Testing and Assessment of Mozzify, the first integrated mhealth app for dengue fever in the Philippines (Preprint)
BACKGROUND The Philippines recently declared a national dengue fever (DF) epidemic. Yet, to our knowledge, Philippines relies its DF surveillance system on passive surveillance method (notifications from barangay/village health centers, municipal or city health offices, hospitals and clinics), and there is no available integrated mhealth app for dengue fever that includes all the appropriate surveillance methods in early detection of disease outbreaks in the country. OBJECTIVE This study aimed to test and assess the Mozzify app in terms of the Mobile App Rating Scale (MARS) subscales: objective quality (engagement, functionality, aesthetics, information), app-subjective and app-specific qualities and compare the total app mean score ratings by socio-demographic profile and self and family DF history to see what factors are associated with high app mean score rating. We also conducted individual interviews and focus group discussions among the participants, and analyze their comments and suggestions to help structure further improvement and future development of the app. METHODS We have tested and assessed Mozzify, among healthcare professionals and members of the school-based samples using the Mobile Application Rating Scale (MARS) professional and user versions (uMARS). We compared the total app mean score ratings by socio-demographic and DF history using mean difference analyses. Content analysis was used to analyse the topics raised in individual interviews and focus group discussions. RESULTS Mozzify obtained an over-all >4 (out of 5) mean score ratings in the MARS’ and uMARS’ app objective quality (4.45), subjective (4.17) and specific (4.55) scales among 979 participants (healthcare professionals n = 94; school-based samples n = 885). Mean difference analyses revealed that total app mean score ratings were not significantly different across ages and gender among healthcare professionals and school-based samples. Similar results were found across income categories, and self and family DF history but not gender (P <0.001), among the school-based samples. Content analyses of the topics discussed in the individual interviews and focus group discussions revealed eight major themes: suggestions on multi-language options and including other diseases; Android version availability; improvements on the app’s content, design and engagement; inclusion of users from low-income and rural areas; Wi-Fi connection and app size concerns; data credibility, and user security and privacy issues. CONCLUSIONS This study confirms that Mozzify can be a promising integrated strategic health intervention and surveillance system for reporting and mapping DF cases, increasing awareness, improving knowledge, and facilitating behavior change (practicing preventive measures against DF). It can be used by healthcare professionals and school-based samples of any age (>18 years), socioeconomic status and DF history. However, in spite of its many strengths and unique features, improvements that are tailored to the needs of the intended users should still be done without compromising their security and privacy. Based from the findings, once we have completed further improvements, a longitudinal trial of Mozzify should be done among community-based participants to finally conclude if this can be an appropriate surveillance method in early detection of disease outbreaks in the Philippines and other countries where DF is endemic. CLINICALTRIAL