Quality Of Apps Research Articles

Design overview and usability of the codesigned My Surgical Pathway E-health tool for supporting patient self-managed surgical preparation and recovery

IntroductionSurgery plays a critical role in global health, often facing significant quality challenges such as high rates of postoperative complications, variability in patient outcomes, and inconsistencies in care pathways, due to the complex nature of the perioperative journey. The My Surgical Pathway (MSP) app is an e-health intervention designed to address these challenges by supporting self-management and integrated care throughout the entire perioperative journey. This study aims to describe the features and functions of MSP and report on the results of usability testing from both patients and healthcare workers. MethodsThis mixed-methods study evaluated the usability of the My Surgical Pathway (MSP) app using quantitative surveys, qualitative feedback, and observation data from patients and healthcare workers. Structured 2-hour user testing sessions included interaction with the MSP app, completion of the User Version of the Mobile Application Rating Scale (uMARS), and think-aloud activities. Data analysis combined quantitative and qualitative insights to identify usability issues and inform potential improvements. ResultsThe mixed-method user-testing evaluation of the co-designed e-health intervention revealed high overall app quality scores, with an average of 4.50 out of 5. All user-type interfaces received mean scores above the minimum acceptability threshold of 3.0, demonstrating the intervention's efficacy in supporting patient surgery journeys, enhancing healthcare worker coordination, and meeting diverse user needs. Notably, the highest individual item scores were for credibility of source (4.92) and interactivity (4.85), highlighting the application's reliability and engaging nature. ConclusionsThe study evaluated the 'My Surgical Pathway' (MSP) e-health intervention, co-designed with consumers and healthcare workers to support self-management of surgical care. Results indicate high user satisfaction, with an overall app quality score of 4.50 out of 5 on the uMARS tool. Users praised MSP's engagement, education, and responsiveness, highlighting its potential to improve patient experiences and clinician workflows. Recommendations for future research include expanding participant diversity and hospital settings, and employing longitudinal designs for a comprehensive evaluation.

Nurses' Use of mHealth Apps for Chronic Conditions: Cross-Sectional Survey.

Mobile health (mHealth) is increasingly used to support public health practice, as it has positive benefits such as enhancing self-efficacy and facilitating chronic disease management. Yet, relatively few studies have explored the use of mHealth apps among nurses, despite their important role in caring for patients with and at risk of chronic conditions. The aim of the study is to explore nurses' use of mHealth apps to support adults with or at risk of chronic conditions and understand the factors that influence technology adoption. A web-based cross-sectional survey was conducted between September 2022 and January 2023. The survey was shared via social media and professional nursing organizations to Australian nurses caring for adults with or at risk of chronic conditions. A total of 158 responses were included in the analysis. More than two-thirds (n=108, 68.4%) of respondents reported that they personally used at least 1 mHealth app. Over half (n=83, 52.5% to n=108, 68.4%) reported they use mHealth apps at least a few times a month for clinical purposes. Logistic regression demonstrated that performance expectancy (P=.04), facilitating condition (P=.05), and personal use of mHealth apps (P=.05) were significantly associated with mHealth app recommendation. In contrast, effort expectancy (P=.09) and social influence (P=.46) did not have a significant influence on whether respondents recommended mHealth apps to patients. The inability to identify the quality of mHealth apps and the lack of access to mobile devices or internet were the most common barriers to mHealth app recommendation. While nurses use mHealth apps personally, there is potential to increase their clinical application. Given the challenges reported in appraising and assessing mHealth apps, app regulation and upskilling nurses will help to integrate mHealth apps into usual patient care.

Supporting parents with acutely ill children: Environment scan and user evaluation of mobile applications (the SuPa kids project)

BackgroundChildren are one of the biggest users of emergency departments in the UK, sometimes utilising services when experiencing acute illnesses that can be managed at home. mHealth can be an efficacious way for parents/guardians to manage acute illnesses. It has also become a ubiquitous resource to promote public health interests within a resource constrained health system. However, to be effective, co-design is necessary with concepts such as usefulness, ease of use, trustworthiness and security underpinning the utility of mHealth interventions for acute childhood illness. ObjectiveThe objective of this study was to conduct an environmental scan of mHealth apps for parental assessment and management of acute childhood illnesses in 0- to 5-year-olds, review the content and functionality of each identified app against the list of desired attributes identified in previous research and synthesise publicly available reviews from end users to demonstrate the quality of current apps in the marketplace and identify areas for improvement. MethodApp characteristics were mapped to an a priori defined list of desirable attributes. End user reviews were mapped to a modified Technology Acceptance Model framework that included overarching themes of: Perceived Usefulness (PU), Perceived Ease of Use (PEU), Perceived Trustworthiness (PT) and Perceived Security (PS) using reflexive thematic analysis. ResultsOverall, 15 apps were included in the analysis (Table 2). Fourteen of the 15 apps were available on both the iOS and Android platforms. ‘Baby Illness, Prevention, Cure’ was only available on the Android store. All apps were free to download and did not restrict access to information or features via in-app purchases. Baby and child first aid (British Red Cross) was the earliest app to be released (2014). This app was updated annually, with the most recent update being 2022. The most recent apps to be released (2018) were ‘AskFirst’ (formerly Ask NHS), ‘Essex Child Health’ and ‘The Lullaby Trust Baby Check’, updated in 2022, 2020 and 2019, respectively. No individual app met all the desirable attributes highlighted by parents in previous research. Both ‘Healthier Together’, and ‘The Lullaby Trust Baby Check’ included all but one desirable attributes (video), as did the ‘’CATCH (Common Approach to Children’s Health), which did not utilise a traffic light system. Apps that were locality specific were not rated by users (Berkshire Child Health, Cheshire Child Health, Child Health Guide Newham, Child Health HMR, Oldham Child Illness and Walsall Healthy Child). All other apps were rated from 2/5 to 5/5 stars. When considering localities, the ‘CATCH’ app was only supported in Halton, Cheshire, Knowsley, Liverpool, St Helens and Vale Royal. Further investigation evidenced no correlation between inclusion of the desirable attributes and app rating. ConclusionOverall, this research has highlighted several aspects of best practise when developing mHealth apps for the management of acute childhood illnesses, for increasing PU, PEU, PT and PS; and also, places importance on co-design.

Measurement of Physical and Mental Workload in Onlline Ojek Drivers: A Case Study in Serang City

The development of online motorcycle taxi transportation has received a good response in the community. With this application, it makes it easier for people to order motorcycle taxis more practically. Many online motorcycle taxi drivers have complaints while working, one of which is the obligation to meet life's necessities which causes the physical and mental workload to increase. This study aims to measure the physical and mental workload of online motorcycle taxi drivers in Serang City. Data collection was carried out by measuring heart rate with a Polar H10 and filling out the NASA-TLX questionnaire which was distributed to online motorcycle taxi drivers who were willing to be respondents. Data processing starts from measuring heart rate, with an average %CVL value obtained of 40.08%. This value is included in the physical workload category that requires improvement. Mental workload data, calculated through the NASA-TLX method, averaged 74.20, which is classified as high. To alleviate these workloads, it's suggested to incorporate 90-minute break periods, redesign automatic motorcycles with extra footrests, use energy sprays, implement road congestion detection tools, enhance the quality of ride-hailing apps, and minimize exposure to heat stress.

#703 Usability of a mobile health app for peritoneal dialysis patients: a pilot study

Abstract Background and Aims Technology has changed how people interact with the world, so health apps may be useful for patients with long term conditions, facilitating adherence and enabling remote monitoring. Usability is a critical factor when evaluating the quality of a mobile health app, as it indicates the ease with which a user can use it to achieve specific clinically orientated goals with effectiveness, efficiency, and satisfaction. Method The mHealth App Usability Questionnaire (MAUQ), a reliable and validated tool, was used to evaluate the MyPD® mobile health app's usability for adult peritoneal dialysis (PD) patients. The arm using the My PD app in a pilot randomized clinical study in six renal clinics in Colombia from September 2022 to August 2023 was evaluated. The MAUQ questionnaire includes 18 items assessing 3 domains related to ease of use (5 items), interface and satisfaction (7 items) and usefulness (6 items). Patients rated each item on a seven-point Likert scale, with one (1) strongly disagreeing and seven (7) strongly agreeing. The overall rating is the mean of eighteen items (standalone version); closer to seven (7), higher usability. The socio-demographic and clinical characteristics of all patients were summarized descriptively. Results MyPD app allows patients to collect and view their clinical information and dialysis treatment. Figure 1 shows a general overview of the different navigation windows. A total of 65 patients were included in this analysis; the mean age was 52.2 years, 44.6% were in CAPD, and 21.5 % achieved elementary school education or were illiterate (Table 1). The overall usability was 6.5 (SD 0.7), the maximum possible score is 7. The items related to satisfaction and interface have a mean of 6.8 (SD 0.5). Regarding ease of use, the mean was 6.6 (SD 0.8), a very high figure given the socio-cultural context of a middle-income country. In relation to usefulness, the mean was 6.1 (SD 1.5). Patients rated the overall satisfaction item with the app as 6.8 (SD 0.6). See details in Table 2. These results are better than those reported by other authors (Table 3). Conclusion The usability of the health app MyPD® was rated very high by patients, which will allow this application to be used widely as a tool that supports the outpatient care of PD patients.

Mobile-UI-Repair: a deep learning based UI smell detection technique for mobile user interface

The graphical user interface (GUI) in mobile applications plays a crucial role in connecting users with mobile applications. GUIs often receive many UI design smells, bugs, or feature enhancement requests. The design smells include text overlap, component occlusion, blur screens, null values, and missing images. It also provides for the behavior of mobile applications during their usage. Manual testing of mobile applications (app as short in the rest of the document) is essential to ensuring app quality, especially for identifying usability and accessibility that may be missed during automated testing. However, it is time-consuming and inefficient due to the need for testers to perform actions repeatedly and the possibility of missing some functionalities. Although several approaches have been proposed, they require significant performance improvement. In addition, the key challenges of these approaches are incorporating the design guidelines and rules necessary to follow during app development and combine the syntactical and semantic information available on the development forums. In this study, we proposed a UI bug identification and localization approach called Mobile-UI-Repair (M-UI-R). M-UI-R is capable of recognizing graphical user interfaces (GUIs) display issues and accurately identifying the specific location of the bug within the GUI. M-UI-R is trained and tested on the history data and also validated on real-time data. The evaluation shows that the average precision is 87.7% and the average recall is 86.5% achieved in the detection of UI display issues. M-UI-R also achieved an average precision of 71.5% and an average recall of 70.7% in the localization of UI design smell. Moreover, a survey involving eight developers demonstrates that the proposed approach provides valuable support for enhancing the user interface of mobile applications. This aids developers in their efforts to fix bugs.

Privacy or trust: understanding the privacy paradox in users intentions towards e-pharmacy adoption through the lens of privacy-calculus model

Purpose This study aims to present a comprehensive investigation into users’ behavioural intentions to use e-pharmacies through the lens of the privacy calculus model. The present study also investigates the effects of perceived benefit, perceived privacy risk, timeliness and perceived app quality on e-pharmacy usage through the mediating role of trustworthiness. Design/methodology/approach The study used a deductive approach and collected data from 338 respondents using the purposive sampling technique. partial least squares structural equation modelling was applied to analyse the data. Findings The findings of the study indicate that perceived benefit, perceived privacy risk, timeliness and perceived app quality do not directly impact users’ behavioural intentions towards e-pharmacy adoption. Instead, it demonstrated that perceived benefit, perceived privacy risk, timeliness and perceived app quality influenced behavioural intention indirectly through the mediating role of trustworthiness Originality/value This study offers valuable insights to entrepreneurs, marketers and policymakers, enabling them to develop regulations, guidelines and policies that cultivate trust, safeguard privacy, ensure prompt services and create an enabling environment for the adoption of e-pharmacies. The present study also contributes to the existing literature by extending the privacy calculus model with the integration of timeliness and perceived app quality to explain users’ adoption behaviour towards e-pharmacy.

Why this app? How user ratings and app store rankings impact educators' selection of educational apps

Research indicates that educators value certain benchmarks of educational quality when choosing educational apps from app stores (i.e., curriculum, feedback, scaffolding, learning theory, and development team). However, it is unclear how other users' ratings of the app, or the app's ranking on the app store's list of “top” educational apps, might impact educators' evaluations. The present study examines how educational benchmarks, ratings, and rankings influence educators' selection of educational apps. One-hundred and fifty elementary educators viewed 18 researcher-created educational app pages and indicated their willingness to download, pay for, and rate each app. Results from a repeated-measures MANOVA and non-parametric tests revealed that educators preferred benchmark apps to buzzword apps, with a medium sized effect. However, they also had a strong preference for apps with positive user ratings, with a large effect, and preferred apps with a bottom ranking, with a medium effect. To improve app selection, educators should rely on their own knowledge to choose apps rather than relying on user ratings or company rankings. Companies running app stores should improve their user ratings and rankings systems to facilitate selection of apps that include evidence-backed benchmarks of app quality.

Digital Apps to Improve Mobility in Adults with Neurological Conditions: A Health App-Focused Systematic Review.

The provision of mobility exercises through a smartphone application (app) for people undertaking neurological rehabilitation may improve mobility outcomes. However, it is difficult for clinicians and consumers to select high-quality, appropriate apps. This review aimed to identify (1) which mobile health (mHealth) apps are suitable for prescribing mobility exercises for adults with neurological health conditions, (2) how well these apps incorporate telehealth strategies, and (3) how well these apps rate in terms of quality and capacity for behaviour change. The Australian Apple iTunes Store was systematically searched, by using a search code and manually, for apps suitable for training mobility in neurological rehabilitation. Additional searches were conducted in known app repositories and for web-based apps. Trained reviewers extracted data from the included apps, including population-specific characteristics; quality, by using the Mobile App Rating Scale (MARS); and behaviour change potential, by using the App Behaviour Change Scale (ABACUS). The included apps (n = 18) provided <50 to >10,000 exercises, many incurred a subscription fee (n = 13), and half included telehealth features. App quality was moderate (mean MARS score of 3.2/5 and SD of 0.5), and potential for behaviour change was poor (mean ABACUS score of 5.7/21 and SD of 2.1). A limited number of high-quality apps are available for the prescription of mobility exercises in people with neurological conditions.

Evaluating the World Health Organization's SkinNTDs App as a Training Tool for Skin Neglected Tropical Diseases in Ghana and Kenya: Cross-Sectional Study.

Neglected tropical diseases (NTDs) affect over 1.5 billion people worldwide, primarily impoverished populations in low- and middle-income countries. Skin NTDs, a significant subgroup, manifest primarily as skin lesions and require extensive diagnosis and treatment resources, including trained personnel and financial backing. The World Health Organization has introduced the SkinNTDs app, a mobile health tool designed to train and be used as a decision support tool for frontline health care workers. As most digital health guidelines prioritize the thorough evaluation of mobile health interventions, it is essential to conduct a rigorous and validated assessment of this app. This study aims to assess the usability and user experience of World Health Organization SkinNTDs app (version 3) as a capacity-building tool and decision-support tool for frontline health care workers. A cross-sectional study was conducted in Ghana and Kenya. Frontline health care workers dealing with skin NTDs were recruited through snowball sampling. They used the SkinNTDs app for at least 5 days before completing a web-based survey containing demographic variables and the user version of the Mobile Application Rating Scale (uMARS), a validated scale for assessing health apps. A smaller group of participants took part in semistructured interviews and one focus group. Quantitative data were analyzed using SPSS with a 95% CI and P≤.05 for statistical significance and qualitative data using ATLAS.ti to identify attributes, cluster themes, and code various dimensions that were explored. Overall, 60 participants participated in the quantitative phase and 17 in the qualitative phase. The SkinNTDs app scored highly on the uMARS questionnaire, with an app quality mean score of 4.02 (SD 0.47) of 5, a subjective quality score of 3.82 (SD 0.61) of 5, and a perceived impact of 4.47 (SD 0.56) of 5. There was no significant association between the app quality mean score and any of the categorical variables examined, according to Pearson correlation analysis; app quality mean score vs age (P=.37), sex (P=.70), type of health worker (P=.35), country (P=.94), work context (P=.17), frequency of dealing with skin NTDs (P=.09), and dermatology experience (P=.63). Qualitative results echoed the quantitative outcomes, highlighting the ease of use, the offline functionality, and the potential utility for frontline health care workers in remote and resource-constrained settings. Areas for improvement were identified, such as enhancing the signs and symptoms section. The SkinNTDs app demonstrates notable usability and user-friendliness. The results indicate that the app could play a crucial role in improving capacity building of frontline health care workers dealing with skin NTDs. It could be improved in the future by including new features such as epidemiological context and direct contact with experts. The possibility of using the app as a diagnostic tool should be considered. RR2-10.2196/39393.

Attributes, Quality, and Downloads of Dementia-Related Mobile Apps for Patients With Dementia and Their Caregivers: App Review and Evaluation Study.

The adoption of mobile health (mHealth) apps among older adults (>65 years) is rapidly increasing. However, use of such apps has not been fully effective in supporting people with dementia and their caregivers in their daily lives. This is mainly attributed to the heterogeneous quality of mHealth apps, highlighting the need for improved app quality in the development of dementia-related mHealth apps. The aims of this study were (1) to assess the quality and content of mobile apps for dementia management and (2) to investigate the relationship between app quality and download numbers. We reviewed dementia-related mHealth apps available in the Google Play Store and Apple App Store in Taiwan. The identified mobile apps were stratified according to a random sampling approach and evaluated by five independent reviewers with sufficient training and proficiency in the field of mHealth and the related health care sector. App quality was scored according to the user version of the Mobile Application Rating Scale. A correlation analysis was then performed between the app quality score and number of app downloads. Among the 17 apps that were evaluated, only one was specifically designed to provide dementia-related education. The mean score for the overall app quality was 3.35 (SD 0.56), with the engagement (mean 3.04, SD 0.82) and information (mean 3.14, SD 0.88) sections of the scale receiving the lowest ratings. Our analyses showed clear differences between the top three- and bottom three-rated apps, particularly in the entertainment and interest subsections of the engagement category where the ratings ranged from 1.4 to 5. The top three apps had a common feature in their interface, which included memory, attention, focus, calculation, and speed-training games, whereas the apps that received lower ratings were found to be deficient in providing adequate information. Although there was a correlation between the number of downloads (5000 or more) and app quality (t15=4.087, P<.001), this may not be a significant determinant of the app's perceived impact. The quality of dementia-related mHealth apps is highly variable. In particular, our results show that the top three quality apps performed well in terms of engagement and information, and they all received more than 5000 downloads. The findings of this study are limited due to the small sample size and possibility of disregarding exceptional occurrences. Publicly available expert ratings of mobile apps could help people with dementia and their caregivers choose a quality mHealth app.

Pilot and feasibility of the SMART IBD mobile app to improve self-management in pediatric inflammatory bowel disease.

Access to evidence-based self-management support in pediatric inflammatory bowel disease (IBD) is a significant challenge. Digital therapeutic solutions can increase access and provide data to patients and providers that would otherwise not be available. We have iteratively developed a mobile application, Self-Management Assistance with Recommended Treatment (SMART) IBD, that allows patients to access self-management support and record symptoms and medication adherence. We conducted a pilot and feasibility study for this digital therapeutic tool in which patients used SMART IBD for 30 days. Results indicated that patients rated the app quality as good and accessed the app adequately overall, with some pages being used often. Medication adherence increased over the course of the study and was associated with sleep duration, mood, and stool consistency and blood content. Overall, this study demonstrated adequate feasibility for the SMART IBD app and initial findings suggest that additional research is needed to explore the potential impact of this tool in clinical care.

Problems and Barriers Related to the Use of mHealth Apps From the Perspective of Patients: Focus Group and Interview Study.

Since fall 2020, mobile health (mHealth) apps have become an integral part of the German health care system. The belief that mHealth apps have the potential to make the health care system more efficient, close gaps in care, and improve the economic outcomes related to health is unwavering and already partially confirmed. Nevertheless, problems and barriers in the context of mHealth apps usually remain unconsidered. The focus groups and interviews conducted in this study aim to shed light on problems and barriers in the context of mHealth apps from the perspective of patients. Guided focus groups and individual interviews were conducted with patients with a disease for which an approved mHealth app was available at the time of the interviews. Participants were recruited via self-help groups. The interviews were recorded, transcribed, and subjected to a qualitative content analysis. The content analysis was based on 10 problem categories ("validity," "usability," "technology," "use and adherence," "data privacy and security," "patient-physician relationship," "knowledge and skills," "individuality," "implementation," and "costs") identified in a previously conducted scoping review. Participants were asked to fill out an additional questionnaire about their sociodemographic data and about their use of technology. A total of 38 patients were interviewed in 5 focus groups (3 onsite and 2 web-based) and 5 individual web-based interviews. The additional questionnaire was completed by 32 of the participants. Patients presented with a variety of different diseases, such as arthrosis, tinnitus, depression, or lung cancer. Overall, 16% (5/32) of the participants had already been prescribed an app. During the interviews, all 10 problem categories were discussed and considered important by patients. A myriad of problem manifestations could be identified for each category. This study shows that there are relevant problems and barriers in the context of mHealth apps from the perspective of patients, which warrant further attention. There are essentially 3 different areas of problems in the context of mHealth apps that could be addressed to improve care: quality of the respective mHealth app, its integration into health care, and the expandable digital literacy of patients.

Automatic App Review Using Android Application

DeepMatcher comes with a tool that connects usage data from app analytics to error reports in the monitored data. DeepMatcher uses advanced techniques to automate this process, enabling developers to quickly spot bugs and dynamically improve bug reporting. In this Paper we have got Simple Mail Transfer protocol (SMTP) which can send and receive Mail to concerned app developers for the improvement in app experience. As our abstract aims to make a standalone app that can make the user give feedback directly to developer so that the app satisfies the user as NLP required in DeepMatcher to report the SMTP used is simplified and make the developer easily rectify the issue with regards to this research we propose DeepMatcher, a tool to automate bug detection and enhance bug reporting in app development .We contrast our solution to an alternative, SMTP (Simple Mail Transfer Protocol), featuring distinct advantages. Whilst DeepMatcher illustrates automation, SMTP provides user-to-developer direct and immediate communication channels, simplifying feedback submission and bug reports. This direct approach provides timely and detailed feedback, faster bug resolution and higher app quality resulting in improved user satisfaction. Keywords— SMTP, CoRe, Standalone, Feedback, Developer, Generated

Patient-Centered Chronic Wound Care Mobile Apps: Systematic Identification, Analysis, and Assessment.

The prevalence of chronic wounds is predicted to increase within the aging populations in industrialized countries. Patients experience significant distress due to pain, wound secretions, and the resulting immobilization. As the number of wounds continues to rise, their adequate care becomes increasingly costly in terms of health care resources worldwide. eHealth support systems are being increasingly integrated into patient care. However, to date, no systematic analysis of such apps for chronic wounds has been published. The aims of this study were to systematically identify and subjectively assess publicly available German- or English-language mobile apps for patients with chronic wounds, with quality assessments performed by both patients and physicians. Two reviewers independently conducted a systematic search and assessment of German- or English-language mobile apps for patients with chronic wounds that were available in the Google Play Store and Apple App Store from April 2022 to May 2022. In total, 3 apps met the inclusion and exclusion criteria and were reviewed independently by 10 physicians using the German Mobile App Rating Scale (MARS) and the System Usability Scale (SUS). The app with the highest mean MARS score was subsequently reviewed by 11 patients with chronic wounds using the German user version of the MARS (uMARS) and the SUS. Additionally, Affinity for Technology Interaction (ATI) scale scores were collected from both patients and physicians. This study assessed mobile apps for patients with chronic wounds that were selected from a pool of 118 identified apps. Of the 73 apps available in both app stores, 10 were patient oriented. After excluding apps with advertisements or costs, 3 apps were evaluated by 10 physicians. Mean MARS scores ranged from 2.64 (SD 0.65) to 3.88 (SD 0.65) out of 5, and mean SUS scores ranged from 50.75 (SD 27) to 80.5 (SD 17.7) out of 100. WUND APP received the highest mean MARS score (mean 3.88, SD 0.65 out of 5) among physicians. Hence, it was subsequently assessed by 11 patients and achieved a similar rating (uMARS score: mean 3.89, SD 0.4 out of 5). Technical affinity, as measured with the ATI scale, was slightly lower in patients (score: mean 3.62, SD 1.35 out of 6) compared to physicians (score: mean 3.88, SD 1.03 out 6). The quality ratings from physicians and patients were comparable and indicated mediocre app quality. Technical affinity, as assessed by using the ATI scale, was slightly lower for patients. Adequate apps for patients with chronic wounds remain limited, emphasizing the need for improved app development to meet patient needs. The ATI scale proved valuable for assessing technical affinity among different user groups.

Mobile Apps for Common Noncommunicable Disease Management: Systematic Search in App Stores and Evaluation Using the Mobile App Rating Scale.

The success of mobile apps in improving the lifestyle of patients with noncommunicable diseases through self-management interventions is contingent upon the emerging growth in this field. While users of mobile health (mHealth) apps continue to grow in number, little is known about the quality of available apps that provide self-management for common noncommunicable diseases such as diabetes, hypertension, and obesity. We aimed to investigate the availability, characteristics, and quality of mHealth apps for common noncommunicable disease health management that included dietary aspects (based on the developer's description), as well as their features for promoting health outcomes and self-monitoring. A systematic search of English-language apps on the Google Play Store (Google LLC) and Apple App Store (Apple Inc) was conducted between August 7, 2022, and September 13, 2022. The search terms used included weight management, obesity, diabetes, hypertension, cardiovascular diseases, stroke, and diet. The selected mHealth apps' titles and content were screened based on the description that was provided. Apps that were not designed with self-management features were excluded. We analyzed the mHealth apps by category and whether they involved health care professionals, were based on scientific testing, and had self-monitoring features. A validated and multidimensional tool, the Mobile App Rating Scale (MARS), was used to evaluate each mHealth app's quality based on a 5-point Likert scale from 1 (inadequate) to 5 (excellent). Overall, 42 apps were identified. Diabetes-specific mHealth apps accounted for 7% (n=3) of the market, hypertension apps for 12% (n=5), and general noncommunicable disease management apps for 21% (n=9). About 38% (n=16) of the apps were for managing chronic diseases, while 74% (n=31) were for weight management. Self-management features such as weight tracking, BMI calculators, diet tracking, and fluid intake tracking were seen in 86% (n=36) of the apps. Most mHealth apps (n=37, 88%) did not indicate whether there was involvement of health professionals in app development. Additionally, none of the apps reported scientific evidence demonstrating their efficacy in managing health. The overall mean MARS score was 3.2 of 5, with a range of 2.0 to 4.1. Functionality was the best-rated category (mean score 3.9, SD 0.5), followed by aesthetics (mean score 3.2, SD 0.9), information (mean score 3.1, SD 0.7), and engagement (mean score 2.9, SD 0.6). The quality of mHealth apps for managing chronic diseases was heterogeneous, with roughly half of them falling short of acceptable standards for both quality and content. The majority of apps contained scant information about scientific evidence and the developer's history. To increase user confidence and accomplish desired health outcomes, mHealth apps should be optimized with the help of health care professionals. Future studies on mHealth content analysis should focus on other diseases as well.

Mobile Applications to Support Multiple Sclerosis Communities: The Post-COVID-19 Scenario.

Introduction: The increase in the use of mobile apps since the COVID-19 pandemic, even among people with multiple sclerosis (PwMS) and health care providers (HCPs), has enabled access to reliable information, symptoms monitoring and management, and social connections. The pandemic has undoubtedly contributed to the acceleration of the "digital revolution." But how far has it progressed for the MS communities? Methods: Italian Google Play and App Store were queried, selecting MS-specific apps in English or Italian language and usable by a wide public. Results: Fifty-four (n = 54) MS-specific apps were identified; most were PwMS-oriented (83%), free of charge (94%), and in English language (76%). The 45 PwMS-oriented apps focused on increasing MS knowledge (71%), tracking symptoms (33%), and promoting networking with peers or HCPs (38%). The 13 HCPs-oriented tools addressed education and updates on MS (62%), disease assessment and management (54%), and research (15%). Google Search tool was also queried to find non-MS-specific apps to fulfill some unmet domains (as sleep, pain, sexual or mental health). Twenty-four additional apps were listed to provide a valuable contribution. Conclusion: The "digital revolution" led to increasingly customized tools for PwMS, especially as m-health or social-networking apps. However, apps to support other specific MS-relevant domains, appealing HCPs-oriented apps, and specific mobile tools for MS caregivers are still lacking. The absence of data assessing the usability and quality of MS apps in ecologically contexts leads to not reliable conclusions about potential benefits. A strong dialogue between MS communities and the digital industry is encouraged to fill this gap.

Don't judge a book or health app by its cover: User ratings and downloads are not linked to quality.

To analyse the relationship between health app quality with user ratings and the number of downloads of corresponding health apps. Utilising a dataset of 881 Android-based health apps, assessed via the 300-point objective Organisation for the Review of Care and Health Applications (ORCHA) assessment tool, we explored whether subjective user-level indicators of quality (user ratings and downloads) correlate with objective quality scores in the domains of user experience, data privacy and professional/clinical assurance. For this purpose, we applied spearman correlation and multiple linear regression models. For user experience, professional/clinical assurance and data privacy scores, all models had very low adjusted R squared values (< .02). Suggesting that there is no meaningful link between subjective user ratings or the number of health app downloads and objective quality measures. Spearman correlations suggested that prior downloads only had a very weak positive correlation with user experience scores (Spearman = .084, p = .012) and data privacy scores (Spearman = .088, p = .009). There was a very weak negative correlation between downloads and professional/clinical assurance score (Spearman = -.081, p = .016). Additionally, user ratings demonstrated a very weak correlation with no statistically significant correlations observed between user ratings and the scores (all p > 0.05). For ORCHA scores multiple linear regression had adjusted R-squared = -.002. This study highlights that widely available proxies which users may perceive to signify the quality of health apps, namely user ratings and downloads, are inaccurate predictors for estimating quality. This indicates the need for wider use of quality assurance methodologies which can accurately determine the quality, safety, and compliance of health apps. Findings suggest more should be done to enable users to recognise high-quality health apps, including digital health literacy training and the provision of nationally endorsed "libraries".

Mobile health applications for epilepsy in Indian app stores: A systematic review and content analysis using the mobile app rating scale

ObjectiveThe growing prevalence of smartphones may prompt individuals with epilepsy to pursue unfulfilled healthcare requirements through mobile health (mHealth) apps, but the content and quality of these mHealth apps are rarely analysed. Hence, this study aimed to identify and assess the quality of epilepsy apps for patients with epilepsy (PWE), their caregivers, and healthcare practitioners (HCPs) available in the Play Store and App Store of India. MethodsWe performed a systematic search on the Google Play Store and Apple App Store of India to identify the mHealth apps for epilepsy which were released and updated till May 2023. The identified applications were downloaded and the quality was assessed using a Mobile app rating scale (MARS) for the overall quality, Aesthetics, Engagement, Functionality, and Information by three independent reviewers. The intraclass correlation coefficient (ICC) was calculated to assess the interrater reliability between the reviewers. An unpaired t-test was calculated to analyse the difference in mean scores for Android and iOS applications. ResultsThe systematic search yielded a total of 2518 apps, out of which 26 were selected for inclusion in the study. Among these, 9 apps were compatible with Android, 11 with iOS, and 6 on both platforms. The mean (SD) MARS score of the apps was 3.5 (0.6) and the ICC for the overall app quality was 0.90 (95% CI: 0.82–0.96). Overall, apps scored highest in functionality (3.9), followed by aesthetics (3.6), information (3.3), and engagement (3.2). Among the included apps, the overall quality score was found to be higher for iOS apps than Android (MD = 0.54; 95% CI: 0.02 – 1.07; p-value: 0.042). ConclusionOur study identified twenty-six mHealth applications for epilepsy that integrated various aspects of epilepsy self-management. The results of this study emphasize the importance of ensuring that current and future applications offer evidence-based information, integrate features that align with patient preferences, and generate evidence regarding the effectiveness of application usage.

Learning letters, not language: The nature and quality of language and literacy apps used during remote learning with preschool children in the United States

ABSTRACT During the COVID-19 pandemic, early childhood educators (ECEs) made a rapid pivot to remote instruction. Much of this instruction was facilitated by digital learning resources, but the nature and quality of these resources for children’s language and literacy learning is an open question. This paper draws on a national U.S. survey of ECEs during the second pandemic school year (2020–2021), which asked them to report on the apps and websites they asked children to use during remote learning. We then engaged in a content analysis of the apps/websites used most frequently, evaluating their quality along several dimensions, including support for a full range of literacy competencies, equity, and accessibility. Survey results indicated that preschool children were asked to use a wide range of apps, but six were used most frequently: YouTube, Seesaw, Starfall, Epic, Boom Cards, and ABC Mouse. The content analysis indicated that most apps supported code-focused literacy skills, but had less capacity to foster oral language and comprehension. Apps also presented few opportunities to approximate the active, hands-on learning characteristic of in-person preschool. Our analysis points to the pressing need for teacher guidance in the selection and use of apps that provide comprehensive support for language and literacy.