scholarly journals A systematic review of dialectical behavior therapy mobile apps for content and usability

Author(s):  
Chelsey R. Wilks ◽  
Kyrill Gurtovenko ◽  
Kevin Rebmann ◽  
James Williamson ◽  
Josh Lovell ◽  
...  

Abstract Background The gap between treatment need and treatment availability is particularly wide for individuals seeking Dialectical Behavior Therapy (DBT), and mobile apps based on DBT may be useful in increasing access to care and augmenting in-person DBT. This review examines DBT based apps, with a specific focus on content quality and usability. Methods All apps referring to DBT were identified in Google Play and iOS app stores and were systematically reviewed for app content and quality. The Mobile App Rating Scale (MARS) was used to evaluate app usability and engagement. Results A total of 21 free to download apps were identified. The majority of apps (71%) included a component of skills training, five apps included a diary card feature. Most (76.19%) apps were designed to function without help from a therapist. The average user “star” rating was 4.39 out of 5. The mean overall MARS score was 3.41, with a range of 2.15 to 4.59, and 71.43% were considered minimally ‘acceptable,’ as defined by a score of 3 or higher. The average star rating was correlated with the total MARS score (r = .51, p = .02). Estimates of app usage differed substantially between popular and unpopular apps, with the three most popular apps accounting for 89.3% of monthly active users. Conclusions While the present study identified many usable and engaging apps in app stores designed based on DBT, there are limited apps for clinicians. DBT based mobile apps should be carefully developed and clinically evaluated.

2021 ◽  
Author(s):  
Nicole E Werner ◽  
Janetta C Brown ◽  
Priya Loganathar ◽  
Richard J Holden

BACKGROUND The over 11 million care partners in the US who provide care to people living with Alzheimer’s disease and related dementias (ADRD) cite persistent and pervasive unmet needs related to all aspects of their caregiving role. The proliferation of mobile applications (apps) for care partners has potential to meet the care partners’ needs, but the quality of apps is unknown. OBJECTIVE The present study aimed to 1) evaluate the quality of publicly available apps for care partners of people living with ADRD and 2) identify design features of low- and high-quality apps to guide future research and app development. METHODS We searched the US Apple and Google Play app stores with the criteria that the app needed to be 1) available in US Google play or Apple app stores, 2) directly accessible to users “out of the box”, 3) primarily intended for use by an informal (family, friend) caregiver or caregivers of a person with dementia. The included apps were then evaluated using the Mobile App Rating Scale (MARS), which includes descriptive app classification and rating using 23 items across five dimensions: engagement, functionality, aesthetics, information, and subjective quality. Next, we computed descriptive statistics for each rating. To identify recommendations for future research and app development, we categorized rater comments on the score driving factors for each item and what the app could have done to improve the score for that item. RESULTS We evaluated 17 apps (41% iOS only, 12% Android only, 47% both iOS and Android). We found that on average, the apps are of minimally acceptable quality. Although we identified apps above and below minimally acceptable quality, many apps had broken features and were rated as below acceptable for engagement and information. CONCLUSIONS Minimally acceptable quality is likely insufficient to meet care partner needs. Future research should establish minimum quality standards across dimensions for mobile apps for care partners. The design features of high-quality apps we identified in this research can provide the foundation for benchmarking those standards.


10.2196/20009 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e20009
Author(s):  
Meredith C Meacham ◽  
Erin A Vogel ◽  
Johannes Thrul

Background In response to health concerns about vaping devices (eg, youth nicotine use, lung injury), Apple removed 181 previously approved vaping-related apps from the App Store in November 2019. This policy change may lessen youth exposure to content that glamorizes vaping; however, it may also block important sources of information and vaping device control for adults seeking to use vaping devices safely. Objective Understanding the types of nicotine and cannabis vaping–related apps still available in the competing Google Play Store can shed light on how digital apps may reflect information available to consumers. Methods In December 2019, we searched the Google Play Store for vaping-related apps using the keywords "vape" and "vaping" and reviewed the first 100 apps presented in the results. We reviewed app titles, descriptions, screenshots, and metadata to categorize the intended substance (nicotine or cannabis/tetrahydrocannabinol) and the app’s purpose. The most installed apps in each purpose category were downloaded and evaluated for quality and usability with the Mobile App Rating Scale. Results Of the first 100 apps, 79 were related to vaping. Of these 79 apps, 43 (54%) were specific to nicotine, 3 (4%) were specific to cannabis, 1 (1%) was intended for either, and for the remaining 31 (39%), the intended substance was unclear. The most common purposes of the apps were making do-it-yourself e-liquids (28/79, 35%) or coils (25/79, 32%), games/entertainment (19/79, 24%), social networking (16/79, 20%), and shopping for vaping products (15/79, 19%). Of the 79 apps, at least 4 apps (5%) paired with vaping devices to control temperature or dose settings, 8 apps (10%) claimed to help people quit smoking using vaping, and 2 apps (3%) had the goal of helping people quit vaping. Conclusions The majority of vaping-related apps in the Google Play Store had features either to help users continue vaping, such as information for modifying devices, or to maintain interest in vaping. Few apps were for controlling device settings or assisting with quitting smoking or vaping. Assuming that these Google Play Store apps were similar in content to the Apple App Store apps that were removed, it appears that Apple’s ban would have a minimal effect on people who vape with the intention of quitting smoking or who are seeking information about safer vaping via mobile apps.


10.2196/18858 ◽  
2020 ◽  
Vol 8 (10) ◽  
pp. e18858
Author(s):  
Atiyeh Vaezipour ◽  
Jessica Campbell ◽  
Deborah Theodoros ◽  
Trevor Russell

Background Worldwide, more than 75% of people with acquired brain injury (ABI) experience communication disorders. Communication disorders are impairments in the ability to communicate effectively, that is, sending, receiving, processing, and comprehending verbal and nonverbal concepts and symbols. Such disorders may have enduring impacts on employment, social participation, and quality of life. Technology-enabled interventions such as mobile apps have the potential to increase the reach of speech-language therapy to treat communication disorders. However, ensuring that apps are evidence-based and of high quality is critical for facilitating safe and effective treatment for adults with communication disorders. Objective The aim of this review is to identify mobile apps that are currently widely available to adults with communication disorders for speech-language therapy and to assess their content and quality using the validated Mobile App Rating Scale (MARS). Methods Google Play Store, Apple App Store, and webpages were searched to identify mobile apps for speech-language therapy. Apps were included in the review if they were designed for the treatment of adult communication disorders after ABI, were in English, and were either free or for purchase. Certified speech-language pathologists used the MARS to assess the quality of the apps. Results From a total of 2680 apps identified from Google Play Store, Apple App Store, and web searches, 2.61% (70/2680) apps met the eligibility criteria for inclusion. Overall, 61% (43/70) were available for download on the iPhone Operating System (iOS) platform, 20% (14/70) on the Android platform, and 19% (13/70) on both iOS and Android platforms. A content analysis of the apps revealed 43 apps for language, 17 apps for speech, 8 apps for cognitive communication, 6 apps for voice, and 5 apps for oromotor function or numeracy. The overall MARS mean score was 3.7 out of 5, SD 0.6, ranging between 2.1 and 4.5, with functionality being the highest-scored subscale (4.3, SD 0.6), followed by aesthetics (3.8, SD 0.8), information (3.4, SD 0.6), and engagement (3.3, SD 0.6). The top 5 apps were Naming Therapy (4.6/5), Speech Flipbook Standard (4.6/5), Number Therapy (4.5/5), Answering Therapy, and Constant Therapy (4.4/5). Conclusions To our knowledge, this is the first study to systematically identify and evaluate a broad range of mobile apps for speech-language therapy for adults with communication disorders after sustaining ABI. We found a lack of interactive and engaging elements in the apps, a critical factor in sustaining self-managed speech-language therapy. More evidence-based apps with a focus on human factors, user experience, and a patient-led design approach are required to enhance effectiveness and long-term use.


10.2196/23921 ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. e23921
Author(s):  
Lisa Furlong ◽  
Tanya Serry ◽  
Shane Erickson ◽  
Meg E Morris

Background The use of mobile apps to manage and promote health is becoming increasingly popular. Mobile apps are gaining popularity particularly in educational and interventional settings owing to their perceived advantages including support for and engagement of individuals with reading difficulties. In the context of COVID-19, the need for technology-based tools has increased. For practitioners and educators who wish to use apps in their practice or recommend apps to individuals with reading difficulties, it is challenging to identify high-quality apps in app stores. Objective This protocol describes a systematic search, selection, and appraisal process for tablet apps targeting phonics knowledge and phonological awareness skills. This protocol aimed to (1) provide a systematic method for identifying tablet apps targeting phonics knowledge and phonological awareness skills in the Google Play Store and Apple’s App Store and (2) describe an evidence-based approach for quality appraisal of these apps by using structured tools. Methods This protocol describes an evidence-based method guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework to systematically search, select, and appraise apps targeting phonics knowledge and phonological awareness skills, present in Google Play and the App Store. We intend to perform a systematic and comprehensive search and a 2-step process for screening: (1) broad screening (app titles) and (2) narrow screening (marketing descriptions). Quality appraisal of the included apps will involve two structured appraisal tools: (1) the Mobile Application Rating Scale and (2) the Appraising Apps for Reading Checklist. Results This method will help determine the number of apps targeting phonics knowledge and phonological awareness, present on the Android and iOS platforms. The content, quality, and usability of these apps will be determined using structured appraisal tools. We have planned to conduct searches on Google Play and the App Store in January-March 2021; broad and focused screening, from April 2021; and data extraction and quality appraisal in October 2021. Conclusions This protocol provides a basis for locating and evaluating apps targeting phonics knowledge and phonological awareness skills. This protocol will support practitioners, educators, and families to make informed decisions when purchasing apps for instructional use. International Registered Report Identifier (IRRID) PRR1-10.2196/23921


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
H Woo ◽  
G h Kim ◽  
Y w Kim

Abstract Background With the number of skin healthcare-related apps users increasing, the selection of high-quality apps is not a simple task. The aim of this study was to (1)describe the content of available skin healthcare apps, (2)evaluate their objective quality regarding engagement, functionality, aesthetics, information and subjective quality. Methods The App Store and Google Play store were systematically searched to identify skin healthcare mobile apps for general population use. Eligible apps were downloaded and independently evaluated for quality by 4 reviewers using the Mobile App Rating Scale(MARS). The MARS is the only currently available tool that provides a comprehensive, multidimensional evaluation of app quality. MARS assesses the dimensions of engagement, functionality, aesthetics, information, and subjective quality on 5-point scales. In addition, the correlation between MARS score and user score was analyzed. Results The overall 37 apps obtained a mean quality score of 2.77(SD.62). 'Trove skin(Android: 4.13)' received the highest score, while 'Complete Beauty Guides(Android: 1.8)' received the lowest score. User scores were found to have no significant correlation between overall quality scores through MARS and content scores(r= .240, p= .153)(r= .290, p= .081), the overall quality score through MARS and the Content Score were significant static correlation(r= .487, p= .002). Conclusions As the use, and introduction, of mobile apps continue to grow, it will become increasingly important for consumers to adopt high-quality apps. Understanding the effectiveness of high-quality apps compared with low-quality apps can make it easier and more accurate for consumers decisions about using related to skin healthcare apps. Furthermore, qualities of apps that ranked higher could be used to improve existing apps or help with the development of new ones. Key messages Consumers refer to the User Score when selecting skin healthcare-related apps. However, User Score was not correlated with MARS content quality assessment scores evaluated by experts. This study is a significant help that enables consumers to select good-quality skin healthcare apps by high-quality content information through MARS.


2020 ◽  
Author(s):  
Luz Bustamante ◽  
Cédric Gill Ménard ◽  
Sabrina Julien ◽  
Lucia Romo

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.


2020 ◽  
Author(s):  
Meredith C Meacham ◽  
Erin A Vogel ◽  
Johannes Thrul

BACKGROUND In response to health concerns about vaping devices (eg, youth nicotine use, lung injury), Apple removed 181 previously approved vaping-related apps from the App Store in November 2019. This policy change may lessen youth exposure to content that glamorizes vaping; however, it may also block important sources of information and vaping device control for adults seeking to use vaping devices safely. OBJECTIVE Understanding the types of nicotine and cannabis vaping–related apps still available in the competing Google Play Store can shed light on how digital apps may reflect information available to consumers. METHODS In December 2019, we searched the Google Play Store for vaping-related apps using the keywords "vape" and "vaping" and reviewed the first 100 apps presented in the results. We reviewed app titles, descriptions, screenshots, and metadata to categorize the intended substance (nicotine or cannabis/tetrahydrocannabinol) and the app’s purpose. The most installed apps in each purpose category were downloaded and evaluated for quality and usability with the Mobile App Rating Scale. RESULTS Of the first 100 apps, 79 were related to vaping. Of these 79 apps, 43 (54%) were specific to nicotine, 3 (4%) were specific to cannabis, 1 (1%) was intended for either, and for the remaining 31 (39%), the intended substance was unclear. The most common purposes of the apps were making do-it-yourself e-liquids (28/79, 35%) or coils (25/79, 32%), games/entertainment (19/79, 24%), social networking (16/79, 20%), and shopping for vaping products (15/79, 19%). Of the 79 apps, at least 4 apps (5%) paired with vaping devices to control temperature or dose settings, 8 apps (10%) claimed to help people quit smoking using vaping, and 2 apps (3%) had the goal of helping people quit vaping. CONCLUSIONS The majority of vaping-related apps in the Google Play Store had features either to help users continue vaping, such as information for modifying devices, or to maintain interest in vaping. Few apps were for controlling device settings or assisting with quitting smoking or vaping. Assuming that these Google Play Store apps were similar in content to the Apple App Store apps that were removed, it appears that Apple’s ban would have a minimal effect on people who vape with the intention of quitting smoking or who are seeking information about safer vaping via mobile apps.


2020 ◽  
Author(s):  
Atiyeh Vaezipour ◽  
Jessica Campbell ◽  
Deborah Theodoros ◽  
Trevor Russell

BACKGROUND Worldwide, more than 75% of people with acquired brain injury (ABI) experience communication disorders. Communication disorders are impairments in the ability to communicate effectively, that is, sending, receiving, processing, and comprehending verbal and nonverbal concepts and symbols. Such disorders may have enduring impacts on employment, social participation, and quality of life. Technology-enabled interventions such as mobile apps have the potential to increase the reach of speech-language therapy to treat communication disorders. However, ensuring that apps are evidence-based and of high quality is critical for facilitating safe and effective treatment for adults with communication disorders. OBJECTIVE The aim of this review is to identify mobile apps that are currently widely available to adults with communication disorders for speech-language therapy and to assess their content and quality using the validated Mobile App Rating Scale (MARS). METHODS Google Play Store, Apple App Store, and webpages were searched to identify mobile apps for speech-language therapy. Apps were included in the review if they were designed for the treatment of adult communication disorders after ABI, were in English, and were either free or for purchase. Certified speech-language pathologists used the MARS to assess the quality of the apps. RESULTS From a total of 2680 apps identified from Google Play Store, Apple App Store, and web searches, 2.61% (70/2680) apps met the eligibility criteria for inclusion. Overall, 61% (43/70) were available for download on the iPhone Operating System (iOS) platform, 20% (14/70) on the Android platform, and 19% (13/70) on both iOS and Android platforms. A content analysis of the apps revealed 43 apps for <i>language</i>, 17 apps for <i>speech</i>, 8 apps for <i>cognitive communication</i>, 6 apps for <i>voice</i>, and 5 apps for <i>oromotor function</i> or <i>numeracy</i>. The overall MARS mean score was 3.7 out of 5, SD 0.6, ranging between 2.1 and 4.5, with <i>functionality</i> being the highest-scored subscale (4.3, SD 0.6)<i>, followed by aesthetics</i> (3.8, SD 0.8), <i>information</i> (3.4, SD 0.6)<i>, and engagement</i> (3.3, SD 0.6). The top 5 apps were <i>Naming Therapy</i> (4.6/5), <i>Speech Flipbook Standard</i> (4.6/5), <i>Number Therapy</i> (4.5/5), <i>Answering Therapy</i>, and <i>Constant Therapy</i> (4.4/5). CONCLUSIONS To our knowledge, this is the first study to systematically identify and evaluate a broad range of mobile apps for speech-language therapy for adults with communication disorders after sustaining ABI. We found a lack of interactive and engaging elements in the apps, a critical factor in sustaining self-managed speech-language therapy. More evidence-based apps with a focus on human factors, user experience, and a patient-led design approach are required to enhance effectiveness and long-term use.


2020 ◽  
Author(s):  
Atiyeh Vaezipour ◽  
Jessica Campbell ◽  
Deborah Theodoros ◽  
Trevor Russell

UNSTRUCTURED Worldwide, more than 75% of people with acquired brain injury (ABI) experience communication disorders. Communication disorders are impairments in the ability to communicate effectively, that is, sending, receiving, processing, and comprehending verbal and nonverbal concepts and symbols. Such disorders may have enduring impacts on employment, social participation, and quality of life. Technology-enabled interventions such as mobile apps have the potential to increase the reach of speech-language therapy to treat communication disorders. However, ensuring that apps are evidence-based and of high quality is critical for facilitating safe and effective treatment for adults with communication disorders. The aim of this review is to identify mobile apps that are currently widely available to adults with communication disorders for speech-language therapy and to assess their content and quality using the validated Mobile App Rating Scale(MARS). Google Play Store, Apple App Store, and webpages were searched to identify mobile apps for speech-language therapy. Apps were included in the review if they were designed for the treatment of adult communication disorders after ABI, were in English, and were either free or for purchase. Certified speech-language pathologists used the MARS to assess the quality of the apps. From a total of 2680 apps identified from Google Play Store, Apple App Store, and web searches, 2.61% (70/2680) apps met the eligibility criteria for inclusion. Overall, 61% (43/70) were available for download on the iPhone Operating System (iOS) platform, 20% (14/70) on the Android platform, and 19% (13/70) on both iOS and Android platforms. A content analysis of the apps revealed 43 apps for language, 17 apps for speech, 8 apps for cognitive communication, 6 apps for voice, and 5 apps for oromotor function or numeracy. The overall MARS mean score was 3.7 out of 5, SD 0.6, ranging between 2.1 and 4.5, with functionality being the highest-scored subscale (4.3, SD 0.6), followed by aesthetics (3.8, SD 0.8), information (3.4, SD 0.6), and engagement (3.3, SD 0.6). The top 5 apps were Naming Therapy (4.6/5), Speech Flipbook Standard (4.6/5), Number Therapy(4.5/5), Answering Therapy, and Constant Therapy (4.4/5). To our knowledge, this is the first study to systematically identify and evaluate a broad range of mobile apps for speech-language therapy for adults with communication disorders after sustaining ABI. We found a lack of interactive and engaging elements in the apps, a critical factor in sustaining self-managed speech-language therapy. More evidence-based apps with a focus on human factors, user experience, and a patient-led design approach are required to enhance effectiveness and long-term use.


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