scholarly journals Availability and quality of mobile health app privacy policies

2014 ◽  
Vol 22 (e1) ◽  
pp. e28-e33 ◽  
Author(s):  
Ali Sunyaev ◽  
Tobias Dehling ◽  
Patrick L Taylor ◽  
Kenneth D Mandl
Keyword(s):  
Mobile Health ◽  
Grade Level ◽  
Information Privacy ◽  
College Level ◽  
Privacy Policies ◽  
Informed Decisions ◽  
Reading Grade Level ◽  
Mhealth Apps

Abstract Mobile health (mHealth) customers shopping for applications (apps) should be aware of app privacy practices so they can make informed decisions about purchase and use. We sought to assess the availability, scope, and transparency of mHealth app privacy policies on iOS and Android. Over 35 000 mHealth apps are available for iOS and Android. Of the 600 most commonly used apps, only 183 (30.5%) had privacy policies. Average policy length was 1755 (SD 1301) words with a reading grade level of 16 (SD 2.9). Two thirds (66.1%) of privacy policies did not specifically address the app itself. Our findings show that currently mHealth developers often fail to provide app privacy policies. The privacy policies that are available do not make information privacy practices transparent to users, require college-level literacy, and are often not focused on the app itself. Further research is warranted to address why privacy policies are often absent, opaque, or irrelevant, and to find a remedy.

The Functionality, Quality and Consistency with International Guidelines of Asthma Mobile Health Applications: Protocol for a Systematic Review. (Preprint)

2021 ◽  
Author(s):  
Billy Robinson ◽  
Enying Gong ◽  
Brian Oldenburg ◽  
Katharine See
Keyword(s):  
Systematic Review ◽  
Mobile Health ◽  
Airflow Limitation ◽  
Significant Variable ◽  
Assessment Framework ◽  
Mobile Health Applications ◽  
Gina Guidelines ◽  
Mhealth Apps ◽  
Health Applications

BACKGROUND Asthma is a chronic respiratory disorder defined clinically as a combination of typical respiratory symptoms, and significant variable reversible airflow limitation. In addition to pharmacotherapy, a key aspect of asthma management is empowering patients to manage their condition and recognise and respond to asthma exacerbations. Mobile health applications (mHealth apps) represent a potential medium through which patients could improve the ability to self-manage their asthma. Few studies have conducted a systematic evaluation of both free and paid asthma mobile applications for the quality and functionality of the apps using a validated tool and to our knowledge none have systematically assessed these applications for the quality of information that they provide compared to available international best practice guidelines. This represents the first study that will undertake both of these evaluations for all available mHealth Apps in Australia targeted towards adult asthmatics. The Global Initiative for Asthma (GINA) guidelines represent a regularly updated guideline based on reviews of the available scientific literature by an international panel of experts. This review will examine the functionality and quality of available asthma mobile health applications and the consistency of these available applications with recommendations from the GINA guidelines. OBJECTIVE The objective of this study is to conduct a systematic review of adult-targeted asthma mobile health applications on the Australian market. As part of this review the potential for an mHealth app to improve asthma self-management and the overall quality of the application will be evaluated, using the Mobile App Rating Scale (MARS) framework, and the quality of the information within an app, using the current GINA guidelines as a reference, will be assessed. METHODS A methodological stepwise approach was taken in creating this review. First the most recent GINA guidelines were independently reviewed by two authors to identify key recommendations that could feasibly be incorporated into a mHealth app. These identified recommendations were then compared to a previously developed asthma application assessment framework. A modified assessment framework was created, ensuring all of these identified recommendations were included. Two popular App stores were then reviewed to identify potential mHealth Apps and then a screening process based on pre-defined inclusion and exclusion criteria occurred to establish what mHealth Apps would be evaluated. Application evaluation then occurred. Technical information was obtained from publicly available information on the application store or within the app itself. The next step was to perform an application quality assessment using the validated MARS framework to objectively determine the quality of the application. Application functionality was then assessed using the IMS Institute for Health Informatics Functionality Scoring system. Finally, the mHealth applications will be assessed using a checklist that we have developed based on what was identified from the international GINA guidelines. RESULTS To date, funding has been received for the project from the Respiratory Department at Northern Health, Victoria. Three reviewers have been recruited to systematically evaluate the applications. Results for this study are expected by the end of this year. CONCLUSIONS Nil as protocol CLINICALTRIAL PROSPERO 269894

scholarly journals Patient Self-Management of Asthma Using Mobile Health Applications: A Systematic Review of the Functionalities and Effects

2017 ◽  
Vol 08 (04) ◽  
pp. 1068-1081 ◽  
Author(s):  
Mehrdad Farzandipour ◽  
Ehsan Nabovati ◽  
Reihane Sharif ◽  
Marzieh Arani ◽  
Shima Anvari
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Mobile Health ◽  
Self Management ◽  
Cochrane Central Register ◽  
Patient Reported ◽  
Mobile Health Applications ◽  
Mhealth Apps ◽  
Health Applications

Objective The aim of this systematic review was to summarize the evidence regarding the effects of mobile health applications (mHealth apps) for self-management outcomes in patients with asthma and to assess the functionalities of effective interventions. Methods We systematically searched Medline, Scopus, and the Cochrane Central Register of Controlled Trials. We included English-language studies that evaluated the effects of smartphone or tablet computer apps on self-management outcomes in asthmatic patients. The characteristics of these studies, effects of interventions, and features of mHealth apps were extracted. Results A total of 10 studies met all the inclusion criteria. Outcomes that were assessed in the included studies were categorized into three groups (clinical, patient-reported, and economic). mHealth apps improved asthma control (five studies) and lung function (two studies) from the clinical outcomes. From the patient-reported outcomes, quality of life (three studies) was statistically significantly improved, while there was no significant impact on self-efficacy scores (two studies). Effects on economic outcomes were equivocal, so that the number of visits (in two studies) and admission and hospitalization-relevant outcomes (in one study) statistically significantly improved; and in four other studies, these outcomes did not improve significantly. mHealth apps features were categorized into seven categories (inform, instruct, record, display, guide, remind/alert, and communicate). Eight of the 10 mHealth apps included more than one functionality. Nearly all interventions had the functionality of recording user-entered data and half of them had the functionality of providing educational information and reminders to patients. Conclusion Multifunctional mHealth apps have good potential in the control of asthma and in improving the quality of life in such patients compared with traditional interventions. Further studies are needed to identify the effectiveness of these interventions on outcomes related to medication adherence and costs.

scholarly journals Content and Quality of Websites for Patients With Chronic Kidney Disease: An Environmental Scan

2019 ◽  
Vol 6 ◽  
pp. 205435811986309 ◽  
Author(s):  
Michelle Smekal ◽  
Sarah Gil ◽  
Maoliosa Donald ◽  
Heather Beanlands ◽  
Sharon Straus ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Grade Level ◽  
Information Needs ◽  
The United States ◽  
Self Management ◽  
Accessible Information ◽  
Reading Grade Level ◽  
The Mean

Background: Although numerous websites for patients with chronic kidney disease (CKD) are available, little is known about their content and quality. Objective: To evaluate the quality of CKD websites, and the degree to which they align with information needs identified by patients with CKD. Methods: We identified websites by entering “chronic kidney disease” in 3 search engines: Google.com (with regional variants for Australia, Canada, the United Kingdom, and the United States), Bing.com, and Yahoo.com. We included the first 50 unique English-language sites from each search. We evaluated website content using a 30-point scale comprising 8 priority content domains identified by patients with CKD ( understanding CKD, diet, symptoms, medications, mental/physical health, finances, travel, and work/school). We used standardized tools to evaluate usability, reliability, and readability (DISCERN, HONcode, LIDA, Reading Ease, and Reading Grade Level). Two reviewers independently conducted the search, screen, and evaluation. Results: Of the 2093 websites identified, 115 were included. Overall, sites covered a mean (SD) of 29% (17.8) of the CKD content areas. The proportion of sites covering content related to understanding CKD, symptoms, and diet was highest (97%, 80%, and 72%, respectively). The proportion of sites covering travel, finances, and work/school content was lowest (22%, 12%, and 12%, respectively). The mean (SD) scores for DISCERN, LIDA and HONcode were 68% (14.6), 71% (14.4), and 75% (17.2), respectively, considered above average for usability and reliability. The mean (SD) Reading Grade Level was 10.6 (2.8) and Reading Ease was 49.8 (14.4), suggesting poor readability. Conclusions: Although many CKD web sites were of reasonable quality, their readability was poor. Furthermore, most sites covered less than 30% of the content patients identified as important for CKD self-management. These results will inform content gaps in internet-accessible information on CKD self-management that should be addressed by future eHealth web-based tools.

Assessing the quality and readability of NHS urology webpages in England

2021 ◽  
pp. 205141582110119
Author(s):  
Celina J Pook ◽  
Kay Thomas ◽  
Matthew F Bultitude
Keyword(s):  
General Population ◽  
Grade Level ◽  
Specific Information ◽  
Level Of Evidence ◽  
Reading Grade Level ◽  
Ease Score ◽  
The Mean ◽  
Aid Decision ◽  
Standard Framework

Objective: To examine the readability of urology webpages to assess their suitability for the general population and their inclusivity for varied levels of health literacy. Methods: We accessed all urology department websites from NHS trusts in England. A standard framework was used to assess these for ease of navigation, availability and quality of urology-specific information. Text was analysed using Flesch–Kincaid Grade Level and Ease Score to measure readability. Results: From the 132 NHS trust websites investigated, 117 (88.6%) had a urology-specific webpage, a considerable increase from 98 trusts (68%) in 2010. However, a smaller proportion of websites explained their services and procedures, and only 23.9% explained common urological conditions. Websites still appeared outdated, 23.9% had spelling errors, and 75.2% made none or poor use of images. The mean reading grade level was 13.40, equivalent to a UK reading age above 18 years, and the mean reading ease score was 30.35, in the range of ‘difficult’ text. Conclusion: Our data suggest that urology-specific webpages are not providing useful content for patients and are too complex for the general population to understand. Improvement would allow patients to be able to utilise such resources to aid decision making and to navigate complex NHS pathways. Level of evidence: Not applicable

scholarly journals Assessment of the Fairness of Privacy Policies of Mobile Health Apps: Scale Development and Evaluation in Cancer Apps (Preprint)

2019 ◽  
Author(s):  
Jaime Benjumea ◽  
Jorge Ropero ◽  
Octavio Rivera-Romero ◽  
Enrique Dorronzoro-Zubiete ◽  
Alejandro Carrasco
Keyword(s):  
Mobile Health ◽  
Mobile Apps ◽  
Privacy Policies ◽  
Sensitive Data ◽  
General Data Protection Regulation ◽  
Android Apps ◽  
Mobile Health Apps ◽  
General Data ◽  
Adjusted Scores ◽  
Mhealth Apps

BACKGROUND Cancer patients are increasingly using mobile health (mHealth) apps to take control of their health. Many studies have explored their efficiency, content, usability, and adherence; however, these apps have created a new set of privacy challenges, as they store personal and sensitive data. OBJECTIVE The purpose of this study was to refine and evaluate a scale based on the General Data Protection Regulation and assess the fairness of privacy policies of mHealth apps. METHODS Based on the experience gained from our previous work, we redefined some of the items and scores of our privacy scale. Using the new version of our scale, we conducted a case study in which we analyzed the privacy policies of cancer Android apps. A systematic search of cancer mobile apps was performed in the Spanish version of the Google Play website. RESULTS The redefinition of certain items reduced discrepancies between reviewers. Thus, use of the scale was made easier, not only for the reviewers but also for any other potential users of our scale. Assessment of the privacy policies revealed that 29% (9/31) of the apps included in the study did not have a privacy policy, 32% (10/31) had a score over 50 out of a maximum of 100 points, and 39% (12/31) scored fewer than 50 points. CONCLUSIONS In this paper, we present a scale for the assessment of mHealth apps that is an improved version of our previous scale with adjusted scores. The results showed a lack of fairness in the mHealth app privacy policies that we examined, and the scale provides developers with a tool to evaluate their privacy policies.

The Functionality, Quality and Consistency with International Guidelines of Asthma Mobile Health Applications: Protocol for a Systematic Review. (Preprint)

2021 ◽  
Author(s):  
Billy Robinson ◽  
Enying Gong ◽  
Brian Oldenburg ◽  
Katharine See
Keyword(s):  
Systematic Review ◽  
Mobile Health ◽  
Best Practice ◽  
Self Management ◽  
Best Practice Guidelines ◽  
Mobile Health Applications ◽  
Gina Guidelines ◽  
Mhealth Apps ◽  
Health Applications

BACKGROUND Asthma is a chronic respiratory disorder which requires long-term pharmacotherapy and patient empowerment to manage their condition and recognise and respond to asthma exacerbations. Mobile health applications (mHealth apps) represent a potential medium through which patients could improve the ability to self-manage their asthma. Few studies have conducted a systematic evaluation of asthma mobile applications for the quality and functionality of the apps using a validated tool. None of these reviews have systematically assessed these applications for their content compared to available international best practice guidelines. OBJECTIVE The objective of this study is to conduct a systematic review of adult-targeted asthma mobile health applications. As part of this review the potential for an mHealth app to improve asthma self-management and the overall quality of the application will be evaluated, using the Mobile App Rating Scale (MARS) framework, and the quality of the information within an app, using the current Global Initiative for Asthma (GINA) guidelines as a reference, will be assessed. METHODS A methodological stepwise approach was taken in creating this review. First the most recent GINA guidelines were independently reviewed by two authors to identify key recommendations that could feasibly be incorporated into a mHealth app. A previously developed asthma assessment framework was identified and modified to suit our research and ensure all of these identified recommendations were included. Two popular App stores were then reviewed to identify potential mHealth Apps. These Apps were screened based on pre-defined inclusion and exclusion criteria. Suitable applications were then evaluated. Technical information was obtained from publicly available information. The next step was to perform an application quality assessment using the validated MARS framework to objectively determine the quality of the application. Application functionality was then assessed using the IMS Institute for Health Informatics Functionality Scoring system. Finally, the mHealth applications will be assessed using a checklist that we have developed. RESULTS To date, funding has been received for the project from the Respiratory Department at Northern Health, Victoria. Three reviewers have been recruited to systematically evaluate the applications. Results for this study are expected by the end of this year. CONCLUSIONS This review represents the first that we know of that will examine all mobile health applications available in Australia targeted to adult asthmatics for their functionality, quality and consistency with international best practice guidelines. Though the review will only be conducted on mHealth Apps available in Australia, many applications are available internationally and thus should be largely generalisable to other English-speaking regions and users. The results of this review will help to fill gaps in the literature and assist clinicians in providing evidence-based advice to adult patients wishing to use mHealth apps as part of their asthma self-management. CLINICALTRIAL PROSPERO 269894

Mobile Health Applications, Cancer Survivors and Lifestyle Modification: An Integrative Review (Preprint)

2019 ◽  
Author(s):  
Marjorie M. Kelley ◽  
Jennifer Kue ◽  
Lynne Brophy ◽  
Andrea L. Peabody ◽  
Randi E. Foraker ◽  
...  
Keyword(s):  
Behavior Change ◽  
Cancer Survivors ◽  
Mobile Health ◽  
Lifestyle Modification ◽  
Lifestyle Behaviors ◽  
Design Development ◽  
Lifestyle Behavior ◽  
Traditional Approaches ◽  
Mhealth Apps

BACKGROUND In 2016, there were 15.5 million cancer survivors in the United States. Survivors’ mortality and well-being are threatened by the risk of cancer recurrence and the prevalence of chronic diseases resulting from cancer treatments. Improving lifestyle behaviors attenuates these risks. Traditional approaches to lifestyle modification (i.e., counseling), are expensive, require significant human resources, and are difficult to scale. Mobile health (mHealth) interventions offer a novel alternative to traditional approaches. Although mHealth interventions are a relatively new phenomenon (c. 2010), their presence and use have increased exponentially in the last few years. However, to date, systematic reviews have failed to examine the use of mHealth interventions in lifestyle behavior change among cancer survivors. OBJECTIVE : The specific objectives of this integrative review were to (1) identify and synthesize the research in the use of mHealth apps for lifestyle behavior modification among cancer survivors; (2) critically appraise the scientific literature; (3) examine the use of theory in mHealth app design, development and testing; and (4) identify cancer survivors’ preferences in using mHealth apps for lifestyle behavior change. METHODS The review process was guided by Whittemore and Knafl’s framework and the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. We searched 8 databases and 3 journals for studies reported between January 1, 2007, and April 15, 2019, using concepts associated with mobile health, cancer, and lifestyle behaviors. The inclusion of studies and study quality were assessed by at least two research team members, using pre-established criteria and validated tools. We assessed theory use with a coding scheme developed by Michie and Prestwich. RESULTS Of the 1,351 manuscripts retrieved, 19 articles (17 studies) met eligibility requirements. Ten articles reported on the use of mHealth interventions while 9 described mHealth features and functions important to survivors. No RCTs were identified and only 2 quasi-experimental studies were included. Breast cancer survivors were over-represented in the studies as was the lifestyle behavior of physical activity (PA) (n=15). The 2 non-PA studies included in this review focused on stress. Survivors’ perceptions about using mHealth were synthesized into 6 common themes: App Functionality & Features, Social Relationships & Support, Provider Relationships, Support & Communications, Content, Acceptability, and Barriers to Use. The overall quality of the studies was low, except for 3 pilot studies (2 moderate, 1 strong). Only 1 study reported the use of theory in the design, development, or testing of the mHealth intervention. CONCLUSIONS Overall, the low-quality of studies included in this review validated a need for rigorous, theory-based pilot and efficacy studies before use of mHealth interventions can be safely and effectively recommended and used to improve lifestyle behaviors in cancer survivors.

scholarly journals Need for the Development of a Specific Regulatory Framework for Evaluation of Mobile Health Apps in Peru: Systematic Search on App Stores and Content Analysis

10.2196/16753 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e16753
Author(s):  
Leonardo Rojas Mezarina ◽  
Javier Silva-Valencia ◽  
Stefan Escobar-Agreda ◽  
Daniel Hector Espinoza Herrera ◽  
Miguel S Egoavil ◽  
...  
Keyword(s):  
Data Quality ◽  
Health Information ◽  
Mobile Health ◽  
Regulatory Framework ◽  
Security And Privacy ◽  
Government Agencies ◽  
Quality Of Information ◽  
The Creation ◽  
Mhealth Apps

Background In Peru, there is an increase in the creation of mobile health (mHealth) apps; however, this situation could present problems related to the quality of information these apps share, data security and privacy, usability, and effectiveness, as there is no specific local regulation about their creation and use. Objective The objective of this study was to review mHealth apps created, uploaded, or used in Peru, and perform an analysis of the national regulatory framework that could be applied to evaluate whether there is a need to develop and implement a specific regulation to these apps. Methods A total of 3 reviews were performed. First, we reviewed information about Peruvian mHealth apps created up to May 2019 from scientific publications, news, government communications, and virtual stores, and evaluated their purpose, creator, and the available evidence of their usability and effectiveness. The second review was carried out by taking a sample of the 10 most commonly used mHealth apps in Peru (regardless of the country of creation), to evaluate the information they collect and classify them according to the possible risks that they could present in terms of security and privacy. In addition, we evaluated whether they refer to or endorse the information they provided. Finally, in the third review, we searched for Peruvian standards related to electronic health (eHealth) that involve information technology that can be applied to regulate these apps. Results A total of 66 apps meeting our inclusion criteria were identified; of these, 47% (n=31) belonged to government agencies and 47% (n=31) were designed for administrative purposes (private and government agencies). There was no evidence about the usability or effectiveness of any of these apps. Concerning the 10 most commonly used mHealth apps in Peru, about the half of them gathered user information that could be leaked, changed, or lost, thus posing a great harm to their users or to their related patients. In addition, 6/10 (60%) of these apps did not mention the source of the information they provided. Among the Peruvian norms, the Law on the Protection of Personal Data, Law on Medical Devices, and administrative directives on standards and criteria for health information systems have some regulations that could be applied to these apps; however, these do not fully cover all aspects concerning the evaluation of security and privacy of data, quality of provided information, and evidence of an app’s usability and effectiveness. Conclusions Because many Peruvian mHealth apps have issues related to security and privacy of data, quality of information provided, and lack of available evidence of their usability and effectiveness, there is an urgent need to develop a regulatory framework based on existing medical device and health information system norms in order to promote the evaluation and regulation of all the aforesaid aspects, including the creation of a national repository for these apps that describes all these characteristics.

scholarly journals Evaluating the Quality and Readability of Online Resources for Covid-19 in Pregnancy: An Assessment of Web Based Information (Preprint)

2021 ◽  
Author(s):  
Thomas Owens ◽  
Catherine Ford ◽  
Lopa Pandya
Keyword(s):  
Grade Level ◽  
Interrater Reliability ◽  
Kappa Statistic ◽  
The Internet ◽  
Web Based ◽  
Grade Levels ◽  
Reading Grade Level ◽  
Website Content ◽  
In Pregnancy

BACKGROUND The internet is a source for inquiries and a way to distribute information. Pregnant women may look to the internet for information about COVID-19’s impact on pregnancy. As providers, it’s vital to provide patients with information that is both reliable and comprehendible. The purpose of this study is to evaluate the readability and quality of web-based information regarding Covid-19 in pregnancy. OBJECTIVE The primary aim of this study was to evaluate the quality, readability, and accuracy of web-based information regarding Covid-19 in pregnancy. METHODS The JAMA benchmark tool was used to evaluate the websites. Readability was assessed using Flesch-Kincaid reading ease and Flesch-Kincaid grade level. An interrater reliability analysis using the Kappa statistic was performed to determine consistency among raters. RESULTS The mean score using the JAMA tool was 3.53 (SD, 0.74). The majority of the websites came from news sites (37.8%). The median reading grade level was 11.9. The interrater reliability for the raters was found to be Kappa=0.363 (P<0.001). CONCLUSIONS Our study indicated that reliable information regarding Covid-19 in pregnancy was available online. An assessment of website content indicated that both grade levels and reading ease was higher than recommended. By guiding patients to reliable and accurate sources we can educate our patients while also guiding shared decision making.

Information Privacy

2011 ◽  
pp. 81-100
Author(s):  
Gerald C. Kane ◽  
Kathy Stewart Schwaig ◽  
Veda C. Storey
Keyword(s):  
Private Information ◽  
Personal Information ◽  
Information Privacy ◽  
Privacy Policies ◽  
High Quality ◽  
Virtual Communication ◽  
Information Practices ◽  
Privacy Issues ◽  
Privacy Statements

The acquisition and use of personal information by large corporations continues to be a leading issue in the age of virtual communication and collaboration. This research reviews and analyzes the privacy policies of large US companies to evaluate the substance and quality of their stated information practices. Six factors are identified that indicate the extent to which a firm is dependent upon consumer personal information, and therefore, more likely to develop high quality privacy statements. The study’s findings provide practical and theoretical implications for information privacy issues, particularly for consumers who need to decide whether to disclose their personal identifying information to firms. The research also highlights the complexity and challenges of managing personal private information.

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