App Content Research Articles

Validity, Reliability, Feasibility, and Usefulness of Pain Monitor: A Multidimensional Smartphone App for Daily Monitoring of Adults With Heterogenous Chronic Pain.

Ecological momentary assessment has been recommended in the management of chronic pain. Smartphone apps might be a useful tool for that purpose. This goal of this study was to develop and test a multidimensional smartphone app for adults with chronic pain. A multidisciplinary team developed the app content after a series of meetings, considering clinical guidelines for pain measurement. The content included pain intensity and interference, fatigue, mood, perceived health status, activity level, side effects of the medication, use of rescue medication, and pain-related sychological constructs (catastrophizing, acceptance, fear, and coping). Thirty-eight participants (21 to 59 y) used the app, called Pain Monitor, twice a day during 30 consecutive days. Patients completed a set of well-established measures at the beginning and end of the study via paper-and-pencil. Weekly phone assessments were also made for pain intensity, pain interference, fatigue, and mood. Construct validity was revealed by moderate-to-strong correlations between app content and traditional measures. Feasibility was supported by high compliance (between 70% and 82%) and high acceptability and ease of use. Both side effects of the medication and use of rescue medication were found to be useful tools to guide treatment. The new assessment protocol in the app allows for an easy and rapid multidimensional assessment of chronic pain patients.

Leveraging Community Engagement to Develop a Mobile Health Application for Older Women With HIV Infection

ObjectiveTo develop a mobile health app for older women with HIV infection that will be used in a larger study. DesignA qualitative study design. SettingBaltimore–Washington metropolitan area clinics and communities. ParticipantsTen women 50 years and older (mean age = 62.8 years, standard deviation = 3.62, range = 58–69 years) who self-identified as Black or African American and were infected with HIV. MethodsAt the start of the study, we used relevant empirical and the self-determination theory to inform the draft Web-based app content that was shared with two focus groups. Data were analyzed with input from a community advisory board (CAB) to inform the development of the mobile health app. ResultsWe inductively identified eight subthemes within the coding structure of two overall themes: Navigating Content, Functions, and Features and Enhancing Provider Interaction With Patients that represented the perspectives of participants regarding the app. From the eight subthemes, we integrated the contributions from the CAB, which we then used to further optimize the app. ConclusionThe app was designed to provide support, tools, and resources for older women with HIV. Engagement of community collaborators could be challenging because of multiple personal and structural barriers. Nonetheless, the potential community member benefits are invaluable. If successful, the Web-based app could be a model to address the needs of older persons with HIV infection.

Launching and evaluating a mobile phone app to provide contemporary, evidence-based advice about self-treatable conditions

Rationale, aims and objectives: As government-funded healthcare provisions are stretched to their limits, it is important that healthcare professionals provide evidence-based advice about minor ailments to facilitate people’s abilities to self-treat these conditions effectively and appropriately, given that self-care is one of the many components of person-centered healthcare. Unfortunately, despite the expanding over-the-counter (OTC) medicines market, there have been doubts cast about advice given by UK community pharmacists. Indeed, research conducted with pharmacists revealed that evidence of effectiveness was a secondary consideration when making decisions about OTC recommendations. We aimed to address these concerns and support decision-making by providing high quality, evidence-based, information about self-treatable conditions and over-the-counter consultations through a mobile phone app.Method: There were 4 main stages, namely: (1) app development (content and design); (2) piloting (use-testing); (3) publication on Apple and Android stores and marketing of the app and, finally, (4) an evaluation (using analytical data obtained through the app content management system, feedback obtained via email, the star-rating and reviews posted on Google Play and Apple stores and comments obtained at events. Additionally, following ethical approval and piloting, we invited 100 people, representing different groups within the pharmacy profession in Northern Ireland, to complete an evaluation questionnaire.Results: Since launching the project in February 2017, there have been over 5000 downloads, 68,453 sessions of use and the app has received a 5-star rating on both Apple and Google Play stores. Positive feedback has centred on the material being relevant and up-to-date, that it facilitates quick access to information in the workplace and is easy to navigate and that it is a good training tool. Future suggestions for improvement include expanding the number of conditions and providing self-assessment questions to help students prepare for professional examinations.Conclusions: The app appears to have had a positive impact on OTC consultations, but it is still evolving to ensure its usefulness in practice is maximised.

Mobile Applications for Allergic Rhinitis.

To study and review the currently available mobile applications relating to allergic rhinitis. The Apple and Google mobile app stores were queried with search terms relating to allergic rhinitis. Apps were assigned to categories and analyzed based on description and characteristics such as popularity, reviews, cost, platform, and physician involvement in development. A total of 72 apps related to allergic rhinitis were identified. Fifty-four apps were unique, with 18 apps found on both operating systems. Forty (55.5%) apps were available in the Apple App store, and 32 (44.4%) apps were available in the Google Play app store. They were grouped into the following categories: patient education (18; 25%), journals (15; 20.8%), symptom tracking (14; 19.4%), clinical/private practice (13; 18.1%), pollen forecast (7; 9.7%), medical education (4; 5.6%), and other (1; 1.4%). The majority of apps were free of charge (67; 93.1%), with paid apps ranging from $1.47 to $4.99. Apps that were reviewed had an average rating of 3.9 out of 5. Physicians were involved in the development of 37 (51.4%) apps. The collection of mobile apps developed for allergic rhinitis includes those for both educational and clinical use. Mobile apps may have an increasing role in otolaryngic allergy and rhinology practices in the future. Thus, continued research is warranted to determine the best way to ensure the accuracy and quality of app content as well as the extent mobile apps can benefit allergic rhinitis patients.

A multi-level usability evaluation of mobile health applications: A case study.

To report a methodological approach for the development of a usable mHealth application (app). This work was guided by a 3-level stratified view of health information technology (IT) usability evaluation framework. We first describe a number of methodologies for operationalizing each level of the framework. Following the description of each methodology, we present a case study which illustrates the use of our preferred methodologies for the development of a mHealth app. At level 1 (user-task), we applied a card sorting technique to guide the information architecture of a mobile HIV symptom self-management app, entitled mVIP. At level 2 (user-task-system), we conducted a usability evaluation of mVIP in a laboratory setting through end-user usability testing and heuristic evaluation with informatics experts. At level 3 (user-task-system-environment), usability of mVIP was evaluated in a real-world setting following the use of the app during a 3-month trial. The 3-level usability evaluation guided our work exploring in-depth interactions between the user, task, system, and environment. Integral to the findings from the 3-level usability evaluation, we iteratively refined the app's content, functionality, and interface to meet the needs of our intended end-users. The stratified view of the health IT usability evaluation framework is a useful methodological approach for the design, development, and evaluation of mHealth apps. The methodological recommendations for using the theoretical framework can inform future usability studies of mHealth apps.

Time to Work Out! Examining the Behavior Change Techniques and Relevant Theoretical Mechanisms that Predict the Popularity of Fitness Mobile Apps with Chinese-Language User Interfaces

ABSTRACTEyeing the huge potential mHealth market in China, developers both inside and outside of China have created an increasing number of fitness mobile applications with Chinese-language user interfaces. The present study analyzes the content of those fitness mobile apps (N = 177), with a particular focus on their behavior change techniques and relevant theoretical mechanisms. It finds that three theoretical mechanisms, modeling/observational learning, self-regulation, and social comparison/social support, are prevalent among fitness mobile apps with Chinese-language user interfaces. Moreover, based on the configurations of the behavior change techniques, three distinct clusters are identified: “instructional apps” (N = 75), “self-regulation apps” (N = 58), and “triathlon apps” (N = 44). Among them, “triathlon apps” equipped with technical features reflecting all three theoretical mechanisms are found to be the most popular among users. This suggests the usefulness of health behavior change theories in promoting physical activity via mobile apps in that the inclusion of more theoretical content in the app design enhances the app’s effectiveness. More theoretical and practical implications are also discussed.

Pharmacist-Led Digital Care Improved Community Diabetes Control in China—An Observational Study in a Large Population Sample

Objective: To evaluate the effects of digital diabetic care and pilot-test the healthcare ecosystem with retail pharmacists as the care provider. Methods: We managed to build a digital healthcare ecosystem that engages diabetic patients and pharmacists with a cloud engine that operates 5 different algorithms for diabetic care support. A set of glucose tele-monitor and an App was installed in the drug stores and pharmacists provided personalized interventions to the walk-in patients according to the onsite glucose tests and the supporting App contents generated by the cloud engine in real-time. Between Jun 6th 2015 and Dec 26th 2017, we served a total of 283,938 patients in 4,035 pharmacies in 183 cities, and 14,609 of them were selected in this analysis following 4 inclusion criteria: 1) the baseline fasting blood glucose (FBG) or random blood glucose (RBG) were diabetic, 2) the intervention duration was ≥ 1 month, 3) the number of received diabetic care was ≥ 3 times, and 4) the baseline characteristics were complete. Among them, 11,131 received FBG tests, 4,731 had RBG tests and 1,253 had both. Results: FBG and RBG were reduced on average by 0.8 mM (baseline: 9.1 ± 2.2 mM, last time: 8.3 ± 2.2 mM, n=11,131, P< 0.001) and 3.2 mM (baseline: 14.5 ± 3.2 mM, last time: 11.3 ± 4.0 mM, n= 4,731, P<0.001), respectively. The diabetes control rates were improved with 3,165 patients of the FBG population (28%) and 2,545 patients of the RBG population (54%) returning to normal. The greatest glycemic control effect took place following the initial intervention with the reduction of FBG by 11% and RBG by 18%. Nonlinear fitting using compound function identified descending glucose reduction to time: FBG, y = 1.122x-1/3 + 7.970; RBG, y = 2.927x-1-0.003x + 11.070. Conclusion: Retail pharmacists equipped with digital tools can effectively control diabetes and are valuable resources to help streamline the process of community healthcare delivery. Disclosure J. Cao: None. Y. Li: None. W. Wang: None. Z. Wang: None. D. Li: None. H. Zhang: None. K. Liu: None.

Development and implementation of a mobile device-based pediatric electronic decision support tool as part of a national practice standardization project.

ObjectiveImplementing evidence-based practices requires a multi-faceted approach. Electronic clinical decision support (ECDS) tools may encourage evidence-based practice adoption. However, data regarding the role of mobile ECDS tools in pediatrics is scant. Our objective is to describe the development, distribution, and usage patterns of a smartphone-based ECDS tool within a national practice standardization project.Materials and MethodsWe developed a smartphone-based ECDS tool for use in the American Academy of Pediatrics, Value in Inpatient Pediatrics Network project entitled “Reducing Excessive Variation in the Infant Sepsis Evaluation (REVISE).” The mobile application (app), PedsGuide, was developed using evidence-based recommendations created by an interdisciplinary panel. App workflow and content were aligned with clinical benchmarks; app interface was adjusted after usability heuristic review. Usage patterns were measured using Google Analytics.ResultsOverall, 3805 users across the United States downloaded PedsGuide from December 1, 2016, to July 31, 2017, leading to 14 256 use sessions (average 3.75 sessions per user). Users engaged in 60 442 screen views, including 37 424 (61.8%) screen views that displayed content related to the REVISE clinical practice benchmarks, including hospital admission appropriateness (26.8%), length of hospitalization (14.6%), and diagnostic testing recommendations (17.0%). Median user touch depth was 5 [IQR 5].DiscussionWe observed rapid dissemination and in-depth engagement with PedsGuide, demonstrating feasibility for using smartphone-based ECDS tools within national practice improvement projects.ConclusionsECDS tools may prove valuable in future national practice standardization initiatives. Work should next focus on developing robust analytics to determine ECDS tools’ impact on medical decision making, clinical practice, and health outcomes.

MyHealthyGut: development of a theory-based self-regulatory app to effectively manage celiac disease.

Celiac disease affects approximately 1% of the North American population and the only treatment is to follow a strict gluten-free (GF) diet. Unfortunately, the GF diet can be challenging, and poor adherence can lead to detrimental physical and psychological health outcomes for people with celiac disease. The goal of this study was to design, develop and pilot test a smartphone app (MyHealthyGut), to promote effective self-management of celiac disease and improve gut health. In Part 1, feedback from end-users (adults with celiac disease) regarding the desired functions and content of an app to manage celiac disease was gathered. Part 2 was a pilot test of the MyHealthyGut app with end-users and healthcare professionals. Part 1: 118 adults diagnosed with celiac disease participated in the initial survey. Based on findings from this study, version 1.0 of the app was created. Part 2: 12 adults with celiac disease engaged in focus groups to provide feedback after testing the app for a 1-week period; and seven healthcare professionals (dietitians and physicians) provided online feedback about the app after using it for a 2-week period. Part 1: over 90% of participants indicated a need for an app for celiac disease. Ease of use, available functions, nutritious GF recipes and cost were the top four most important perceived factors to 40-60% of participants for an app to manage celiac disease. Over 25% of participants also indicated it was important to have a list of the top 100 GF foods and evidence-based supplements, the ability to track symptoms and cooking tips. Part 2: focus group participants suggested revisions to the app pertaining to functionality and ease of use (e.g., clearly marked way-finding buttons, enhance onboarding), improving the symptom journaling feature, and app content (e.g., add information on irritable bowel syndrome). The majority of healthcare professionals reported positive perceptions of the app and reported similar revisions to content, functionality and ease of use. Health-related mobile applications make smartphones useful tools in providing point of care to the user. Participants reported a need for the MyHealthyGut app, listed desired content, features and functions and provided feedback to revise the content, features and functions of version 1.0 of the MyHealthyGut app. MyHealthyGut is the first evidence-based app that may be helpful in empowering users to effectively self-manage celiac disease and promote general gut health.

Supply and Demand in mHealth Apps for Persons With Multiple Sclerosis: Systematic Search in App Stores and Scoping Literature Review.

BackgroundMultiple sclerosis (MS) is a non-curable chronic inflammatory disease of the central nervous system that affects more than 2 million people worldwide. MS-related symptoms impact negatively on the quality of life of persons with MS, who need to be active in the management of their health. mHealth apps could support these patient groups by offering useful tools, providing reliable information, and monitoring symptoms. A previous study from this group identified needs, barriers, and facilitators for the use of mHealth solutions among persons with MS. It is unknown how commercially available health apps meet these needs.ObjectiveThe main objective of this review was to assess how the features present in MS apps meet the reported needs of persons with MS.MethodsWe followed a combination of scoping review methodology and systematic assessment of features and content of mHealth apps. A search strategy was defined for the two most popular app stores (Google Play and Apple App Store) to identify relevant apps. Reviewers independently conducted a screening process to filter apps according to the selection criteria. Interrater reliability was assessed through the Fleiss-Cohen coefficient (k=.885). Data from the included MS apps were extracted and explored according to classification criteria.ResultsAn initial total of 581 potentially relevant apps was found. After removing duplicates and applying inclusion and exclusion criteria, 30 unique apps were included in the study. A similar number of apps was found in both stores. The majority of the apps dealt with disease management and disease and treatment information. Most apps were developed by small and medium-sized enterprises, followed by pharmaceutical companies. Patient education and personal data management were among the most frequently included features in these apps. Energy management and remote monitoring were often not present in MS apps. Very few contained gamification elements.ConclusionsCurrently available MS apps fail to meet the needs and demands of persons with MS. There is a need for health professionals, researchers, and industry partners to collaborate in the design of mHealth solutions for persons with MS to increase adoption and engagement.

Undergraduate use of medical radiation science mobile applications

IntroductionDespite the technologically intense nature of the medical radiation science (MRS) profession, literature specifically supporting the adoption of mobile learning in MRS education is scarce. To this aim, we explored student utilization of and influences for choosing MRS applications (apps, a specific type of mobile learning) within the Bachelor of Medical Radiation Science course at Charles Sturt University (CSU), Australia. Secondary objectives briefly investigated content reliability within selected chosen apps and overall student willingness to embrace this methodology prior to mainstream integration. MethodsA mixed-method census survey was delivered to 415 enrolled students using the software Survey Monkey to compile responses to 28 questions. Inclusion criteria included students who owned a smartphone or tablet and who used any apps listed on the survey. ResultsAmong the 97 students who completed the survey, 37% (36/97) freely use MRS apps at least weekly (70%, 21/30), of which anatomy atlases were reported as most popular. Peer recommendation influenced 67% (20/30) of students to choose the MRS apps used. Thirty-seven percent (11/30) of students integrated only one method to check the accuracy of app content prior to download. Students who do not use MRS apps (78%, 76/97) stated they were unaware of this resource; however, 91% (80/88) of the respondents indicated they would use MRS apps if incorporated into the curriculum. ConclusionThe majority of CSU students agreed that apps offer a convenient way to engage in a variety of interactive content both in the classroom and on-the-go, using apps most pertinent to their specific curriculum and/or for revision. Students preferred to use MRS apps if integrated as supplemental study tools vetted by the lecturer.

Mobi-SAGE-RS: A sparse additive generative model-based mobile application recommender system

With the rapid prevalence of smart mobile devices and the dramatic proliferation of mobile applications (Apps), App recommendation becomes an emergent task that will benefit different stockholders of mobile App ecosystems. However, the extreme sparsity of user-App matrix and many newly emerging Apps create severe challenges, causing CF-based methods to degrade significantly in their recommendation performance. Besides, unlike traditional items, Apps have rights to access users’ personal resources (e.g., location, message and contact) which may lead to security risk or privacy leak. Thus, users’ choosing of Apps are influenced by not only their personal interests but also their privacy preferences. Moreover, user privacy preferences vary with App categories. In light of the above challenges, we propose a mobile sparse additive generative model (Mobi-SAGE) to recommend Apps by considering both user interests and category-aware user privacy preferences in this paper. To overcome the challenges from data sparsity and cold start, Mobi-SAGE exploits both textual and visual content associated with Apps to learn multi-view topics for user interest modeling. We collected a large-scale and real-world dataset from 360 App store - the biggest Android App platform in China, and conducted extensive experiments on it. The experimental results demonstrate that our Mobi-SAGE consistently and significantly outperforms the other existing state-of-the-art methods, which implies the importance of exploiting category-aware user privacy preferences and the multi-modal App content data on personalized App recommendation.

Preferences for Web-Based Information Material for Low Back Pain: Qualitative Interview Study on People Consulting a General Practitioner.

BackgroundInformation on self-management, including addressing people’s fears and concerns, are core aspects of managing patients with low back pain (LBP). Web apps with patient information may be used to extend patient-physician consultations and encourage self-management outside of the consultation room. It is, however, important to identify the end users’ needs and preferences in order to maximize acceptance.ObjectiveThe aim of this study was to identify preferences for the content, design, and functionality of a Web app with evidence-based information and advice for people with LBP in Denmark.MethodsThis is a phenomenological qualitative study. Adults who had consulted their general practitioner because of LBP within the past 14 days were included. Each participated in a semistructured interview, which was audiotaped and transcribed for text condensation. Interviews were conducted at the participant’s home by 2 interviewers. Participants also completed a questionnaire that requested information on age, gender, internet usage, interest in searching new knowledge, LBP-related function, and pain.ResultsFifteen 45-min interviews were conducted. Participants had a median age of 40 years (range 22-68 years) and reported a median disability of 7 points (range 0-18) using the 23-item Roland Morris Disability Questionnaire. Participants reported that Web-based information should be easy to find and read, easily overviewed, and not be overloaded with information. Subjects found existing Web-based information confusing, often difficult to comprehend, and not relevant for them, and they questioned the motives driving most hosting companies or organizations. The Patient Handbook, a Danish government-funded website that provides information to Danes about health, was mentioned as a trustworthy and preferred site when searching for information and advice regarding LBP.ConclusionsThis study identified important issues to consider when developing and supplementing existing general practice treatment with Web-based information and advice for patients with LBP. Development of a Web app should consider patient input, and developers should carefully address the following domains: readability, customization, design, credibility, and usability.

EpApp: Development and evaluation of a smartphone/tablet app for adolescents with epilepsy

The study aimed to comprehensively evaluate a mobile application (EpApp), designed with stakeholder input, to educate and facilitate management of adolescents with epilepsy. A prospective cohort of adolescents with epilepsy (13–19 years) and their parent/carer participated between June 2015 and December 2016. Primary outcome measure was knowledge acquisition. Secondary outcomes were psychosocial variables (attitude towards illness and seizure self-efficacy) and clinical parameters (medication adherence, seizure burden). Functionality, design, content and app utility were appraised via survey and open-ended questions. 51 adolescents completed baseline surveys (mean age 14.49 years), 36 follow-up surveys. Both self and general epilepsy knowledge increased following intervention (p ≤ 0.005). Significantly fewer medication reminders were required during intervention (M = 2.93, p = .002) and follow-up (M = 3.54, p = .030) compared to baseline (M = 6.64). Measures of app design, content, functionality and utility were very favourable. There was no significant improvement in seizure burden, or psychosocial parameters. Educational page-visits reflected interests and concerns. This study demonstrates that EpApp increases knowledge and is engaging. The app is available free, internationally via Android/Apple platforms.

Adolescents’ Perspectives on a Mobile App for Relationships: Cross-Sectional Survey

BackgroundAdolescence can be a fertile time for relationship issues, with interpersonal conflict being a risk factor for poor mental health. Mobile app interventions may have a significant appeal to young people in assisting with relationship distress. However, currently available apps have not been formally evaluated. Youths’ perspectives on engaging with mobile technology to assist with relationships are also unknown.ObjectiveThis study aimed to examine adolescents’ attitudes toward the concept of a mobile phone app for relationship help and support, and whether they would be likely to use such an intervention.MethodsA cross-sectional Web survey consisting of 42 questions, including 13 free responses, was delivered. The proposed app, including character vignettes, was presented, and participants were asked to indicate whether they had experienced the same relationship issues, whether their peers would relate to the issues, and how helpful they found the proposed advice. Participants were also asked to provide their own suggestions for help, which were analyzed using thematic analyses.ResultsA total of 150 adolescents (aged 15 to 18) participated. Overall, 60.7% (91/150) were likely to use an app for relationship problems, and this was not associated with demographics or social support (all P values >.05). Likelihood of app usage was found to be influenced by perceived need for help, personal beliefs about app effectiveness, and whether the app is engaging and easy to use. Overall, adolescents were receptive of the proposed content with an average of 99.3% (149/150), rating the strategies provided as somewhat to very helpful.ConclusionsAdolescents were likely to use a mobile phone app for relationship support, and use was not influenced by gender, age, social support, or any other background characteristic. Instead, likely use was influenced by need, personal beliefs, usability, and the appropriateness of app content. App developers must address these factors if the app is to have a wide-scale uptake.

Exploring the Influence of a Smartphone App (Young with Diabetes) on Young People's Self-Management: Qualitative Study.

BackgroundAdequate self-management is the cornerstone of preventing type 1 diabetes mellitus (T1DM) complications. However, T1DM self-management is challenging for young people, who often struggle during the transition from childhood to adulthood. The mobile health (mHealth) app Young with Diabetes (YWD) was developed in collaboration with young people to enhance their T1DM self-management during this transition.ObjectiveThe purpose of this study was to explore the influence of YWD on young people’s self-management during a 12-month period.MethodsA qualitative explorative approach was used, comprising a purposive sample of 20 young people (11 females and 9 males, ages 15 to 23 years, with app use of 3 to 64 days) from 3 pediatric and 3 adult departments. Participants were interviewed individually using a semistructured interview guide. Data were collected from January to March 2017 and analyzed using thematic analysis.ResultsA total of 5 themes were identified: (1) not feeling alone anymore (“we are in this together”); (2) gaining competence by sharing experiences and practical knowledge (“they know what they are talking about”); (3) feeling safer (“it’s just a click away”); (4) breaking the ice by starting to share thoughts and feelings and asking for help (“it is an outstretched hand”); and (5) lack of motivating factors (“done with the app”). Young people reported that YWD promoted self-management by peer-to-peer social support, exchanging messages with health care providers, and sharing YWD with parents. Participants recommended YWD as a supplement to self-management for newly diagnosed young people with T1DM and suggested improvements in app content and functionality.ConclusionsThe mHealth app YWD has the potential to support self-management. In particular, peer-to-peer support reduced feelings of loneliness and helped young people to gain knowledge and skills for managing T1DM. A need exists for alternative ways to train health care providers in using YWD and to support collaboration between young people and their parents to further improve young people’s self-management of T1DM.

App store mining is not enough for app improvement

The rise in popularity of mobile devices has led to a parallel growth in the size of the app store market, intriguing several research studies and commercial platforms on mining app stores. App store reviews are used to analyze different aspects of app development and evolution. However, app users’ feedback does not only exist on the app store. In fact, despite the large quantity of posts that are made daily on social media, the importance and value that these discussions provide remain mostly unused in the context of mobile app development. In this paper, we study how Twitter can provide complementary information to support mobile app development. By analyzing a total of 30,793 apps over a period of six weeks, we found strong correlations between the number of reviews and tweets for most apps. Moreover, through applying machine learning classifiers, topic modeling and subsequent crowd-sourcing, we successfully mined 22.4% additional feature requests and 12.89% additional bug reports from Twitter. We also found that 52.1% of all feature requests and bug reports were discussed on both tweets and reviews. In addition to finding common and unique information from Twitter and the app store, sentiment and content analysis were also performed for 70 randomly selected apps. From this, we found that tweets provided more critical and objective views on apps than reviews from the app store. These results show that app store review mining is indeed not enough; other information sources ultimately provide added value and information for app developers.

A parent–science partnership to improve postsurgical pain management in young children: Co-development and usability testing of the Achy Penguin smartphone-based app

ABSTRACT Background Young children are at risk for poorly managed pain after surgery, with significant negative consequence to their quality of life and health outcomes. Mobile applications offer a highly accessible, engaging, and interactive medium to improve pain assessment and management; however, they generally lack scientific foundation or support. Aims The aims of this study were to describe a successful parent–science partnership in the development and testing of Achy Penguin, a parent-developed iOS app to help assess and manage acute pain in young children, and to evaluate and refine the usability of Achy Penguin in young children with acute postoperative pain. Methods Three cycles of iterative usability testing were conducted with 20 4- to 7-year-old children (M = 5.8 years) in hospital who had recently undergone surgery (n = 6–7 children/cycle). Semistructured qualitative interviews were analyzed using simple content analysis. Results Feedback from children and further integration of evidence-based pediatric pain knowledge led to refinements in app pain assessment and management content, as well as app flow and functionality. Changes improved children’s ease of use and understanding and satisfaction by simplifying language in app instructions and content, adding audio and pictorial instructions, and increasing the engagement, interactiveness, immersiveness, and general appeal of pain management strategies. Conclusions This article showcases the value of collaborative partnerships between various stakeholders (parents, app developers, and researcher/health care providers) to address gaps in pediatric pain care. The Achy Penguin app shows promise for improving pain assessment and management in young children, although further evaluation of app effectiveness and implementation is warranted.

Personalized Mobile Tool AskPCOS Delivering Evidence-Based Quality Information about Polycystic Ovary Syndrome.

Despite polycystic ovary syndrome (PCOS) being the most common endocrine condition affecting reproductive-aged women, studies have shown the information needs of PCOS consumers are not currently met. The expressed need by women with PCOS for accessible, evidence-based personalized PCOS information informed the design and development of the PCOS mobile tool-AskPCOS. The App provides a range of unique features such as: evidence-based PCOS health information, self-diagnostic function, a question prompt list to optimize health practitioner engagement, and a commonly asked questions list. A five-phase App development process involved extensive stakeholder consultation, system architecture design, development of the content repository, system prototyping, and evaluation. AskPCOS is the first evidence-based, consumer-driven mobile App developed by women and for women with PCOS and utilizes innovative technology to empower PCOS consumers and optimize health outcomes. The App content repository is enhanced by the best available evidence and expertise extracted from the International Evidence-Based Guideline in PCOS (2018). The AskPCOS App has extensive data capture capability through the usage of data gathering functions and backend analytics to optimize responsiveness to consumer needs. In addition, the multilingual content and not-for-profit cost model is designed to facilitate worldwide adoption of the tool, and address PCOS information inequities in developing countries.

Using Home-Program Adherence App in Pediatric Therapy: Case Study of Sensory Processing Disorder

Pediatric therapies adopt a family-centered approach that encourages a caregiver's involvement in therapy. Contextual interventions in the child's natural environment have been effective in generalization of skills and increasing of child participation in daily activities. The use of home programs is common across a variety of conditions, but adherence has been challenging. Apps have been demonstrated to promote medication adherence and physical activity maintenance. This study suggested and tested a construct for features required for caregivers' behavioral modification during home programs in pediatric therapy. SensoryTreat is an adherence promoting app for home-program treatments of children with sensory processing disorders. The app was evaluated by testing availability of desired features, usage frequency, impact on adherence with home programs, and parental sense of competence. Results suggest a strong significant correlation between SensoryTreat usage frequency and families' adherence with home programs, as well as a strong significant correlation between relevancy and usefulness of SensoryTreat's interventional content, and parental competence and their adherence with home programs. Using SensoryTreat twice or more per week increases parental adherence with home programs. Content plays an important role in promoting adherence and parental sense of competence, yet, as usage frequency grows the interventional content habituates, and other features as goal setting and feedback logs have significant impact on parental competence and adherence with home programs over time. These findings indicate that the content and features of SensoryTreat app have the potential to promote adherence of families with pediatric therapy home programs.