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)

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.

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

Frontiers in Medicine ◽

10.3389/fmed.2021.715345 ◽

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 < 0.004). Older male rheumatic patients reported a higher subjective quality score (P < 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 < 0.042). Preferred time of app usage significantly correlated with engagement (Rho = 0.20; P < 0.024), functionality (Rho = 0.19; P < 0.029), total uMARS score (Rho = 0.21; P < 0.017) and subjective quality score (Rho = 0.21; P < 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.

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Nutrition-Related Mobile Apps in the French App Store: Assessment of Functionality and Quality (Preprint)

10.2196/preprints.35879 ◽

2021 ◽

Author(s):

Florence Carrouel ◽

Prescilla Martinon ◽

Ina Saliasi ◽

Denis Bourgeois ◽

Colette Smenteck ◽

...

Keyword(s):

Rating Scale ◽

Mobile Apps ◽

Intraclass Correlation ◽

Quality Score ◽

Mobile App ◽

Subjective Quality ◽

App Store ◽

Nutritional Health ◽

Long Term Impact ◽

Poor Nutrition

BACKGROUND The global burden of disease attributes 20% of deaths to poor nutrition. Although hundreds of nutrition-related mobile applications have been created to help improve this situation and these have been downloaded by millions of users, the effectiveness of integrating these technologies on the adoption of healthy eating remains mixed. Similarly, no significant evaluation of nutrition applications in French, spoken by approximately 300 million people, has yet been identified in the literature. OBJECTIVE The aim of this study is to review which nutrition mobile apps are currently available on the French market, and to carry out an exhaustive assessment of their quality using the Mobile App Rating Scale (MARS) tool. METHODS A screening of apps related to nutritional health was conducted from March 10 to 17, 2021, on the Google Play Store and the French App Store. A shortlist of 15 apps was identified and assessed using the French version of MARS. Eight dietitian nutritionists assigned to assess seven apps. Remaining apps were randomly allocated to ensure four ratings per app. Intraclass correlation was used to evaluate inter-rater agreement. Mean ± SD scores and their distributions for each section and item were calculated. RESULTS The top scores for quality were obtained by Yazio (mean 3.84 ± standard deviation 0.32), FeelEat (3.71 ± 0.47) and BonneApp (3.65 ± 0.09). The engagement scores (Section A) ranged from 1.95 ± 0.5 for iEatBetter to 3.85 ± 0.44 for Feeleat. The functionality scores (Section B) ranged from 2.25 ± 0.54 for Naor to 4.25 ± 0.46 for Yazio. The Aesthetics scores (Section C) ranged from 2.17 ± 0.34 for Naor to 3.88 ± 0.47 for Yazio. The information scores (Section D) ranged from 2.38 ± 0.60 for iEatBetter:Journal alimentaire to 3.73 ± 0.29 for Yazio. The MARS subjective quality (Section E) varied from 1.13 ± 0.26 for Naor and 1.13 ± 0.25 iEatBetter:Journal alimentaire to 2.28 ± 0.88 for Compteur de calories Fatsecret. The specificity of apps varied from 1.38 ± 0.64 for iEatBetter:Journal alimentaire to 3.50 ± 0.91 for Feeleat. The app-specific score was always lower than the subjective quality score that was always lower than the quality score and that was lower than the rating score from the iOS or Android app stores. CONCLUSIONS Although the prevention and information messages regarding nutritional habits are not scientifically verified before marketing, dieteticians-nutritionists evaluated that the apps quality was quite relevant. The subjective quality and mobile app specificities were associated with lower ratings. Further investigations are needed to assess their alignment with recommendations and their long-term impact on users.

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

Proceedings of The Nutrition Society ◽

10.1017/s0029665120002190 ◽

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.

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Quality evaluation of smartphone applications for laboratory medicine

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2018-0710 ◽

2018 ◽

Vol 57 (3) ◽

pp. 388-397 ◽

Cited By ~ 1

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.

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

10.2196/preprints.10718 ◽

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.

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Assessing the Quality of skin Healthcare Mobile Apps: a systematic review and scoring using the MARS

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.066 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

H Woo ◽

G h Kim ◽

Y w Kim

Keyword(s):

Rating Scale ◽

Mobile Apps ◽

Quality Score ◽

Mobile App ◽

Subjective Quality ◽

High Quality ◽

Simple Task ◽

Content Quality ◽

Assessment Scores ◽

Static Correlation

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.

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Assessing the Quality of Mobile Phone Apps for Weight Management: User-Centered Study With Employees From a Lebanese University (Preprint)

10.2196/preprints.9836 ◽

2018 ◽

Author(s):

Marco Bardus ◽

Ahmed Ali ◽

Farah Demachkieh ◽

Ghassan Hamadeh

Keyword(s):

Weight Management ◽

Weight Control ◽

Information Quality ◽

Rating Scale ◽

Mode Of Delivery ◽

Nonparametric Tests ◽

Mobile App ◽

Subjective Quality ◽

User Centered

BACKGROUND Evaluating the quality of mobile health apps for weight loss and weight management is important to understand whether these can be used for obesity prevention and treatment. Recent reviews call for more research on multidimensional aspects of app quality, especially involving end users, as there are already many expert reviews on this domain. However, no quantitative study has investigated how laypersons see popular apps for weight management and perceive different dimensions of app quality. OBJECTIVE This study aimed to explore how laypersons evaluate the quality of 6 free weight management apps (My Diet Coach, SparkPeople, Lark, MyFitnessPal, MyPlate, and My Diet Diary), which achieved the highest quality ratings in a related and recent expert review. METHODS A user-centered study was conducted with 36 employees of a Lebanese university. Participants enrolled in the study on a rolling basis between October 2016 and March 2017. Participants were randomly assigned an app to use for 2 weeks. App quality was evaluated at the end of the trial period using the Mobile App Rating Scale user version (uMARS). uMARS assesses the dimensions of engagement, functionality, aesthetics, information, and subjective quality on 5-point scales. Internal consistency and interrater agreement were examined. The associations between uMARS scores and users’ demographic characteristics were also explored using nonparametric tests. Analyses were completed in November 2017. RESULTS Overall, the 6 apps were of moderately good quality (median uMARS score 3.6, interquartile range [IQR] 0.3). The highest total uMARS scores were achieved by Lark (mean 4.0 [SD 0.5]) and MyPlate (mean 3.8 [SD 0.4]), which also achieved the highest subjective quality scores (Lark: mean 3.3 [SD 1.4]; MyPlate: mean 3.3 [SD 0.8]). Functionality was the domain with the highest rating (median 3.9, IQR 0.3), followed by aesthetics (median 3.7, IQR 0.5), information (median 3.7, IQR 0.1), and engagement (median 3.3, IQR 0.2). Subjective quality was judged low (median 2.5, IQR 0.9). Overall, subjective quality was strongly and positively related (P<.001) with total uMARS score (ρ=.75), engagement (ρ=.68), information, and aesthetics (ρ=.60) but not functionality (ρ=.40; P=.02). Higher engagement scores were reported among healthy (P=.003) and obese individuals (P=.03), who also showed higher total uMARS (P=.04) and subjective quality (P=.05) scores. CONCLUSIONS Although the apps were considered highly functional, they were relatively weak in engagement and subjective quality scores, indicating a low propensity of using the apps in the future. As engagement was the subdomain most strongly associated with subjective quality, app developers and researchers should focus on creating engaging apps, holding constant the functionality, aesthetics, and information quality. The tested apps (in particular Lark and MyPlate) were perceived as more engaging and of higher quality among healthy, obese individuals, making them a promising mode of delivery for self-directed interventions promoting weight control among the sampled population or in similar and comparable settings.

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Smartphone Apps Targeting Physical Activity in People With Rheumatoid Arthritis: Systematic Quality Appraisal and Content Analysis

JMIR mhealth and uhealth ◽

10.2196/18495 ◽

2020 ◽

Vol 8 (7) ◽

pp. e18495 ◽

Cited By ~ 1

Author(s):

Lindsay M Bearne ◽

Mandeep Sekhon ◽

Rebecca Grainger ◽

Anthony La ◽

Mehrdad Shamali ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Physical Activity ◽

Rating Scale ◽

Mobile App ◽

Information Support ◽

World Health ◽

Smartphone Apps ◽

High Quality ◽

App Store ◽

Google Play

Background Rheumatoid arthritis (RA) is a disabling, inflammatory joint condition affecting 0.5%-1% of the global population. Physical activity (PA) and exercise are recommended for people with RA, but uptake and adherence tend to be low. Smartphone apps could assist people with RA to achieve PA recommendations. However, it is not known whether high quality, evidence-informed PA apps that include behavior change techniques (BCTs) previously identified as effective for PA adherence are available for people with RA. Objective This study aims to systematically identify apps that include goals to facilitate PA for adults with RA and assess app quality and content for the inclusion of relevant BCTs against recommendations for cardiorespiratory, resistance, flexibility, and neuromotor PA and exercise. Methods A systematic search of the Apple App Store and Google Play Store in the United Kingdom was conducted to identify English language apps that promote PA for adults with RA. Two researchers independently assessed app quality (mobile app rating scale [MARS]; range 0-5) and content (BCT Taxonomy version 1, World Health Organization, the American College of Sports Medicine, and the European League against Rheumatism recommendations for PA). The completeness of reporting of PA prescription was evaluated using a modified version of the Consensus on Exercise Reporting Template (CERT; range 0-14). Results A total of 14,047 apps were identified. Following deduplication, 2737 apps were screened for eligibility; 6 apps were downloaded (2 on the Apple App Store and 4 on the Google Play Store), yielding 4 unique apps. App quality varied (MARS score 2.25-4.17). Only 1 app was congruent with all aspects of the PA recommendations. All apps completely or partially recommended flexibility and resistance exercises, 3 apps completely or partially advised some form of neuromotor exercise, but only 2 offered full or partial guidance on cardiorespiratory exercise. Completeness of exercise reporting was mixed (CERT scores 7-14 points) and 3-7 BCTs were identified. Two BCTs were common to all apps (information about health consequences and instruction on how to perform behavior). Higher quality apps included a greater number of BCTs and were more closely aligned to PA guidance. No published trials evaluating the effect of the included apps were identified. Conclusions This review identifies 4 PA apps of mixed quality and content for use by people with RA. Higher quality apps were more closely aligned to PA guidance and included a greater number of BCTs. One high-quality app (Rheumatoid Arthritis Information Support and Education) included 7 BCTs and was fully aligned with PA and exercise guidance. The effect of apps on PA adherence should be established before implementation.

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The Arabic Version of the Mobile App Rating Scale: Development and Validation Study (Preprint)

10.2196/preprints.16956 ◽

2019 ◽

Author(s):

Marco Bardus ◽

Nathalie Awada ◽

Lilian A Ghandour ◽

Elie-Jacques Fares ◽

Tarek Gherbal ◽

...

Keyword(s):

Weight Management ◽

Information Quality ◽

Rating Scale ◽

Arab World ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Mobile App ◽

Health Apps ◽

Highly Correlated

BACKGROUND With thousands of health apps in app stores globally, it is crucial to systemically and thoroughly evaluate the quality of these apps due to their potential influence on health decisions and outcomes. The Mobile App Rating Scale (MARS) is the only currently available tool that provides a comprehensive, multidimensional evaluation of app quality, which has been used to compare medical apps from American and European app stores in various areas, available in English, Italian, Spanish, and German. However, this tool is not available in Arabic. OBJECTIVE This study aimed to translate and adapt MARS to Arabic and validate the tool with a sample of health apps aimed at managing or preventing obesity and associated disorders. METHODS We followed a well-established and defined “universalist” process of cross-cultural adaptation using a mixed methods approach. Early translations of the tool, accompanied by confirmation of the contents by two rounds of separate discussions, were included and culminated in a final version, which was then back-translated into English. Two trained researchers piloted the MARS in Arabic (MARS-Ar) with a sample of 10 weight management apps obtained from Google Play and the App Store. Interrater reliability was established using intraclass correlation coefficients (ICCs). After reliability was ascertained, the two researchers independently evaluated a set of additional 56 apps. RESULTS MARS-Ar was highly aligned with the original English version. The ICCs for MARS-Ar (0.836, 95% CI 0.817-0.853) and MARS English (0.838, 95% CI 0.819-0.855) were good. The MARS-Ar subscales were highly correlated with the original counterparts (P<.001). The lowest correlation was observed in the area of usability (r=0.685), followed by aesthetics (r=0.827), information quality (r=0.854), engagement (r=0.894), and total app quality (r=0.897). Subjective quality was also highly correlated (r=0.820). CONCLUSIONS MARS-Ar is a valid instrument to assess app quality among trained Arabic-speaking users of health and fitness apps. Researchers and public health professionals in the Arab world can use the overall MARS score and its subscales to reliably evaluate the quality of weight management apps. Further research is necessary to test the MARS-Ar on apps addressing various health issues, such as attention or anxiety prevention, or sexual and reproductive health.

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Quality of Mobile Apps for Care Partners of People with Alzheimer’s Disease and Related Dementias: Mobile App Rating Scale Evaluation (Preprint)

10.2196/preprints.33863 ◽

2021 ◽

Author(s):

Nicole E Werner ◽

Janetta C Brown ◽

Priya Loganathar ◽

Richard J Holden

Keyword(s):

Rating Scale ◽

Mobile Apps ◽

Mobile App ◽

Future Research ◽

App Development ◽

Care Partners ◽

Acceptable Quality ◽

The Us ◽

Google Play

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.

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