scholarly journals A content analysis of the quality and behaviour change techniques of smartphone apps promoting the Mediterranean diet

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Daniel McAleese ◽  
Angeliki Papadaki
Keyword(s):  
Content Analysis ◽  
Mediterranean Diet ◽  
Behaviour Change ◽  
Rating Scale ◽  
Mobile App ◽  
Subjective Quality ◽  
Behaviour Change Techniques ◽  
Smartphone Apps ◽  
The Mediterranean

AbstractThe popularity of smartphone apps is rising globally. However, the quality of widely available health apps and their effectiveness to promote behaviour change, by incorporating behavioural change techniques (BCTs) that have been suggested to result in behaviour change, is questionable. The aim of this study was to conduct a content analysis of smartphone apps that utilise the Mediterranean diet (MD), a dietary pattern linked to numerous health benefits, to promote healthy dietary behaviours. The specific objectives were to evaluate the quality of these apps and their use of BCTs. The iTunes Store and Google Play were searched for all available apps (free and requiring payment to download) promoting the MD. Apps were excluded if they were not available in English, did not focus only on the MD or the download process was corrupt. The Mobile App Rating Scale (MARS) was used to assess app engagement, functionality, aesthetics and information quality (the average of which represents a quality mean score (QMS)) and subjective quality. The Abraham & Michie behaviour change taxonomy was adapted to create a 20-item checklist to assess the presence of BCTs in the eligible apps. Thirty nine apps (64.1% of which were free to download) were analysed. The overall QMS was 2.96 ± 0.46. The lowest and highest scored QMS constructs were engagement (2.42 ± 0.62) and functionality (3.95 ± 0.45), respectively, whilst the overall mean subjective quality score was 1.71 ± 0.51 (scores’ range 1–5). Apps were scored higher for aesthetics if they required payment (3.14 vs. 2.78, p = 0.047). Apps incorporated an average of 3.10 ± 1.87 BCTs, with no difference in the number of BCTs present according to platform or cost. From the five BCTs that have been suggested to promote behaviour change, ‘self-monitoring’ was present in six apps, ‘intention formation’ in 15 and ‘goal setting’ in one. None of the apps incorporated the ‘review of behavioural goals’ and ‘feedback on performance’ BCTs. The total QMS score was positively associated with the presence of BCTs (r = 0.409, p = 0.008). Based on the MARS assessment, apps promoting the MD that are available in the public domain were of moderate quality. In contrast, the low presence, particularly of efficacious, BCTs and low subjective quality scores suggest that apps are actually of poor quality and potentially not effective in promoting behaviour change towards an MD diet. These findings provide important insights for the future development of high-quality apps to promote the MD at population level.

scholarly journals Orthodontic apps: an assessment of quality (using the Mobile App Rating Scale (MARS)) and behaviour change techniques (BCTs)

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
N. R. Siddiqui ◽  
S. J. Hodges ◽  
M. O. Sharif
Keyword(s):  
Behaviour Change ◽  
Rating Scale ◽  
Mobile App ◽  
Behaviour Change Techniques ◽  
List Type ◽  
Behaviour Change Wheel ◽  
Current Availability ◽  
The Uk ◽  
Google Play

Abstract Background Apps have been shown to be an effective tool in changing patients’ behaviours in orthodontics and can be used to improve their compliance with treatment. The Behaviour Change Techniques (BCTs) and quality (using MARS) within these apps have previously not been published. Objectives To evaluate the quality of these apps aiming to change behaviour. To assess BCTs used in patient focused orthodontic apps. Methods The UK Google Play and Apple App Stores were searched to identify all orthodontic apps and 305 apps were identified. All 305 apps were assessed for the presence of BCTs using an accepted taxonomy of BCTs (Behaviour Change Wheel (BCW)), widely utilised in healthcare. Of those containing BCTs, the quality was assessed using the Mobile App Rating Scale (MARS), a validated and multi-dimensional tool which rates apps according to 19 objective criteria. Data collection was carried out by two calibrated, independent assessors and repeated after 6 weeks for 25% of the apps by both assessors. Results BCTs were found in 31 apps, although only 18 of them were analysed for quality and 13 apps were excluded. Six different BCTs were identified: these were most commonly ‘prompts/cues’, and ‘information about health consequences’. All apps were shown to be of moderate quality (range 3.1–3.7/5). Inter-rater and intra-rater reliability for BCT and quality assessment were excellent. Conclusions The current availability of orthodontic apps of sufficient quality to recommend to patients is very limited. There is therefore a need for high-quality orthodontic apps with appropriate BCTs to be created, which may be utilised to improve patients’ compliance with treatment.

Quality of a Supporting Mobile App for Rheumatic Patients: Assessment Using the User Version of the Mobile Application Scale (uMARS) and Associated Patient Characteristics (Preprint)

2021 ◽  
Author(s):  
Antonia Lambrecht ◽  
Nicolas Vuillerme ◽  
Christina Raab ◽  
David Simon ◽  
Eva-Maria Messner ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Psoriatic Arthritis ◽  
Rating Scale ◽  
End Users ◽  
Quality Score ◽  
Mobile App ◽  
Subjective Quality ◽  
Ehealth Literacy ◽  
Rheumatic Patients

BACKGROUND Mobile applications promise to improve current health care. A growing number app quality studies exist to help patients and physicians choose appropriate, helpful and useful applications. However, current mobile app quality ratings are mostly physician-based. They exclude patients although as end-users, patients are able to provide the most relevant feedback. In a recent physician-based review of rheumatic apps, Rheuma Auszeit received the best overall rating (4.2/5), however this app has never been systematically evaluated by the intended end-users, rheumatic patients. OBJECTIVE The aim of this study was (1) to assess the quality of Rheuma Auszeit by rheumatic patients and (2) to evaluate the association between uMARS (User Version of the Mobile App Rating Scale) scores and patients’ characteristics. METHODS Consecutive patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis were seen at the rheumatology clinic at university hospital Erlangen, Germany. They were asked to evaluate the app Rheuma Auszeit using the uMARS and to complete a paper-based survey evaluating the individual preferences, attitudes and ehealth literacy. uMARS assesses the dimensions of engagement, functionality, aesthetics, information, and subjective quality on 5-point scales. The association between uMARS scores and patients’ characteristics was further explored. RESULTS Between December 2018 and January 2019, a total of 126 patients evaluated Rheuma Auszeit using uMARS and filled out the paper-based survey. The median uMARS score was 3.9, IQR 0.7. Functionality was the domain with the highest rating (median 4.8, IQR 0.8), followed by aesthetics (median 4.0, IQR 0.7), information (median 3.5, IQR 0.8), and engagement (median 3.2, IQR 1.0). Subjective quality was average (median 3.0, IQR 1.0). The lowest scoring individual item was customization with a median of 2.5/5. Lower functionality scores were reported among older female rheumatic patients (P<.004). Older male rheumatic patients reported a higher subjective quality score (P<.024). Perceived disease activity and disease duration did not significantly correlate with any uMARS subdomain scores. eHealth literacy significantly correlated with functionality uMARS subdomain ratings (Rho=0.18; P<.042). Preferred time of app usage significantly correlated with engagement (Rho=0.20; P<.024), functionality (Rho=0.19; P<.029), total uMARS score (Rho=0.21; P<.017) and subjective quality score (Rho=0.21; P<.017). The vast majority of rheumatic patients would consider recommending Rheuma Auszeit to other patients (117/126; 92.9%). CONCLUSIONS Rheuma Auszeit was well accepted by patients suffering from rheumatoid arthritis, psoriatic arthritis and ankylosing spondyloarthritis. Lacking customization could lead to low app compliance and should be improved. The study highlights the potential and feasibility of therapeutic complementary digital solutions in rheumatology.

scholarly journals Can existing mobile apps support healthier food purchasing behaviour? Content analysis of nutrition content, behaviour change theory and user quality integration

2017 ◽  
Vol 21 (2) ◽  
pp. 288-298 ◽  
Author(s):  
Sarah-Jane Flaherty ◽  
Mary McCarthy ◽  
Alan Collins ◽  
Fionnuala McAuliffe
Keyword(s):  
Behaviour Change ◽  
Mobile Apps ◽  
Change Theory ◽  
Mobile App ◽  
Behaviour Change Techniques ◽  
Food Purchasing ◽  
Behaviour Change Theory ◽  
User Acceptability ◽  
Purchasing Behaviour

AbstractObjectiveTo assess the quality of nutrition content and the integration of user quality components and behaviour change theory relevant to food purchasing behaviour in a sample of existing mobile apps.DesignDescriptive comparative analysis of eleven mobile apps comprising an assessment of their alignment with existing evidence on nutrition, behaviour change and user quality, and their potential ability to support healthier food purchasing behaviour.SettingMobile apps freely available for public use in GoogePlay were assessed and scored according to agreed criteria to assess nutrition content quality and integration of behaviour change theory and user quality components.SubjectsA sample of eleven mobile apps that met predefined inclusion criteria to ensure relevance and good quality.ResultsThe quality of the nutrition content varied. Improvements to the accuracy and appropriateness of nutrition content are needed to ensure mobile apps support a healthy behaviour change process and are accessible to a wider population. There appears to be a narrow focus towards behaviour change with an overemphasis on behavioural outcomes and a small number of behaviour change techniques, which may limit effectiveness. A significant effort from the user was required to use the mobile apps appropriately which may negatively influence user acceptability and subsequent utilisation.ConclusionsExisting mobile apps may offer a potentially effective approach to supporting healthier food purchasing behaviour but improvements in mobile app design are required to maximise their potential effectiveness. Engagement of mobile app users and nutrition professionals is recommended to support effective design.

scholarly journals Quality evaluation of smartphone applications for laboratory medicine

2018 ◽  
Vol 57 (3) ◽  
pp. 388-397 ◽  
Author(s):  
Snežana Jovičić ◽  
Joanna Siodmiak ◽  
Ian D. Watson
Keyword(s):  
Quality Evaluation ◽  
Rating Scale ◽  
Laboratory Medicine ◽  
Mobile App ◽  
Subjective Quality ◽  
Total Quality ◽  
Technical Aspects ◽  
Health Apps ◽  
Significant Difference

Abstract Background Many of the mobile applications (apps) used for delivering health interventions involve laboratory medicine data. This survey was conducted to search the online market for health apps that manage laboratory medicine data. The aim was to review them and perform a quality evaluation. Methods Apps search criteria were “Lab results blood work”, “Lab results”, and “Health apps”. After the stepwise exclusion process, 52 selected apps were downloaded and analyzed. For review and content analysis of the apps, a multidimensional tool for classifying and rating the quality of mobile health apps – Mobile App Rating Scale (MARS), was used. Results Selected apps were classified into five categories according to their intended use by patients or physicians, and the type of data engaged. Spearman’s correlation analysis found significant correlations between MARS individual scoring items, as with the subjective quality and number of technical aspects. Kruskal-Wallis analysis showed a significant difference in the number of technical aspects employed, MARS engagement and informational quality score items, total score, and subjective quality. The lowest values for all of these items were in the category of apps designed for patients, and the post hoc test showed that the difference was statistically significant between this and the values in all other categories. Conclusions Apps designed for patients, are of the poorest quality, considering the total quality of the content and information they provide, estimated using the MARS tool. This estimation needs to be validated for laboratory medicine apps, and eventually modified after consideration of specific quality benchmarks.

scholarly journals Quality of a Supporting Mobile App for Rheumatic Patients: Patient-Based Assessment Using the User Version of the Mobile Application Scale (uMARS)

2021 ◽  
Vol 8 ◽  
Author(s):  
Antonia Lambrecht ◽  
Nicolas Vuillerme ◽  
Christina Raab ◽  
David Simon ◽  
Eva-Maria Messner ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Psoriatic Arthritis ◽  
Rating Scale ◽  
Quality Score ◽  
Mobile App ◽  
Subjective Quality ◽  
University Hospital ◽  
Ehealth Literacy ◽  
Rheumatic Patients

Introduction: Mobile applications promise to improve current health care. However, current mobile app quality ratings are mostly physician-based. The aim of this study was (1) to assess the quality of the self-management app Rheuma Auszeit using the validated uMARS (User Version of the Mobile App Rating Scale) app quality assessment tool and (2) to evaluate the association between uMARS scores and patients' characteristics.Materials and Methods: Consecutive patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis were seen at the rheumatology clinic at university hospital Erlangen, Germany. They were asked to test Rheuma Auszeit, evaluate its quality using uMARS and complete a paper-based survey evaluating the individual preferences, attitudes and ehealth literacy. The association between uMARS scores and patients' characteristics was further explored.Results: Between December 2018 and January 2019, a total of 126 patients evaluated Rheuma Auszeit using uMARS and filled out the paper-based survey. The median uMARS score was 3.9, IQR 0.7. Functionality was the domain with the highest rating (median 4.8, IQR 0.8), followed by aesthetics (median 4.0, IQR 0.7), information (median 3.5, IQR 0.8), and engagement (median 3.2, IQR 1.0). Subjective quality was average (median 3.0, IQR 1.0). The lowest scoring individual item was customization with a median of 2.5/5. Lower functionality scores were reported among older female rheumatic patients (P &lt; 0.004). Older male rheumatic patients reported a higher subjective quality score (P &lt; 0.024). Perceived disease activity and disease duration did not significantly correlate with any uMARS subdomain scores. eHealth literacy significantly correlated with functionality uMARS subdomain ratings (Rho = 0.18; P &lt; 0.042). Preferred time of app usage significantly correlated with engagement (Rho = 0.20; P &lt; 0.024), functionality (Rho = 0.19; P &lt; 0.029), total uMARS score (Rho = 0.21; P &lt; 0.017) and subjective quality score (Rho = 0.21; P &lt; 0.017). The vast majority of rheumatic patients would consider recommending Rheuma Auszeit to other patients (117/126; 92.9%).Conclusion: Rheuma Auszeit was well-accepted by German patients suffering from rheumatoid arthritis, psoriatic arthritis and ankylosing spondyloarthritis. Lacking customization could lead to low app compliance and should be improved. Lower functionality scores among older female rheumatic patients highlight the need for patient education. The study underlines the potential and feasibility of therapeutic complementary digital solutions in rheumatology.

scholarly journals Content and Quality of Infant Feeding Smartphone Apps: Five-Year Update on a Systematic Search and Evaluation

10.2196/17300 ◽  
2020 ◽  
Vol 8 (5) ◽  
pp. e17300 ◽  
Author(s):  
Heilok Cheng ◽  
Alison Tutt ◽  
Catherine Llewellyn ◽  
Donna Size ◽  
Jennifer Jones ◽  
...  
Keyword(s):  
Health Care ◽  
Health Information ◽  
Infant Feeding ◽  
Rating Scale ◽  
Mobile App ◽  
Formula Feeding ◽  
Evidence Based ◽  
Smartphone Apps ◽  
Low Coverage

Background Parents use apps to access information on child health, but there are no standards for providing evidence-based advice, support, and information. Well-developed apps that promote appropriate infant feeding and play can support healthy growth and development. A 2015 systematic assessment of smartphone apps in Australia about infant feeding and play found that most apps had minimal information, with poor readability and app quality. Objective This study aimed to systematically evaluate the information and quality of smartphone apps providing information on breastfeeding, formula feeding, introducing solids, or infant play for consumers. Methods The Google Play store and Apple App Store were searched for free and paid Android and iPhone Operating System (iOS) apps using keywords for infant feeding, breastfeeding, formula feeding, and tummy time. The apps were evaluated between September 2018 and January 2019 for information content based on Australian guidelines, app quality using the 5-point Mobile App Rating Scale, readability, and suitability of health information. Results A total of 2196 unique apps were found and screened. Overall, 47 apps were evaluated, totaling 59 evaluations for apps across both the Android and iOS platforms. In all, 11 apps had affiliations to universities and health services as app developers, writers, or editors. Furthermore, 33 apps were commercially developed. The information contained within the apps was poor: 64% (38/59) of the evaluations found no or low coverage of information found in the Australian guidelines on infant feeding and activity, and 53% (31/59) of the evaluations found incomplete or incorrect information with regard to the depth of information provided. Subjective app assessment by health care practitioners on whether they would use, purchase, or recommend the app ranged from poor to acceptable (median 2.50). Objective assessment of the apps’ engagement, functionality, aesthetics, and information was scored as acceptable (median 3.63). The median readability score for the apps was at the American Grade 8 reading level. The suitability of health information was rated superior or adequate for content, reading demand, layout, and interaction with the readers. Conclusions The quality of smartphone apps on infant feeding and activity was moderate based on the objective measurements of engagement, functionality, aesthetics, and information from a reliable source. The overall quality of information on infant feeding and activity was poor, indicated by low coverage of topics and incomplete or partially complete information. The key areas for improvement involved providing evidence-based information consistent with the Australian National Health and Medical Research Council’s Infant Feeding Guidelines. Apps supported and developed by health care professionals with adequate health service funding can ensure that parents are provided with credible and reliable resources.

scholarly journals Content and Quality of Infant Feeding Smartphone Apps: Five-Year Update on a Systematic Search and Evaluation (Preprint)

2019 ◽  
Author(s):  
Heilok Cheng ◽  
Alison Tutt ◽  
Catherine Llewellyn ◽  
Donna Size ◽  
Jennifer Jones ◽  
...  
Keyword(s):  
Health Care ◽  
Health Information ◽  
Infant Feeding ◽  
Rating Scale ◽  
Mobile App ◽  
Formula Feeding ◽  
Evidence Based ◽  
Smartphone Apps ◽  
Low Coverage

BACKGROUND Parents use apps to access information on child health, but there are no standards for providing evidence-based advice, support, and information. Well-developed apps that promote appropriate infant feeding and play can support healthy growth and development. A 2015 systematic assessment of smartphone apps in Australia about infant feeding and play found that most apps had minimal information, with poor readability and app quality. OBJECTIVE This study aimed to systematically evaluate the information and quality of smartphone apps providing information on breastfeeding, formula feeding, introducing solids, or infant play for consumers. METHODS The Google Play store and Apple App Store were searched for free and paid Android and iPhone Operating System (iOS) apps using keywords for infant feeding, breastfeeding, formula feeding, and tummy time. The apps were evaluated between September 2018 and January 2019 for information content based on Australian guidelines, app quality using the 5-point Mobile App Rating Scale, readability, and suitability of health information. RESULTS A total of 2196 unique apps were found and screened. Overall, 47 apps were evaluated, totaling 59 evaluations for apps across both the Android and iOS platforms. In all, 11 apps had affiliations to universities and health services as app developers, writers, or editors. Furthermore, 33 apps were commercially developed. The information contained within the apps was poor: 64% (38/59) of the evaluations found no or low coverage of information found in the Australian guidelines on infant feeding and activity, and 53% (31/59) of the evaluations found incomplete or incorrect information with regard to the depth of information provided. Subjective app assessment by health care practitioners on whether they would use, purchase, or recommend the app ranged from poor to acceptable (median 2.50). Objective assessment of the apps’ engagement, functionality, aesthetics, and information was scored as acceptable (median 3.63). The median readability score for the apps was at the American Grade 8 reading level. The suitability of health information was rated superior or adequate for content, reading demand, layout, and interaction with the readers. CONCLUSIONS The quality of smartphone apps on infant feeding and activity was moderate based on the objective measurements of engagement, functionality, aesthetics, and information from a reliable source. The overall quality of information on infant feeding and activity was poor, indicated by low coverage of topics and incomplete or partially complete information. The key areas for improvement involved providing evidence-based information consistent with the Australian National Health and Medical Research Council’s Infant Feeding Guidelines. Apps supported and developed by health care professionals with adequate health service funding can ensure that parents are provided with credible and reliable resources.

scholarly journals Measuring the Quality of Mobile Apps for the Management of Pain: Systematic Search and Evaluation Using the Mobile App Rating Scale (Preprint)

2018 ◽  
Author(s):  
Alejandro Salazar ◽  
Helena de Sola ◽  
Inmaculada Failde ◽  
Jose Antonio Moral-Munoz
Keyword(s):  
New Technologies ◽  
Rating Scale ◽  
Mobile Apps ◽  
Scientific Evidence ◽  
Mobile App ◽  
Subjective Quality ◽  
Global Quality ◽  
Final Score ◽  
Biopsychosocial Model Of Pain

BACKGROUND Chronic pain is a major health issue requiring an approach that not only considers medication, but also many other factors included in the biopsychosocial model of pain. New technologies, such as mobile apps, are tools to address these factors, although in many cases they lack proven quality or are not based on scientific evidence, so it is necessary to review and measure their quality. OBJECTIVE The aim is to evaluate and measure the quality of mobile apps for the management of pain using the Mobile App Rating Scale (MARS). METHODS This study included 18 pain-related mobile apps from the App Store and Play Store. The MARS was administered to measure their quality. We list the scores (of each section and the final score) of every app and we report the mean score (and standard deviation) for an overall vision of the quality of the pain-related apps. We compare the section scores between the groups defined according to the tertiles via analysis of variance (ANOVA) or Kruskal-Wallis test, depending on the normality of the distribution (Shapiro-Wilk test). RESULTS The global quality ranged from 1.74 (worst app) to 4.35 (best app). Overall, the 18 apps obtained a mean score of 3.17 (SD 0.75). The best-rated sections were functionality (mean 3.92, SD 0.72), esthetics (mean 3.29, SD 1.05), and engagement (mean 2.87, SD 1.14), whereas the worst rated were app specific (mean 2.48, SD 1.00), information (mean 2.52, SD 0.82), and app subjective quality (mean 2.68, SD 1.22). The main differences between tertiles were found on app subjective quality, engagement, esthetics, and app specific. CONCLUSIONS Current pain-related apps are of a certain quality mainly regarding their technical aspects, although they fail to offer information and have an impact on the user. Most apps are not based on scientific evidence, have not been rigorously tested, and the confidentiality of the information collected is not guaranteed. Future apps would need to improve these aspects and exploit the capabilities of current devices.

scholarly journals Content analysis of behavior change techniques in popular mobile apps for smoking cessation in France. (Preprint)

2020 ◽  
Author(s):  
Luz Bustamante ◽  
Cédric Gill Ménard ◽  
Sabrina Julien ◽  
Lucia Romo
Keyword(s):  
Smoking Cessation ◽  
Content Analysis ◽  
Rating Scale ◽  
Mobile Apps ◽  
Mobile App ◽  
Smoking Cessation Treatment ◽  
Content Quality ◽  
Cessation Treatment ◽  
General Quality

BACKGROUND The mobile app market differs from country to country, and to date no previous review of smoking cessation applications (apps) content quality has been conducted in France. OBJECTIVE The current review aims to examine the general quality of the most popular smoking cessation apps in France and also determine the degree to which apps adhere to established behavioral and cognitive techniques (BCT’s) proven effective in clinical practice. METHODS A systematic research of smoking cessation apps was conducted in both Google Play and Apple store in the French market. The general quality of popular apps was rated with the Mobile App Rating Scale (MARS) and the therapeutical quality was assessed with the ratio of adherence of the BCT taxonomy for smoking cessation treatment. RESULTS 14 mobile apps met all the inclusion criteria of the content analysis. The inter-rater reliability varies from “substantial’ (0,79) to “almost perfect” (0,9) for both measures. The mean MARS score was 3,5 out of 5 (median 3,1- IQR 1,3). Findings suggest that popular apps focused primary on the functionality dimension of the MARS scale (4.2 out of 5). The average number of BCT techniques was 22, with a huge difference between apps (min=4/max=38). At least half of the apps addressed motivation (63%) and advise on using behavioral skills in order to quit or stay nonsmoker (62%). However, only a handful of apps gathered important information (42%) in order to deliver proper advice regarding the use of approved medication or the implementation of the behavioral techniques (31%). The average MARS score was positively correlated with the price (r = .70, p = < .001), and with the number of BCT’s used (r = .66, p = < .005). User rating was not correlated with any quality scale. CONCLUSIONS Content quality of popular smoking cessation apps in France varied by app type and price. Most popular apps propose in general a good quality content but lack the implementation of evidence based BCT’s associated with effectiveness on smoking cessation treatment. Further research is needed to evaluate the improvement of the quality content of smoking cessation apps in France.

The quality and potential of Apps to promote behaviour change in patients with a chronic condition or multimorbidity: A systematic search in App Store and Google Play (Preprint)

2021 ◽  
Author(s):  
Alessio Bricca ◽  
Alessandro Pellegrini ◽  
Graziella Zangger ◽  
Jonas Ahler J ◽  
Madalina Jäger ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Rating Scale ◽  
Mobile App ◽  
Systematic Search ◽  
Chronic Obstructive ◽  
App Store ◽  
Google Play

BACKGROUND Mobile applications (Apps) offer an opportunity to improve the lifestyle of patients with chronic conditions or multimorbidity. However, for Apps to be recommended in clinical practice, their quality and potential for behaviour change are important. OBJECTIVE To investigate the quality and potential for behaviour change of health Apps for patients with a chronic condition or multimorbidity (defined as two or more chronic conditions). METHODS We followed the Cochrane Handbook guidelines to conduct and report this study. A systematic search of Apps available in English or Danish on App Store and Google Play for patients with one or more of the following common and disabling conditions: osteoarthritis, heart condition (heart failure and ischaemic heart disease), hypertension, type 2 diabetes mellitus, depression and chronic obstructive pulmonary disease was conducted. The search strategy combined keywords related to these conditions. One author screened the title and content of the identified apps. Subsequently, three authors independently downloaded the Apps in a smartphone and assessed the quality of the Apps and their potential for behaviour change using the Mobile App Rating Scale (MARS-21 items, score ranging 0-5, higher is better) and the App Behavior Change Scale (ABACUS-21 items, score ranging 0-21, higher is better), respectively. We included the five highest-rated and the five most downloaded apps but only assessed the quality and potential for behaviour change of the free content. RESULTS We screened 453 Apps and ultimately included 60. Most of the Apps were available in both the App Store and Google Play (58%). The overall average quality of the Apps was 3.48 (SD 0.28) on the MARS scale, and the overall potential for behaviour change was 8.07 (SD 2.30) on the ABACUS scale. Apps for depression and patients with multimorbidity tended to have higher overall MARS and ABACUS scores, respectively. The most common self-monitoring features presented in the Apps in support of behaviour change were physiological (e.g., blood pressure monitoring) in 64% of the Apps, weight/diet, or physical activity in 41% and 36%, respectively, and stress management in 37%. Only 14% of the Apps were completely free, while 86% had in-app-purchase for some content. CONCLUSIONS Apps for patients with a chronic condition or multimorbidity appear to be of acceptable quality but have a low-to-moderate potential for behaviour change. Our results provide a useful overview for patients and clinicians who would like to use Apps for managing chronic conditions and suggest the need to improve the Apps in terms of quality and potential for behaviour change. CLINICALTRIAL https://osf.io/nvhuy/

Sign in / Sign up

Export Citation Format

Share Document