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