confidence in maternal medication use during lactation; however, the increase was not sustained at three months. Even with one-time training and lactation-specific mobile app access, simply providing an informational resource is insufficient to support evidence-informed care for lactating patients. Longitudinal training on evidence-based medication safety is critical to care for the lactating dyad.

Effectiveness of a Self-Monitoring App in Supporting Physical Activity Maintenance Among Rural Canadians With Cancer After an Exercise Oncology Program: Cluster Randomized Controlled Trial.

Despite the benefits of physical activity (PA) for individuals with cancer, most remain insufficiently active. Exercise oncology interventions can improve PA levels. Individuals struggle to maintain PA levels after interventions because of persistent psychological and environmental PA barriers. Health technology (eHealth) may address some PA barriers and deliver effective, scalable PA interventions in oncology, yet its effectiveness for changing PA levels remains mixed. Using eHealth to support PA maintenance among rural populations with cancer, who may need greater PA support given lower PA levels and worse health outcomes, remains under-studied. This study examined the effectiveness of an app-based self-monitoring intervention in supporting PA maintenance among rural populations with cancer after a supervised web-based exercise oncology program. This 2-arm, cluster randomized controlled trial was embedded within the Exercise for Cancer to Enhance Living Well (EXCEL) effectiveness-implementation study. Upon consent, participants were randomized 1:1 by EXCEL class clusters to the intervention (24 weeks of app-based PA self-monitoring) or waitlist control (app access after 24 weeks). Both groups completed a 12-week supervised web-based exercise oncology program followed by a 12-week self-directed PA maintenance period. Baseline demographics, eHealth literacy, and patient-reported outcomes were compared using chi-square and 2-tailed t tests. App use was measured throughout the intervention. The primary outcome-self-reported moderate-to-vigorous PA (MVPA) minutes-and secondary outcomes-objective MVPA minutes and steps and app usability ratings-were collected at baseline, 12 weeks, and 24 weeks. Intervention effects on self-report MVPA maintenance were assessed via linear mixed modeling, with secondary outcomes explored descriptively. Of the 359 eligible EXCEL participants, 205 (57.1%) consented, 199 (55.4%; intervention: 106/199, 53.3%; control: 93/199, 46.7%) started the study, and 183 (51%; intervention: 100/183, 54.6%; control: 83/183, 45.4%) and 141 (39.3%; intervention: 69/141, 48.9%; control: 72/141, 51.1%) completed 12- and 24-week measures, respectively. Mean age was 57.3 (SD 11.5) years. Most participants were female (174/199, 87.4%), White (163/199, 81.9%), and diagnosed with breast cancer (108/199, 54.3%). Median baseline self-report weekly MVPA minutes were 60.0 (IQR 0-180) and 40.0 (IQR 0-135) for the intervention and waitlist control groups, respectively (P=.74). Median app use duration was 10.3 (IQR 1.3-23.9) weeks, with 9.6 (IQR 4.4-17.8) self-monitoring entries/week. Both groups increased their weekly MVPA minutes significantly at 12 weeks (P<.001) and maintained the increases at 24 weeks (P<.001), relative to baseline, with no between-group differences (P=.87). The intervention group had significantly higher step counts for 7 of the 12 weeks during the PA maintenance period (P=.048 to <.001). The app-based self-monitoring intervention did not improve MVPA maintenance but may have contributed to increased step counts during the PA maintenance period. More work is needed to realize the full potential of eHealth in exercise oncology. ClinicalTrials.gov NCT04790578; https://clinicaltrials.gov/study/NCT04790578. RR2-10.1016/j.cct.2021.106474.

Outcomes of End-User Testing of a Care Coordination Mobile App With Families of Children With Special Health Care Needs: Simulation Study.

Care for children with special health care needs relies on a network of providers who work to address the medical, behavioral, developmental, educational, social, and economic needs of the child and their family. Family-directed, manually created visual depictions of care team composition (ie, care mapping) and detailed note-taking curated by caregivers (eg, care binders) have been shown to enhance care coordination for families of these children, but they are difficult to implement in clinical settings owing to a lack of integration with electronic health records and limited visibility of family-generated insights for care providers. Caremap is an electronic health record-integrated digital personal health record mobile app designed to integrate the benefits of care mapping and care binders. Currently, there is sparse literature describing end-user participation in the co-design of digital health tools. In this paper, we describe a project that evaluated the usability and proof of concept of the Caremap app through end-user simulation. This study aimed to conduct proof-of-concept testing of the Caremap app to coordinate care for children with special health care needs and explore early end-user engagement in simulation testing. The specific aims included engaging end users in app co-design via app simulation, evaluating the usability of the app using validated measures, and exploring user perspectives on how to make further improvements to the app. Caregivers of children with special health care needs were recruited to participate in a simulation exercise using Caremap to coordinate care for a simulated case of a child with complex medical and behavioral needs. Participants completed a postsimulation questionnaire adapted from 2 validated surveys: the Pediatric Integrated Care Survey (PICS) and the user version of the Mobile Application Rating Scale (uMARS). A key informant interview was also conducted with a liaison to Spanish-speaking families regarding app accessibility for non-English-speaking users. A Caremap simulation was successfully developed in partnership with families of children with special health care needs. Overall, 38 families recruited from 19 different US states participated in the simulation exercise and completed the survey. The average rating for the survey adapted from the PICS was 4.1 (SD 0.82) out of 5, and the average rating for the adapted uMARS survey was 4 (SD 0.83) out of 5. The highest-rated app feature was the ability to track progress toward short-term, patient- and family-defined care goals. Internet-based simulation successfully facilitated end-user engagement and feedback for a digital health care coordination app for families of children with special health care needs. The families who completed simulation with Caremap rated it highly across several domains related to care coordination. The simulation study results elucidated key areas for improvement that translated into actionable next steps in app development.

Developing and testing a prototype smartphone educational application to address incivility and bullying in nursing workplaces

BackgroundIncivility and bullying in the nursing workplace may induce psychological trauma and increase staff turnover, however, the effects can be mitigated by cognitive rehearsal therapy. Smartphone education applications have emerged as an important educational tool in recent years. However, to date, no educational applications have been developed that combine cognitive rehearsal approaches with clinical situations. Therefore, in this study an education application (Easy Play Communication) was developed and tested to address incivility and bullying in the nursing workplace. Design/methodsThis study design was employed in two phases. Phase 1 (February 2020–March 2021) combined analysis, design, development, implementation, and evaluation (ADDIE model) stages in the application development process. This phase involved conducting research into educational training and cognitive rehearsal literature, consultations with seven experts in related fields and administering a user needs questionnaire among 41 nurses. Phase 2 (April 2021–December 2021) was a pilot test phase, where 47 Mandarin and Taiwanese speaking nurses used the application to conduct cognitive rehearsal training. Changes in workplace incivility and bullying were tested using a pretest–posttest design. The posttest was conducted one week after the pretest. ResultsPhase 1 showed user satisfaction with the app's accessibility (96.3 %), practicality (81.4 %), willingness to use (92.6 %), information content (88.9 %), information quality (88.9 %), and interface quality (88.9 %). Phase 2 showed that participants' perceived incivility in their interactions with other nurses, physicians, and patients and their family members decreased over the study period. Discussion/implicationsThe findings indicate that smartphone applications combining theoretical knowledge with practical exercises can have a positive impact on nurses in the context of workplace incivility and bullying. We also demonstrated a development process that can be used to build applications for clinical nurses.

Features, Design, and Adherence to Evidence-Based Behavioral Parenting Principles in Commercial mHealth Parenting Apps: Systematic Review.

There is a need to disseminate evidence-based parenting interventions for adolescent externalizing concerns. Although family-based treatments have demonstrated efficacy for such concerns, they have limitations and challenges when disseminated in the community. Behavioral-based parenting techniques form an integral part of well-established, family-based interventions for adolescent behavioral problems and are ideal for dissemination through coupling with smartphone technology. Despite the vast number of "parent" apps currently available in commercial markets, there is a dearth of reviews focused on evaluating mobile health apps through the lens of behavioral parenting training (BPT). This study aimed to conduct a systematic review of commercial mobile health apps for parents to increase effective parenting skills that include behavioral components. A search of the Google Play and Apple App Stores identified 57 apps that were included in the review and coded for availability, popularity, and infrastructure. In total, 89% (51/57) of them were sufficiently functional to be assessed for app design quality (engagement, functionality, esthetics, and information), and 53% (30/57) proceeded to the final evaluation of level of adherence to BPT principles. In total, 57 apps met the initial inclusion criteria. Accessibility was high across these apps given that 44% (25/57) were available on both the Google Play and Apple App Stores and 68% (39/57) were free of charge. However, privacy concerns were addressed inconsistently among the apps. App design quality was average across the included apps, and apps with positive user star ratings or a high number of downloads received higher ratings on app design quality. In contrast, the identified apps largely fell short in providing BPT components adequately and with high interactivity, with low levels of adherence to BPT (mean 20.74%, SD 11%) across all commercial apps evaluated. Commercially popular apps did not show higher levels of adherence to BPT. Overall, a moderate relationship between app design quality and adherence to BPT was found. App features that have been found to increase user engagement, such as gamification and individualization, were only observed in a small minority of apps. Overall, there was a lack of focus on teenage development. Future app developers hoping to increase the dissemination of BPT should aim for free and accessible apps that balance high-quality design features (eg, simple esthetics, interactivity, and individualization) with content consistent with BPT principles. They should also consider key issues that are inconsistently addressed in current apps, including privacy and teenage development. Future app developments will likely benefit from multisector (industry and academic) collaboration throughout the design process and involving end users (ie, parents) during different stages of app development.

Enhancing type 2 diabetes treatment through digital plans of care. Patterns of access to a care-planning app over the first 3 months of a digital health intervention.

Enhancing type 2 diabetes treatment through digital plans of care. Patterns of access to a care-planning app over the first 3 months of a digital health intervention.

Longitudinal follow-up of the randomized controlled trial of access to the trauma-focused self-management app PTSD Coach

Apps that target posttraumatic stress are rarely evaluated and long-term examination of symptom change is rare. In a waitlist-controlled randomized controlled trial, we found that the Swedish version of the self-management app PTSD Coach confers benefits on posttraumatic stress and depressive symptoms after three months use. Here, we aimed to evaluate between-group effects on functional disability as well as within-group changes on mental health, somatic illness and functional disability after access to the Swedish PTSD Coach app during 9 months. In addition, we described negative effects, helpfulness and satisfaction with the app. Among the 179 trauma-exposed adults (92 % women) randomized to instant access or delayed access to PTSD Coach, symptoms of posttraumatic stress, depression, somatic illness and functional disability decreased and were maintained within 3 to 9 months of app access. Posttraumatic stress continued to improve during follow-up. PTSD Coach was considered slightly to moderately helpful and satisfactory and 43 % reported any negative effect related to using the app. PTSD Coach is an effective self-management intervention for trauma-related distress. Future research should investigate mechanisms of change, as well as individual characteristics that predict symptom reduction after access to PTSD Coach in order to inform clinical practice.

Practical Physical Educator Tools for Evaluating and Using App Accessibility Features

Students with disabilities may experience barriers to curriculum when inaccessible apps are incorporated into the classroom. To support physical educators, this report offers guidance on identifying (section I) and using (section II) app accessibility features within physical education classrooms. Example applications and resources are shared that will empower educators to evaluate and effectively integrate accessible apps within their own practice. A checklist and illustrative examples, FlipGrid & Padlet, provide physical educators with a practical approach to integrating apps that are high in accessibility features (e.g., closed captioning, alternative text for images, screen reader compatibility), create inclusive learning spaces (e.g., multi-modal participation options), and reduce barriers to curriculum and learning.

Using Digital Health Technology to Prevent and Treat Diabetes.

Using Digital Health Technology to Prevent and Treat Diabetes.

Journal Digest: IRT; Motivational Therapy; Mental Health Apps; and More

Journal Digest: IRT; Motivational Therapy; Mental Health Apps; and More

Exploring mHealth design opportunities for blind and visually impaired older users.

Mobile health (mHealth) applications (apps) are crucial in delivering health information and services to older adults. Despite their importance, blind and visually impaired (BVI) older individuals often face significant challenges in app accessibility and usability. This study delves into the design preferences and expectations of BVI older users and underscores the necessity of user-centered design for inclusive mHealth apps. Conducted in September 2023, the study comprised six focus group interviews. Each session involved two to four participants who began with self-introductions, followed by discussions centered on three open-ended interview questions. The study involved 14 participants: four with severe low vision and 10 totally blind. The primary design principles highlighted were "customizability" and "simplicity". The participants stressed the importance of intuitively designed main pages aligning with user patterns. Further, the participants articulated the following mHealth app feature or menu recommendations: editable profiles, emergency contact access, adaptable data presentation, data exportation, audible color details, customizable colors for varying visual needs, audible error feedback, feasible data input methods, toolbars, and habit-establishing reminders. Discussions also touched on the vital role of clear health data visualizations and comprehensible app-based health information. The findings illuminate paths for software developers and health scientists working towards more inclusive mHealth solutions. It is essential during the development phase to prioritize app learnability to accommodate a broad range of users, ensuring that even those with disabilities can effectively use technological innovations to address health disparities.

Runtime Permission Issues in Android Apps: Taxonomy, Practices, and Ways Forward

Android introduces a new permission model that allows apps to request permissions at runtime rather than at the installation time since 6.0 (Marshmallow, API level 23). While this runtime permission model provides users with greater flexibility in controlling an app's access to sensitive data and system features, it brings new challenges to app development. First, as users may grant or revoke permissions at any time while they are using an app, developers need to ensure that the app properly checks and requests required permissions before invoking any permission-protected APIs. Second, Android's permission mechanism keeps evolving and getting customized by device manufacturers. Developers are expected to comprehensively test their apps on different Android versions and device models to make sure permissions are properly requested in all situations. Unfortunately, these requirements are often impractical for developers. In practice, many Android apps suffer from various runtime permission issues (ARP issues). While existing studies have explored ARP issues, the understanding of such issues is still preliminary. To better characterize ARP issues, we performed an empirical study using 135 Stack Overflow posts that discuss ARP issues and 199 real ARP issues archived in popular open-source Android projects on GitHub. Via analyzing the data, we observed 11 types of ARP issues that commonly occur in Android apps. For each type of issues, we systematically studied: (1) how they can be manifested, (2) how pervasive and serious they are in real-world apps, and (3) how they can be fixed. We also analyzed the evolution trend of different types of issues from 2015 to 2020 to understand their impact on the Android ecosystem. Furthermore, we conducted a field survey and in-depth interviews among the practitioners from open-source community and industry, to gain insights from practitioners’ practices and learn their requirements of tools that can help combat ARP issues. Finally, to understand the strengths and weaknesses of the existing tools that can detect ARP issues, we built <sc xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">ARPBench</small> , an open benchmark consisting of 94 real ARP issues, and evaluated the performance of three available tools. The experimental results indicate that the existing tools have very limited supports for detecting our observed issue types and report a large number of false alarms. We further analyzed the tools’ limitations and summarized the challenges of designing an effective ARP issue detection technique. We hope that our findings can shed light on future research and provide useful guidance to practitioners.

A Permission Control Assistant Tool Design for Smart Power Terminals

With the rapid development of smart power terminals equipped with embedded operating systems, business APPs have emerged rapidly along with them. Since various business APPs have excessive access to system resources, this will lead to the waste of system resources, and at the same time, the system security is not guaranteed. Therefore, in this paper, based on the context-aware program access control hardware resource framework, an auxiliary tool is designed to control the access of business APPs with excessive authority. The auxiliary tool trains the model through the steps of training sample collection, sample data processing, feature extraction, parameter selection, and model training. By conducting simulation experiments, the results show that by using the auxiliary tool proposed in this paper, the device can well identify the business APPs with excessive privileges and reduce the abuse of related resources with a small load, which has almost negligible impact on the users’ usage.

Accessibility and availability of smartphone apps for schizophrenia

App-based interventions have the potential to enhance access to and quality of care for patients with schizophrenia. However, less is known about the current state of schizophrenia apps in research and how those translate to publicly available apps. This study, therefore, aimed to review schizophrenia apps offered on marketplaces and research literature with a focus on accessibility and availability. A search of recent reviews, gray literature, PubMed, and Google Scholar was conducted in August 2022. A search of the U.S. Apple App Store and Google Play App Store was conducted in July 2022. All eligible studies and apps were systematically screened/reviewed. The academic research search produced 264 results; 60 eligible studies were identified. 51.7% of research apps were built on psychosis-specific platforms and 48.3% of research apps were built on non-specific platforms. 83.3% of research apps offered monitoring functionalities. Only nine apps, two designed on psychosis-specific platforms and seven on non-specific platforms were easily accessible. The search of app marketplaces uncovered 537 apps; only six eligible marketplace apps were identified. 83.3% of marketplace apps only offered psychoeducation. All marketplace apps lacked frequent updates with the average time since last update 1121 days. There are few clinically relevant apps accessible to patients on the commercial marketplaces. While research efforts are expanding, many research apps are unavailable today. Better translation of apps from research to the marketplace and a focus on sustainable interventions are important targets for the field.

FRIDA, a Framework for Software Design, Applied in the Treatment of Children with Autistic Disorder

The “FRIDA” framework is a guide for the agile development of accessible software for users with Autism Spectrum Disorder (ASD), as a tool for strengthening emotional and social skills in the treatment of autism. It is based on the use of accessible software for the development of emotional and social skills, and designed with a focus on the user with intellectual disabilities. A mixed quasi-experimental study is carried out with three focus groups: children with ASD, expert therapists in ASD treatments and software designers adapting the Design Thinking model for the co-creation of the functional characteristics of the software and its use in therapies. The findings and results show that using FRIDA facilitates the agile design of accessible apps by reducing their development time by 94% and increasing their usability level by more than 90%. This facilitates the treatment of people with ASD, especially in the development of emotional self-recognition skills and social adaptation. The experience applied collaborative design thinking models and agile software design methodologies, articulating knowledge between software developers, therapists, and families of users with ASD. Users were characterized separately, and the functionalities required for the software that would be developed and linked in the treatment of autism were identified.

ODP198 Free Diabetes Apps: An Intervention to Reduce Health Disparities in our Diabetic Patients

Abstract Background 85% of Americans own a smartphone and there were 230 billion downloads in 2021. 1,2 American diabetic patients have been reported to have limited health literacy. 3 55% of Americans do not graduate from high school. 4 African American, Hispanic patients and Asian patients comprise 20%, 22% and 19% of diabetic patients, respectively, but a greater proportion of hospitalization rates. 5 Many of these patients and their families use mobile apps for health questions. The accessibility of eHealth apps is changing how patients access health information. Purpose To evaluate free diabetes health apps as an intervention to reduce health disparities in our diabetic patients. Methods Using search term, "diabetes" in GooglePlayStore(Android/AD) and AppleAppStore(iOS) to find the best, free diabetes apps. Exclusion criteria: less than 100,000 downloads (DL) on Google and&amp;lt;1600 reviews (RE) on Apple (Apple does not provide download data). The app introduction was "pasted" into readabilityformulas.com and webfx.com for analysis via Flesch-Kincaid Reading Ease (FRE), Flesch-Kincaid Grade Level Score (FGL), Simple Measure of Gobbledygook Index (SI), and the Dale-Chall Adjusted Grade Level (DCGL). Results AD(DL): 1-mySugr(1M),2-OnetouchReveal(1M),3-DiabetesBloodSugar(1M),4-BloodGlucoseTracker(500K),5-Diabetes(500K),6-Health2Sync(500K),7-DiabetesM(500K), 8-GlucoseBuddy(500K), 9-BeatDiabetes(100K), 10- Contour Diabetes App (100K);iOS(RE): 1-OnetouchReveal(87K), 2-GlucoseBuddyDiabetesTracker(21K), 3-Onedrop(20K), 4-GlucoseBloodSugarTracker(17K), 5-Livongo(13K), 6-mySugr(9.6K), 7-Sugarmate(9.4K),8-Klinio(3K), 9- Glycemic Index Load Net Carbs (2.2K), 10- Diabetes Logs (1.6K). Push notification=19/20 apps(AD=9, iOS=10). Connect users to GoodRx=0/20 apps. Connect users to professional care team/diabetes education=8/20 apps(AD=3, iOS=5). Connect users to free/discounted insulin/health products=0/20 apps. Spanish=11/20, Chinese=5/20 apps (AD=3, iOS=8, some apps have both). Only 2/20 apps were at 7-8th grade and the rest were high school and beyond. Free test strips were offered only on 1/20 apps(Livongo). Conclusion Free diabetes apps are helpful and may serve as an easily accessible educational tool for our patients. The physician can play a role in navigating the eHealth space with the patient.