Quality Of Apps Research Articles

A Narrative Review of the Digital Equity Gap of Apps for Cigarette Smoking Cessation for Persons Living in the Hispanosphere

Abstract Purpose of Review The Hispanosphere is a vast region of the world that has received little attention in the digital health literature. No study to date has examined the availability and quality of publicly available mobile applications (apps) for cigarette smoking cessation in this region. Three coders utilized the American Psychiatry Association (APA)’s Brief App Evaluation Model Screener (Brief-AEM Screener) to evaluate the quality of the label and public-facing screens of smoking cessation apps in Spanish. Availability of apps in the Hispanosphere was compared to availability of apps in the Anglosphere. Recent Findings We identified and reviewed 19 apps in Spanish in Google Play. The median score using the Brief-AEM Screener was 63 out of 100 suggesting generally acceptable app quality and features according to the quality standards for digital health tools proposed by the APA. However, we found (1) notable inaccurate and misleading labelling claims, (2) poor grammar or incomplete translations, and (3) a lack of cultural and linguistic adaptation to countries in the Hispanosphere. Our comparison of smoking cessation apps between the Hispanosphere and the Anglosphere suggested that there is a large digital equity gap between these two regions, with a four to sevenfold gap in app availability. Summary There is a relative shortage of quality and quantity of digital health apps for smoking cessation in the Hispanosphere. To ensure the cultural appropriateness of those digital interventions, it is essential that developers of digital health tools establish community partners in the region prior to developing apps for smoking cessation.

Mobile Apps for the Personal Safety of At-Risk Children and Youth: Scoping Review.

Personal safety is a widespread public health issue that affects people of all demographics. There is a growing interest in the use of mobile apps for enhancing personal safety, particularly for children and youth at risk, who are among the most vulnerable groups in society. This study aims to explore what is known about the use of mobile apps for personal safety among children and youth identified to be "at risk." A scoping review following published methodological guidelines was conducted. In total, 5 databases (Scopus, SocINDEX, PsycINFO, Compendex, and Inspec Archive) were searched for relevant scholarly articles published between January 2005 and October 2023. The gray literature was searched using Google and Google Scholar search engines. The results were reported using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. For summarizing the features and users' experiences of the apps, a published framework for evaluating the quality of mobile health apps for youth was used. A total of 1986 articles were identified, and 41 (2.1%) were included in the review. Nine personal safety apps were captured and categorized into 4 groups based on the goals of the apps, as follows: dating and sexual violence prevention (n=4, 44% of apps), bullying and school violence prevention (n=2, 22% of apps), self-harm and suicide prevention (n=2, 22% of apps), and homeless youth support (n=1, 11% of apps). Of the 41 articles, 25 (61%) provided data solely on app descriptions and features, while the remaining 16 (39%) articles provided data on app evaluations and descriptions. Outcomes focused on app engagement, users' experiences, and effectiveness. Four articles reported on app use, 3 (75%) of which reported relatively high app use. Data on users' experience were obtained from 13 studies. In general, participants found the app features to be easy to use and useful as educational resources and personal safety tools. Most of the views were positive. Negative perceptions included redundancy of app features and a lack of usefulness. Five apps were evaluated for effectiveness (n=2, 40% dating and sexual violence prevention; n=2, 40% self-harm and suicide prevention; and n=1, 20% bullying and school violence prevention) and were all associated with a statistically significant reduction (P=.001 to .048) in harm or risk to participants at the 95% CI. Although many personal safety apps are available, few studies have specifically evaluated those designed for youth. However, the evidence suggests that mobile safety apps generally appear to be beneficial for reducing harm to at-risk children and youth without any associated adverse events. Recommendations for future research have been made to strengthen the evidence and increase the availability of effective personal safety apps for children and youth.

MOBILE HEALTH: ECG MONITORING FOR ATRIAL FIBRILLATION DETECTION

This systematic review examines the use of mobile health (mHealth) technologies, such as smartphone apps and wearable devices, for detecting atrial fibrillation (AF). The review includes studies assessing the quality and performance of mobile apps and smartwatch algorithms, as well as the clinical validity of ECG measurement and photoplethysmography technology. Findings suggest diverse results, with some studies indicating promising sensitivity and specificity for AF detection. However, there is a need for further research to develop reliable algorithms for diagnosing and managing cardiovascular conditions using mHealth technologies.

Smartphone Apps for Pulmonary Hypertension: Systematic Search and Content Evaluation.

Pulmonary hypertension (PH) is a chronic and complex condition, requiring consistent management and education. The widespread use of smartphones has opened possibilities for mobile health apps to support both patients and health care professionals in monitoring and managing PH more effectively. This study aimed to identify and assess the quality of free smartphone apps for PH targeted at either patients or health care professionals. A systematic search was conducted on freely available apps for patients with PH and health care professionals, accessed from a Spanish IP address, on Android (Google Play) and iOS (App Store) platforms. Searches were performed in October 2022 and 2023. Apps were independently analyzed by two reviewers, focusing on general characteristics. Quality assessment was based on the Mobile Application Rating Scale (MARS) framework, and Mann-Whitney U tests compared mean MARS scores against specific variables. In the overall study, 21 apps were identified. In the 2022 search, 19 apps were listed (9 iOS, 7 Android, 3 available on both platforms). In the subsequent 2023 search, 16 apps were identified (6 Android, 7 iOS, 3 available on both platforms). Of those identified in 2022, 14 remained available in 2023, with only 7 updated since 2022. In addition, 12 apps targeted patients or the general population, while 9 targeted health care professionals; none involved patients in the development or design. Conversely, 13 apps involving health care professionals were identified. There were 10 apps that received pharmaceutical industry funding. The primary goal for 81% (17/21) of the apps was to disseminate general information about PH. The overall mean MARS quality was acceptable in 2022 and 2023, with mean ratings of 3.1 (SD 0.6) and 3.3 (SD 0.5), respectively. The functionality category achieved the highest scores in both years, indicating ease of use and intuitive navigation. In contrast, the subjective quality domain consistently received the lowest ratings in the MARS assessment across both years. None of the apps underwent clinical testing themselves; however, 2 incorporated tools or algorithms derived from trials. The overall quality of iOS apps statistically outperformed that of Android apps in both years (P<.05). Furthermore, the involvement of health care professionals in app development was associated with enhanced quality, a trend observed in both years (P=.003 for both years). This review of mobile health apps for PH reveals their emergent development stage, with generally acceptable quality but lacking refinement. It highlights the critical role of health care professionals in app development, as they contribute significantly to quality and reliability. Despite this, a notable stagnation in app quality and functionality improvement over 2 years points to a need for continuous innovation and clinical validation for effective clinical integration. This research advocates for future app developers to actively engage with health care professionals, integrate patient insights, and mandate rigorous clinical validation for PH management.

EvalDepApps: How to evaluate depression management based on evidence and end users

Abstract The use of apps is increasing in the field of mental health due to their ease of use and accessibility, although there is not enough evidence on their effectiveness and safety. EvalDepApps aims to develop an evaluation tool for depression management apps. A systematic review with meta-analysis (SRMA) was performed to evaluate the efficacy and safety of apps for depression, and to identify the evaluation criteria used. PRISMA methodology was followed. The MEDLINE, PsycINFO, and Embase databases were consulted. The risk of bias was assessed with the RoB2 scale. An online 2 rounds Delphi was carried out to prioritize the most relevant criteria identified. 44 people (26 professionals, 18 patients) were invited. They were asked to rate the importance of each criterion on a Likert scale (1 - 6). Those that obtained a high consensus were selected; those with a medium were submitted to the 2nd round. Empathization (6) and co-design (6) sessions were held with patients (23) and professionals (33) in Catalonia, the Canary Islands and Andalusia to identify what relevant aspects the tool should have. Twenty-nine studies were included in the SRMA (67% unclear bias), finding a significant effect of mHealth interventions in reducing depressive symptoms compared to non-active control (Hedges g = −0.62, 95% CI: −0.87 to − 0.37, I2 = 87%). In Round 1 of the Delphi (59% participation) 24 criteria obtained a high consensus, 20 a medium and 7 a low. In Round 2 (52% participation), 4 criteria reached high consensus. The empathy sessions showed that the actions most requested by patients were reduce anxiety, and information about their condition; for professionals, suicide prevention. Regarding co-design, it was proposed that the tool provide ranking of the apps, recommendation systems and a very visual format. The RSMA and Delphi guarantee that the tool will be based on scientific evidence and expert judgment, while empathization and co-design that it will fit with the needs of end users. Key messages • It is relevant to evaluate the quality of health apps, especially those addressed to vulnerable populations such as people with depression. • It is crucial that the development of evaluation tools for digital health interventions will be developed based on evidence-based but also includes end users.

WeCare – Mental healthcare for health professionals

Abstract Issue/Problem Health professionals face physical and mental stressors (risk factors) due to challenging working conditions. Description of the Problem Despite high levels of health literacy among healthcare workers, maintaining healthy habits is challenging due to variable shifts, including nights, high workloads, and intense emotional and mental demands. Adopting a healthier lifestyle requires personal changes that can be difficult to implement, particularly in nursing and caregiving. This is critical, as retaining and attracting new staff in these fields is essential for the healthcare sector. Results/Effects/Changes To address these challenges, it’s crucial to boost intrinsic motivation and provide healthcare workers with practical tools to support their well-being and encourage them to remain in the sector. The WeCare project offers a mobile app designed as a ‘pocket coach,’ accessible at any time. Healthcare professionals can use the app to assess their current mental well-being through self-evaluation. With built-in assessments and predefined thresholds, the app tracks stress levels and quality of life. Depending on the outcomes, users are automatically guided to appropriate information, gamified activities, and exercises tailored to their specific needs. The project, running from 2022 to 2024, is co-funded by the European Union’s Erasmus+ programme. Lessons The app is beta-tested during 2024 in five countries: Germany, Austria, Serbia, Poland, and Italy, with local language support. The test group will consist of healthcare professionals and related professions. The results, including user engagement and motivational factors are analyzed. As the project concludes in autumn, comprehensive recommendations and lessons learned will be compiled and presented at the European Public Health (EPH) Conference. This will also include sharing the app and its solution with the broader healthcare community. Key messages • The WeCare app supports healthcare workers’ mental health with a mobile “pocket coach” that provides personalized exercises. Through gamification, it promotes healthy habits and boosts job motivation. • It is critical to support healthcare workers, as retaining and attracting new persons is essential for the healthcare sector.

French Version of the User Mobile Application Rating Scale: Adaptation and Validation Study.

Managing noncommunicable diseases effectively requires continuous coordination and monitoring, often facilitated by eHealth technologies like mobile health (mHealth) apps. The end-user version of the Mobile Application Rating Scale is a valuable tool for assessing the quality of mHealth apps from the user perspective. However, the absence of a French version restricts its use in French-speaking countries, where the evaluation and regulation of mHealth apps are still lacking, despite the increasing number of apps and their strong relevance in health care. This study aims to translate and culturally adapt a French version of the user Mobile Application Rating Scale (uMARS-F) and to test its overall and internal reliability. Cross-cultural adaptation and translation followed the universalist approach. The uMARS-F was evaluated as part through a cohort study using the French mHealth app "MonSherpa" (Qare). Participants were French-speaking adults with Apple or Android phones, excluding those with difficulty understanding French, prior app use, or physical limitations. They assessed the app using the uMARS-F twice (T1 and T2) 1 week apart. Scores for each section and overall were assessed for normal distribution using the Shapiro-Wilk test and presented as mean (SD), and potential floor or ceiling effects were calculated accordingly. Overall reliability was evaluated using intraclass correlation coefficients and internal reliability using Cronbach α. Concordance between the 3 subscales (objective quality, subjective quality, and perceived impact), 4 sections, and 26 items at T1 and T2 was evaluated using the paired t test (2-tailed) and Pearson correlation. In total, 167 participants assessed the app at both T1 and T2 (100% compliance). Among them, 49.7% (n=83) were female, and 50.3% (n=84) were male, with a mean age of 43 (SD 16) years. The uMARS-F intraclass correlation coefficients were excellent for objective quality (0.959), excellent for subjective quality (0.993), and moderate for perceived impact (0.624). Cronbach α was good for objective quality (0.881), acceptable for subjective quality (0.701), and excellent for perceived impact (0.936). The paired t tests (2-tailed) demonstrated similar scores between the 2 assessments (P>.05), and the Pearson correlation coefficient indicated high consistency in each subscale, section, and item (r>0.76 and P<.001). The reliability and validity of the measures were similar to those found in the original English version as well as in the Spanish, Japanese, Italian, Greek, and Turkish versions that have already been translated and validated. The uMARS-F is a valid tool for end users to assess the quality of mHealth apps in French-speaking countries. The uMARS-F used in combination with the French version of the Mobile Application Rating Scale could enable health care professionals and public health authorities to identify reliable, high-quality, and valid apps for patients and should be part of French health care education programs.

Digital Storytelling for People With Cognitive Impairment Using Available Mobile Apps: Systematic Search in App Stores and Content Analysis.

Growing evidence suggests cognitive and social health benefits can be derived from digital storytelling for older adults with cognitive impairment. Digital storytelling apps offer the potential to serve as an on-demand, easy-to-access platform for enhancing cognitive abilities and promoting social well-being. Yet, despite the increasing quantity of such apps being available on the market, there is a gap in research investigating their quality. This app review aims to assess the digital storytelling apps available in the Chinese market and evaluate them in accordance with the Mobile Application Rating Scale (MARS). The goal was to identify key features and evaluate the overall quality in the context of cognitively impaired users. A systematic search was conducted in both the Google Play store (Google LLC) and iTunes store (Apple Inc), using English and Chinese keywords. Apps were chosen according to specific criteria that included features, including (but not limited to) memory capture, story saving, cue-based reminiscing, and the ability to share stories or memories with others. The MARS was used by 3 individual researchers to independently assess app quality across several domains, such as engagement, functionality, aesthetics, and information quality, for both Android and iOS apps. From an initial screening of 297 apps, only 9 (3%) met the criteria for detailed evaluation using MARS. The reviewed apps featured capture memory, save, reminisce, and share functions, which are critical in supporting cognitive functions and enhancing user engagement. The analysis revealed patterns in platform diversity and geographical distribution of developers, with apps available on both iOS and Android. Memoirs of Life and Memorize: Diaries, Memories, Notes, Ideas, Timelines, Categories (Fair Apps Mobile) had the highest mean MARS scores of 3.35, indicating strong engagement, functionality, and information quality, while the lowest score was 2.33. The overall mean score across all apps was only 3.03 (SD 0.60), highlighting significant variation, particularly in information quality. User feedback also showed considerable variability, ranging from 0 comments for apps such as Grand Storyteller (VarIT Inc) and PWI Storyteller (Project World Impact, LLC) to as many as 5361 comments for FamilySearch, which received extensive positive reviews. This wide range of user feedback underscores the importance of continuous improvement and user-centered design, particularly in enhancing information quality and content accuracy. The systematic search and evaluation highlight the diverse capabilities yet variable quality of digital storytelling apps available within the Chinese market, reflecting user experiences, satisfaction levels, and efficacy in supporting cognitively impaired users. While some apps excel in engagement and functionality, others need significant improvements in information quality and user interface design to better serve those with cognitive impairments. Future research is recommended to investigate regional limitations and features that would result in more inclusive and effective digital storytelling apps.

Nutrition-Related Mobile Apps in the Spanish App Stores: Quality and Content Analysis.

Mobile apps represent accessible and cost-effective tools to improve nutrition and prevent chronic diseases. However, most of these apps have been characterized as having limited functionality, raising concerns about their effectiveness, acceptability, and efficacy. The aims of the study were to assess the quality of popular nutrition-related app platforms in Spain and to describe their characteristics and functionalities. We screened apps providing information on dietary advice, food advice, and nutritional content in the Apple App Store and Google Play Store in Spain from March 2 to March 16, 2024. Apps with a star rating of ≥4 (of 5 stars), those available in Spanish, those that were free of charge, those last updated after January 2022, those with >500 reviews, and those with >500,000 downloads were included. The quality of apps was assessed using the user version of the Mobile App Rating Scale (uMARS). General characteristics and nutritional, health, and market-related functionalities of the nutrition-related apps were described. Correlations among total and uMARS sections, star ratings, and number of reviews and downloads were evaluated. Among the 1460 apps identified in the search, 42 apps met the criteria. The majority of these (n=20, 48%) aimed at recording and analyzing food intake, followed by those providing nutritional plans or diets (n=9, 21%), advising on healthy habits (n=7, 17%), and offering recipes (n=6, 14%). The most prevalent nutritional functionalities offered were recording and monitoring body measurements (n=30, 71%), food tracking (n=26, 62%), and dietary analysis (n=25, 60%), whereas nutrition education was less common (n=16, 38%). Among market-related functionalities, advertisements were the most common among the study apps (n=30, 71%), followed by the option of sharing on social media (n=29, 69%) and customizable reminders (n=26, 62%). Sharing the recorded information in the app with health professionals was infrequent (n=1, 2%). The mean (SD) total uMARS score (maximum 5 points) was 3.78 (0.35), while the mean (SD) uMARS scores for functionality, aesthetics, engagement, and information were 4.21 (0.38), 3.94 (0.54), 3.51 (0.46), and 3.48 (0.44), respectively. Lower mean scores were observed for the subjective quality (mean 2.65, SD 0.56) and perceived impact (mean 3.06, SD 0.67). Moderate to strong positive significant correlations were mostly observed between total uMARS and section-specific uMARS scores, while the correlations between the uMARS section scores were mostly moderate positive. Total uMARS scores were very weakly correlated with user rating, number of reviews, and number of downloads. The quality of popular nutrition-related app platforms in Spain was acceptable, with observed remarkable differences between sections. The majority of the apps were appealing due to their user-friendly interfaces. Only a few apps, however, provided dietary structure analysis or nutritional education. Further research is needed to assess the long-term impact of these apps on users.

Building High-Quality Android Apps with Android Vitals, Firebase Performance Monitoring and Android Studio App Quality Insights

Building High-Quality Android Apps with Android Vitals, Firebase Performance Monitoring and Android Studio App Quality Insights

Challenges and Alternatives to Evaluation Methods and Regulation Approaches for Medical Apps as Mobile Medical Devices: International and Multidisciplinary Focus Group Discussion.

The rapid proliferation of medical apps has transformed the health care landscape by giving patients and health care providers unprecedented access to personalized health information and services. However, concerns regarding the effectiveness and safety of medical apps have raised questions regarding the efficacy of randomized controlled trials (RCTs) in the evaluation of such apps and as a requirement for their regulation as mobile medical devices. This study aims to address this issue by investigating alternative methods, apart from RCTs, for evaluating and regulating medical apps. Using a qualitative approach, a focus group study with 46 international and multidisciplinary public health experts was conducted at the 17th World Congress on Public Health in May 2023 in Rome, Italy. The group was split into 3 subgroups to gather in-depth insights into alternative approaches for evaluating and regulating medical apps. We conducted a policy analysis on the current regulation of medical apps as mobile medical devices for the 4 most represented countries in the workshop: Italy, Germany, Canada, and Australia. We developed a logic model that combines the evaluation and regulation domains on the basis of these findings. The focus group discussions explored the strengths and limitations of the current evaluation and regulation methods and identified potential alternatives that could enhance the quality and safety of medical apps. Although RCTs were only explicitly mentioned in the German regulatory system as one of many options, an analysis of chosen evaluation methods for German apps on prescription pointed toward a "scientific reflex" where RCTs are always the chosen evaluation method. However, this method has substantial limitations when used to evaluate digital interventions such as medical apps. Comparable results were observed during the focus group discussions, where participants expressed similar experiences with their own evaluation approaches. In addition, the participants highlighted numerous alternatives to RCTs. These alternatives can be used at different points during the life cycle of a digital intervention to assess its efficacy and potential harm to users. It is crucial to recognize that unlike analog tools, digital interventions constantly evolve, posing challenges to inflexible evaluation methods such as RCTs. Potential risks include high dropout rates, decreased adherence, and nonsignificant results. However, existing regulations do not explicitly advocate for other evaluation methodologies. Our research highlighted the necessity of overcoming the gap between regulatory demands to demonstrate safety and efficacy of medical apps and evolving scientific practices, ensuring that digital health innovation is evaluated and regulated in a way that considers the unique characteristics of mobile medical devices.

Mobile health apps for cardiovascular risk assessment: a systematic review.

mHealth apps (MHA) are emerging as promising tools for cardiovascular risk assessment, but few meet the standards required for clinical use. We aim to evaluate the quality and functionality of mHealth apps for cardiovascular risk assessment by healthcare professionals. We conducted a systematic review of MHA for cardiovascular risk assessment in the Apple Store, Play Store, and Microsoft Store until August 2023. Our eligibility criteria were based on the 2021 European Society Cardiology Guidelines on Cardiovascular Disease Prevention in Clinical Practice, the Framingham Risk Score, and the Atherosclerotic Cardiovascular Disease score. Our protocol was drafted using the Preferred Reporting items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. To assess quality, we used the validated Mobile Apps Rating Scale (MARS) score, which includes 19 items across four objective scales (engagement, functionality, aesthetics, and information quality) and one additional subjective scale. For functionality evaluation, we used the IMS Institute for Healthcare Informatics functionality scale. We performed data synthesis by generating descriptive statistics. A total of 18 MHA were included in the review. The most common scores used were the Framingham score, ASCVD score, and Score 2. Only six apps achieved an overall score of 4 or greater in the MARS evaluation. The MHA with the highest MARS score was ESC CVD Risk Calculation (5 points), followed by ASCVD Risk Estimator Plus (4.9 points). In the IMS scale, four MHA had a high functionality score: ASCVD Risk Estimator Plus (5 points), ESC CVD Risk Calculation (5 points), MDCalc Medical Calculator (4 points), and Calculate by QsMD (4 points). A gap exists in the availability of high-quality MHA designed for healthcare professionals to facilitate shared decision-making in cardiovascular risk assessment. The International Prospective Register of Systematic Reviews, identifier CRD42023453807.

Analysis of cognitive behavioural therapy apps for generalised anxiety disorder: Evidence-based content and user experience

Mental illness substantially contributes to the global burden of disease, with anxiety high in prevalence. The increase of mobile technology, mental health apps have potential to lessen this burden. However, within apps, the use of evidence-based interventions, such as cognitive behavioural therapy (CBT) are limited. Regardless, many commercially available mental health apps are highly rated by users, highlighting the need to understand what makes mental health apps valuable to the user. The contribution of this study was to uncover apps that support generalised anxiety disorder (GAD) and worry with a CBT basis, explore app functionality, and user experience. Firstly, by identifying apps that support GAD and worry and included CBT. Secondly, by identifying and analysing therapeutic and engagement functions within the apps, and finally, by thematically analysing user reviews. Six apps were identified to support GAD and worry that purported to be CBT-based. However, CBT therapeutic features and engagement features were minimally present in the apps. User reviews yielded 112 comments about the apps and key themes were identified about the app users’ global experiences with the app, and about the combination of technological (e.g., useability, reliability) and therapeutic experiences (e.g., learning and using skills). Future development of quality apps to support GAD and worry must consider the empirical standing of both therapeutic and technology aspects, to provide efficacious and engaging interventions.

Assessment of Eye Care Apps for Children and Adolescents Based on the Mobile App Rating Scale: Content Analysis and Quality Assessment.

In China, the current situation of myopia among children and adolescents is very serious. Prevention and control of myopia are inhibited by the lack of medical resources and the low awareness about eye care. Nevertheless, mobile apps provide an effective means to solve these problems. Since the health app market in China is still immature, it has become particularly important to conduct a study to assess the quality of eye-care apps to facilitate the development of better eye-care service strategies. This study aimed to evaluate the quality, functionality, medical evidence, and professional background of eye-care apps targeting children and adolescents in the Chinese app stores. A systematic search on iOS and Android app stores was performed to identify eye-care apps for children and adolescents. The general characteristics, development context, and functional features of the apps were described. Quality assessment of the apps was completed by 2 independent researchers using the Mobile App Rating Scale. This study included 29 apps, of which 17 (59%) were developed by commercial organizations and 12 (41%) had a design with relevant scientific basis. The main built-in functions of these apps include self-testing (18/29, 62%), eye exercises (16/29, 55%), and eye-care education (16/29, 55%). The mean overall quality of eye-care apps was 3.49 (SD 0.33), with a score ranging from 2.89 to 4.39. The overall Mobile App Rating Scale score exhibited a significant positive correlation with the subscale scores (r=0.81-0.91; P<.001). In addition, although most apps provided basic eye-care features, there are some deficiencies. For example, only a few apps were developed with the participation of medical organizations or professional ophthalmologists, and most of the apps were updated infrequently, failing to provide the latest eye-care information and technology in a timely manner. In general, the quality of eye-care apps for children and teenagers in Chinese app stores is good. These apps fulfill users' needs for eye-care services to a certain extent, but they still suffer from insufficient medical background, low user engagement, and untimely updates. In order to further improve the effectiveness of eye-care apps, cooperation with medical institutions and professional ophthalmologists should be strengthened to enhance the scientific and authoritative nature of the apps. At the same time, interactive features and regular updates should be added to enhance user participation and the continuity of the apps. This study provides a reference for future development or improvement of eye-care apps, which can help promote myopia prevention and control.

A comprehensive evaluation of the service quality of Chinas medical APP based on mobile phones

In light of the rapid advancement of internet-based healthcare and the consequent transformation in medical consultation modalities, an increasing number of individuals, particularly the younger demographic, are opting to seek medical advice or assistance via mobile phones through various online medical platforms or applications. However, the wide range of medical apps with different operational models, varying levels of expertise among resident specialists, and inconsistent quality of medical guidance presents a significant challenge for users in discerning which apps provide accurate and reliable guidance. Consequently, this study aims to comprehensively evaluate the service quality of domestic medical apps from multiple channels and perspectives by utilizing case studies. Rooted in educational materials and diagnostic guidelines for relative diseases, evaluation criteria and a quantitative scoring system are established in this study. The findings are indicated in terms of the accuracy and professionalism of medical consultation services and user experience. This study also proposes that domestic mobile medical apps should enhance their diagnostic quality, expand physician resources, standardize management practices, and strengthen platform infrastructure while developing new functionalities to benefit patients.

Evaluating the Usability and Quality of a Clinical Mobile App for Assisting Physicians in Head Computed Tomography Scan Ordering: Mixed Methods Study.

Among the numerous factors contributing to health care providers' engagement with mobile apps, including user characteristics (eg, dexterity, anatomy, and attitude) and mobile features (eg, screen and button size), usability and quality of apps have been introduced as the most influential factors. This study aims to investigate the usability and quality of the Head Computed Tomography Scan Appropriateness Criteria (HAC) mobile app for physicians' computed tomography scan ordering. Our study design was primarily based on methodological triangulation by using mixed methods research involving quantitative and qualitative think-aloud usability testing, quantitative analysis of the Mobile Apps Rating Scale (MARS) for quality assessment, and debriefing across 3 phases. In total, 16 medical interns participated in quality assessment and testing usability characteristics, including efficiency, effectiveness, learnability, errors, and satisfaction with the HAC app. The efficiency and effectiveness of the HAC app were deemed satisfactory, with ratings of 97.8% and 96.9%, respectively. MARS assessment scale indicated the overall favorable quality score of the HAC app (82 out of 100). Scoring 4 MARS subscales, Information (73.37 out of 100) and Engagement (73.48 out of 100) had the lowest scores, while Aesthetics had the highest score (87.86 out of 100). Analysis of the items in each MARS subscale revealed that in the Engagement subscale, the lowest score of the HAC app was "customization" (63.6 out of 100). In the Functionality subscale, the HAC app's lowest value was "performance" (67.4 out of 100). Qualitative think-aloud usability testing of the HAC app found notable usability issues grouped into 8 main categories: lack of finger-friendly touch targets, poor search capabilities, input problems, inefficient data presentation and information control, unclear control and confirmation, lack of predictive capabilities, poor assistance and support, and unclear navigation logic. Evaluating the quality and usability of mobile apps using a mixed methods approach provides valuable information about their functionality and disadvantages. It is highly recommended to embrace a more holistic and mixed methods strategy when evaluating mobile apps, because results from a single method imperfectly reflect trustworthy and reliable information regarding the usability and quality of apps.

Content, Behaviour Change Techniques, and Quality of Postpartum Depression Apps to Be Recommended by Midwives: Systematic Search and Evaluation.

Postpartum depression is a public health problem that affects a considerable percentage of women. Despite the proliferation of related apps, there are limited data available on the best apps to prevent postpartum depression. We identified which apps available in Spanish could be recommended by midwives based on their content, quality, and behaviour change techniques, as a complementary tool for preventing postpartum depression in women. A systematic search was performed to identify apps available on iOS App Store and Google Play, which were used to replicate how patients' access "postpartum depression prevention" apps. Apps' quality, behaviour change potential, and contents were assessed. A total of 1408 apps were identified, of which 7 were retrieved for assessment (0.5%). The mean objective and subject quality were 3.1 (SD = 1.01) and 2.7 (SD = 1.27), respectively. A total of 24 topics were identified. The mean ABACUS score was 6.6 (SD = 3.64), and the mean number of topics addressed by the apps was 9.9 (SD = 5.90). The results of the present study suggest that a specific free app is not available in Spanish for the prevention of postpartum depression, and only a small percentage of free apps should be recommended based on their quality, BCTs, and contents. The systematic review protocol was not registered.

Evaluation of the quality of oral hygiene mobile apps for children using the mobile app rating scale

BackgroundWith the increased use of smartphones, mobile applications (apps) aimed at promoting healthy behaviors have experienced exponential growth. ObjectivesThis study aimed to provide an overview of mobile apps that use gamification to motivate children to maintain optimal oral hygiene and to evaluate the quality of the oral hygiene apps for children (OHACs) available in the Turkish Google Play Store and the Apple Store. MethodsBetween January 20 and February 2, 2024, OHACs were searched in the Turkish Google Play Store and the Apple Store. Seven apps were assessed using the Mobile Application Rating Scale (MARS) and evidence-based dentistry criteria (EBD). We used Microsoft Office Professional 2016 (Microsoft Excel 2016; Microsoft Corp, Redmond, WA, USA) and IBM SPSS Statistics version 29 for Windows (IBM Corp, Armonk, NY, USA) for all the data analyses and visualizations. ResultsThe best overall MARS scores were obtained for Diş Doktoru: Dentist (3.53 ± 0.15) and Diş Hekimi Oyunları: Dentist Game (3.72 ± 0.33). The worst overall MARS scores were obtained for Truthbrush (2.76 ± 0.06) and Mimizaur (2.85 ± 0.09). Hayvan Diş Hekimi: Animal Dentist, Diş Hekimi Oyunları, and the Brush Teeth Game: Kids Dentist included the most evidence-based content. ConclusionMost OHACs achieved moderate MARS scores for promoting oral hygiene habits among children. Improving the quality and educational content of OHACs could increase personal oral care motivation in children. More research is required to determine the long-term effects of the apps and whether they align with oral hygiene guidance.

Evaluating the Impact of App Quality, Product Attributes, and Customer Relationships on Hotel-Booking App Purchases: Insights from Malaysian Users

Traditional hotel bookings have declined due to changes in travel patterns and evolving consumer preferences. Understanding factors driving the surge in booking-app usage is crucial for hotel businesses to adapt and capitalise on the growing demand for digital booking platforms. This study investigates the factors influencing consumer purchase decisions on these apps, utilising an online questionnaire as a primary method of data collection, which conveniently inviting Malaysian hotel-app users to respond. The findings indicate that app quality, product-related attributes, and customer relationships significantly impact customer purchase decisions. Inferentially, Consumer-Relationship Factor (CRF) shows a medium, positive correlation, indicating that Malaysians highly value customer relationships and past experiences within the app, which have significantly impacted their purchase decisions. Simultaneously, this study also indicates a strong influence of customer relationships on hotel-booking app usage. Hence, the study may suggest that hotel operators enhance customer relationships by conducting satisfaction surveys, providing employee training, and utilising customer-relationship management tools to foster business growth. This is because prioritising customer relationships can lead to increased loyalty, repeat business, and positive reviews, which contribute to success in the hospitality industry.

Development of comprehensive sexual education applications to improve adolescent reproductive health

Background: Adolescence is a period of emotional, mental, and physical change. To improve health-seeking behavior, reduce risky sexual behaviors, and increase knowledge about sexual and reproductive health, adolescents need support and access to services. The increasing availability of mobile apps requires a thorough evaluation of the quality and classification of these mobile apps so that accurate and evidence-based information can reach their users. Because smartphones are a private (intimate) technology, they are a promising means of closing this gap. However, research focusing on sexual health promotion programs delivered through smartphones is still rare.Purposes: Developing and testing a smartphone and internet-based comprehensive sex education app.Methods: This study employed Research and Development consisting of 4 stages, namely Literature Study, Development Stage, Validity Expert, and Trial.Result: The SEMAR app has seven features, ranging from mental health education to human relationships. The convenience score is 70%. The results of the trial show that this application effectively improves health education. 50-83% agree to use it. The sex stigma variable has the most extensive r (r=0.955), which means it has a solid and positive relationship.Conclusion: This application benefits adolescents in improving health education and adolescent reproductive health.