Promoting Health via mHealth Applications Using a French Version of the Mobile App Rating Scale: Adaptation and Validation Study (Preprint)

BACKGROUND In the recent decades, the number of apps promoting health behaviors and health-related strategies and interventions has increased alongside the number of smartphone users. Nevertheless, the validity process for measuring and reporting app quality remains unsatisfactory for health professionals and end users and represents a public health concern. The Mobile Application Rating Scale (MARS) is a tool validated and widely used in the scientific literature to evaluate and compare mHealth app functionalities. However, MARS is not adapted to the French culture nor to the language. OBJECTIVE This study aims to translate, adapt, and validate the equivalent French version of MARS (ie, MARS-F). METHODS The original MARS was first translated to French by two independent bilingual scientists, and their common version was blind back-translated twice by two native English speakers, culminating in a final well-established MARS-F. Its comprehensibility was then evaluated by 6 individuals (3 researchers and 3 nonacademics), and the final MARS-F version was created. Two bilingual raters independently completed the evaluation of 63 apps using MARS and MARS-F. Interrater reliability was assessed using intraclass correlation coefficients. In addition, internal consistency and validity of both scales were assessed. Mokken scale analysis was used to investigate the scalability of both MARS and MARS-F. RESULTS MARS-F had a good alignment with the original MARS, with properties comparable between the two scales. The correlation coefficients (r) between the corresponding dimensions of MARS and MARS-F ranged from 0.97 to 0.99. The internal consistencies of the MARS-F dimensions engagement (ω=0.79), functionality (ω=0.79), esthetics (ω=0.78), and information quality (ω=0.61) were acceptable and that for the overall MARS score (ω=0.86) was good. Mokken scale analysis revealed a strong scalability for MARS (Loevinger H=0.37) and a good scalability for MARS-F (H=0.35). CONCLUSIONS MARS-F is a valid tool, and it would serve as a crucial aid for researchers, health care professionals, public health authorities, and interested third parties, to assess the quality of mHealth apps in French-speaking countries.

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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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Validation of the French Version of the Auditory Hallucination Rating Scale in a Sample of Hallucinating Patients with Schizophrenia

The Canadian Journal of Psychiatry ◽

10.1177/0706743719895641 ◽

2019 ◽

Vol 65 (4) ◽

pp. 237-244 ◽

Cited By ~ 1

Author(s):

Clément Dondé ◽

Frédéric Haesebaert ◽

Emmanuel Poulet ◽

Marine Mondino ◽

Jérôme Brunelin

Keyword(s):

Factor Analysis ◽

Rating Scale ◽

Auditory Hallucination ◽

Intraclass Correlation ◽

Internal Validity ◽

Correlation Coefficients ◽

French Version ◽

Fine Grained ◽

French Speaking ◽

Item Scores

Objective: The aim of this study was to validate the French version of the 7-item Auditory Hallucination Rating Scale (AHRS) so as to facilitate fine-grained assessment of auditory hallucinations (AH) in native French-speaking patients with schizophrenia (SZ) in clinical settings and studies. Method: Patients ( N = 66) were diagnosed with SZ according to the Diagnostic and Statistical Manual of Mental Disorders. The French version of the AHRS was developed using a forward–backward translation procedure. Psychometric properties of the French version of the AHRS were tested including (i) construct validity with a confirmatory one-factor analysis, (ii) internal validity with Pearson correlations and Cronbach α coefficients, and (iii) external validity by correlations with the Scale for Assessment of Positive Symptoms (SAPS-H1), the Positive and Negative Syndrome Scale (PANSS-P3; concurrent), the PANSS-Negative subscale and age of subjects (divergent), and inter-rater intraclass correlation coefficients (ICCs). Results: (i) The confirmatory one-factor analysis found a root mean square error of approximation (RMSEA) = 0.00, 90% confidence interval = [0.000 to 0.011], and a comparative fit index = 0.994. (ii) Correlations between AHRS total score and individual items were mostly ≥0.4. Cronbach α coefficient was 0.61. (iii) Correlations with PANSS-P3 and SAPS-H1 were 0.42 and 0.53, respectively. In a subset of participants ( N = 16), ICC values were extremely high and significant for AHRS total and individual item scores (ICCs range 0.899 to 0.996) Conclusion: The French version of the AHRS is a psychometrically acceptable instrument for the evaluation of AH severity in French-speaking patients with SZ.

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

JMIR mhealth and uhealth ◽

10.2196/16956 ◽

2020 ◽

Vol 8 (3) ◽

pp. e16956

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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Defining Nutritional and Functional Niches of Legumes: A Call for Clarity to Distinguish a Future Role for Pulses in the Dietary Guidelines for Americans

Nutrients ◽

10.3390/nu13041100 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1100

Author(s):

Chelsea Didinger ◽

Henry J. Thompson

Keyword(s):

Public Health ◽

Health Care Professionals ◽

Weight Status ◽

Dietary Guidelines ◽

Health Concern ◽

Healthy Weight ◽

Food Groups ◽

Rich Diversity ◽

Dietary Guidelines For Americans ◽

Dietary Components

Legume food crops can contribute to the solution of diet-related public health challenges. The rich diversity of the botanical family Fabaceae (Leguminosae) allows legumes to fill numerous nutritional niches. Pulses (i.e., a subgroup of legumes including chickpeas, cowpeas, dry beans, dry peas, and lentils) are a nutrient-dense food that could play a key role in eliminating the dramatic underconsumption of dietary fiber and potassium, two dietary components of public health concern, all while maintaining a caloric intake that promotes a healthy weight status. However, incorrect use of terminology—in the commercial and scientific literature as well as in publications and materials prepared for the consuming public—creates confusion and represents a barrier to dissemination of clear dietary guideline messaging. The use of accurate terminology and a simple classification scheme can promote public health through differentiation among types of legumes, better informing the development and implementation of nutritional policies and allowing health care professionals and the public to capitalize on the health benefits associated with different legumes. Although inconsistent grouping of legumes exists across countries, the recently released 2020–2025 Dietary Guidelines for Americans (DGA) were chosen to illustrate potential challenges faced and areas for clarification. In the 2020–2025 DGA, pulses are included in two food groups: the protein food group and ‘beans, peas, lentils’ vegetable subgroup. To evaluate the potential of pulses to contribute to intake of key dietary components within calorie recommendations, we compared 100 kilocalorie edible portions of pulses versus other foods. These comparisons demonstrate the unique nutritional profile of pulses and the opportunity afforded by this type of legume to address public health concerns, which can be greatly advanced by reducing confusion through global harmonization of terminology.

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Mokken Scale Analysis: Discussion and Application

Advances in Social Sciences Research Journal ◽

10.14738/assrj.83.9949 ◽

2021 ◽

Vol 8 (3) ◽

pp. 672-695

Author(s):

Thomas DeVaney

Keyword(s):

Item Response Theory ◽

Item Response ◽

Rating Scale ◽

Scale Analysis ◽

Guttman Scale ◽

Response Theory ◽

Data Set ◽

Mokken Scale Analysis ◽

Irt Models ◽

Guttman Scaling

This article presents a discussion and illustration of Mokken scale analysis (MSA), a nonparametric form of item response theory (IRT), in relation to common IRT models such as Rasch and Guttman scaling. The procedure can be used for dichotomous and ordinal polytomous data commonly used with questionnaires. The assumptions of MSA are discussed as well as characteristics that differentiate a Mokken scale from a Guttman scale. MSA is illustrated using the mokken package with R Studio and a data set that included over 3,340 responses to a modified version of the Statistical Anxiety Rating Scale. Issues addressed in the illustration include monotonicity, scalability, and invariant ordering. The R script for the illustration is included.

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The Effects of Gamification and Oral Self-Care on Oral Hygiene in Children: Systematic Search in App Stores and Evaluation of Apps (Preprint)

10.2196/preprints.16365 ◽

2019 ◽

Author(s):

Nino Fijačko ◽

Lucija Gosak ◽

Leona Cilar ◽

Alenka Novšak ◽

Ruth Masterson Creber ◽

...

Keyword(s):

Public Health ◽

Behavior Change ◽

Oral Hygiene ◽

Rating Scale ◽

Self Care ◽

Public Health Problem ◽

Mobile App ◽

Evidence Based ◽

Behavior Change Techniques ◽

Evidence Based Dentistry

BACKGROUND Poor oral hygiene is a great public health problem worldwide. Oral health care education is a public health priority as the maintenance of oral hygiene is integral to overall health. Maintaining optimal oral hygiene among children is challenging and can be supported by using relevant motivational approaches. OBJECTIVE The primary aim of this study was to identify mobile smartphone apps that include gamification features focused on motivating children to learn, perform, and maintain optimal oral hygiene. METHODS We searched six online app stores using four search terms (“oral hygiene game,” “oral hygiene gamification,” “oral hygiene brush game,” and “oral hygiene brush gamification”). We identified gamification features, identified whether apps were consistent with evidence-based dentistry, performed a quality appraisal with the Mobile App Rating Scale user version (uMARS), and quantified behavior scores (Behavior Change score, uMARS score, and Coventry, Aberdeen, and London-Refined [CALO-RE] score) using three different instruments that measure behavior change. RESULTS Of 612 potentially relevant apps included in the analysis, 17 met the inclusion criteria. On average, apps included 6.87 (SD 4.18) out of 31 possible gamification features. The most frequently used gamification features were time pressure (16/17, 94%), virtual characters (14/17, 82%), and fantasy (13/17, 76%). The most common oral hygiene evidence-based recommendation was brushing time (2-3 minutes), which was identified in 94% (16/17) of apps. The overall mean uMARS score for app quality was high (4.30, SD 0.36), with good mean subjective quality (3.79, SD 0.71) and perceived impact (3.58, SD 0.44). Sufficient behavior change techniques based on three taxonomies were detected in each app. CONCLUSIONS The majority of the analyzed oral hygiene apps included gamification features and behavior change techniques to perform and maintain oral hygiene in children. Overall, the apps contained some educational content consistent with evidence-based dentistry and high-quality background for oral self-care in children; however, there is scope for improvement.

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Interformat Reliability of Web-Based Parent-Rated Questionnaires for Assessing Neurodevelopmental Disorders Among Preschoolers: Cross-sectional Community Study

JMIR Pediatrics and Parenting ◽

10.2196/20172 ◽

2021 ◽

Vol 4 (1) ◽

pp. e20172

Author(s):

Masanori Tanaka ◽

Manabu Saito ◽

Michio Takahashi ◽

Masaki Adachi ◽

Kazuhiko Nakamura

Keyword(s):

Neurodevelopmental Disorders ◽

Rating Scale ◽

Developmental Coordination Disorder ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Autism Spectrum ◽

Cross Sectional ◽

Web Based ◽

Developmental Health ◽

The Web

Background Early detection and intervention for neurodevelopmental disorders are effective. Several types of paper questionnaires have been developed to assess these conditions in early childhood; however, the psychometric equivalence between the web-based and the paper versions of these questionnaires is unknown. Objective This study examined the interformat reliability of the web-based parent-rated version of the Autism Spectrum Screening Questionnaire (ASSQ), Attention-Deficit/Hyperactivity Disorder Rating Scale (ADHD-RS), Developmental Coordination Disorder Questionnaire 2007 (DCDQ), and Strengths and Difficulties Questionnaire (SDQ) among Japanese preschoolers in a community developmental health check-up setting. Methods A set of paper-based questionnaires were distributed for voluntary completion to parents of children aged 5 years. The package of the paper format questionnaires included the ASSQ, ADHD-RS, DCDQ, parent-reported SDQ (P-SDQ), and several additional demographic questions. Responses were received from 508 parents of children who agreed to participate in the study. After 3 months, 300 parents, who were among the initial responders, were randomly selected and asked to complete the web-based versions of these questionnaires. A total of 140 parents replied to the web-based format and were included as a final sample in this study. Results We obtained the McDonald ω coefficients for both the web-based and paper formats of the ASSQ (web-based: ω=.90; paper: ω=.86), ADHD-RS total and subscales (web-based: ω=.88-.94; paper: ω=.87-.93), DCDQ total and subscales (web-based: ω=.82-.94; paper: ω=.74-.92), and P-SDQ total and subscales (web-based: ω=.55-.81; paper: ω=.52-.80). The intraclass correlation coefficients between the web-based and paper formats were all significant at the 99.9% confidence level: ASSQ (r=0.66, P<.001); ADHD-RS total and subscales (r=0.66-0.74, P<.001); DCDQ total and subscales (r=0.66-0.71, P<.001); P-SDQ Total Difficulties and subscales (r=0.55-0.73, P<.001). There were no significant differences between the web-based and paper formats for total mean score of the ASSQ (P=.76), total (P=.12) and subscale (P=.11-.47) mean scores of DCDQ, and the P-SDQ Total Difficulties mean score (P=.20) and mean subscale scores (P=.28-.79). Although significant differences were found between the web-based and paper formats for mean ADHD-RS scores (total: t132=2.83, P=.005; Inattention subscale: t133=2.15, P=.03; Hyperactivity/Impulsivity subscale: t133=3.21, P=.002), the effect sizes were small (Cohen d=0.18-0.22). Conclusions These results suggest that the web-based versions of the ASSQ, ADHD-RS, DCDQ, and P-SDQ were equivalent, with the same level of internal consistency and intrarater reliability as the paper versions, indicating the applicability of the web-based versions of these questionnaires for assessing neurodevelopmental disorders.

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The QardioArm App in the Assessment of Blood Pressure and Heart Rate: Reliability and Validity Study (Preprint)

10.2196/preprints.8458 ◽

2017 ◽

Author(s):

Victoria Mazoteras Pardo ◽

Marta E Losa Iglesias ◽

José López Chicharro ◽

Ricardo Becerro de Bengoa Vallejo

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

European Society ◽

Intraclass Correlation ◽

Reliability And Validity ◽

Correlation Coefficients ◽

Mobile App ◽

Blood Pressure Monitor ◽

Pressure Monitor ◽

Mean Values

BACKGROUND Self-measurement of blood pressure is a priority strategy for managing blood pressure. OBJECTIVE The aim of this study was to evaluate the reliability and validity of blood pressure and heart rate following the European Society of Hypertension’s international validation protocol, as measured with the QardioArm, a fully automatic, noninvasive wireless blood pressure monitor and mobile app. METHODS A total of 100 healthy volunteers older than 25 years from the general population of Ciudad Real, Spain, participated in a test-retest validation study with two measurement sessions separated by 5 to 7 days. In each measurement session, seven systolic blood pressure, diastolic blood pressure, and heart rate assessments were taken, alternating between the two devices. The test device was the QardioArm and the previously validated criterion device was the Omron M3. Sessions took place at a single study site with an evaluation room that was maintained at an appropriate temperature and kept free from noises and distractions. RESULTS The QardioArm displayed very consistent readings both within and across sessions (intraclass correlation coefficients=0.80-0.95, standard errors of measurement=2.5-5.4). The QardioArm measurements corresponded closely to those from the criterion device (r>.96) and mean values for the two devices were nearly identical. The QardioArm easily passed all validation standards set by the European Society of Hypertension International Protocol. CONCLUSIONS The QardioArm mobile app has validity and it can be used free of major measurement error.

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Bolus Residue Scale: An Easy-to-Use and Reliable Videofluoroscopic Analysis Tool to Score Bolus Residue in Patients with Dysphagia

International Journal of Otolaryngology ◽

10.1155/2015/780197 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 11

Author(s):

Nathalie Rommel ◽

Charlotte Borgers ◽

Dirk Van Beckevoort ◽

Ann Goeleven ◽

Eddy Dejaeger ◽

...

Keyword(s):

Rating Scale ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Posterior Pharyngeal Wall ◽

High Specificity ◽

Analysis Tool ◽

Pharyngeal Wall ◽

Specificity And Sensitivity ◽

Low Sensitivity ◽

Sensitivity Specificity

Background. We aimed to validate an easy-to-use videofluoroscopic analysis tool, the bolus residue scale (BRS), for detection and classification of pharyngeal retention in the valleculae, piriform sinuses, and/or the posterior pharyngeal wall.Methods. 50 randomly selected videofluoroscopic images of 10 mL swallows (recorded in 18 dysphagia patients and 8 controls) were analyzed by 4 experts and 6 nonexpert observers. A score from 1 to 6 was assigned according to the number of structures affected by residue. Inter- and intrarater reliabilities were assessed by calculation of intraclass correlation coefficients (ICCs) for expert and nonexpert observers. Sensitivity, specificity, and interrater agreement were analyzed for different BRS levels.Results. Intrarater reproducibility was almost perfect for experts (mean ICC 0.972) and ranged from substantial to almost perfect for nonexperts (mean ICC 0.835). Interjudge agreement of the experts ranged from substantial to almost perfect (mean ICC 0.780), but interrater reliability of nonexperts ranged from substantial to good (mean 0.719). BRS shows for experts a high specificity and sensitivity and for nonexperts a low sensitivity and high specificity.Conclusions. The BRS is a simple, easy-to-carry-out, and accessible rating scale to locate pharyngeal retention on videofluoroscopic images with a good specificity and reproducibility for observers of different expertise levels.

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Development and assessment of the inter-rater and intra-rater reproducibility of a self-administration version of the ALSFRS-R

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2019-321138 ◽

2019 ◽

Vol 91 (1) ◽

pp. 75-81 ◽

Cited By ~ 7

Author(s):

Leonhard A Bakker ◽

Carin D Schröder ◽

Harold H G Tan ◽

Simone M A G Vugts ◽

Ruben P A van Eijk ◽

...

Keyword(s):

Rating Scale ◽

Clinical Care ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

The Self ◽

Coefficient Alpha ◽

Rater Agreement ◽

Self Administration ◽

Limits Of Agreement ◽

Rater Reliability

ObjectiveThe Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) is widely applied to assess disease severity and progression in patients with motor neuron disease (MND). The objective of the study is to assess the inter-rater and intra-rater reproducibility, i.e., the inter-rater and intra-rater reliability and agreement, of a self-administration version of the ALSFRS-R for use in apps, online platforms, clinical care and trials.MethodsThe self-administration version of the ALSFRS-R was developed based on both patient and expert feedback. To assess the inter-rater reproducibility, 59 patients with MND filled out the ALSFRS-R online and were subsequently assessed on the ALSFRS-R by three raters. To assess the intra-rater reproducibility, patients were invited on two occasions to complete the ALSFRS-R online. Reliability was assessed with intraclass correlation coefficients, agreement was assessed with Bland-Altman plots and paired samples t-tests, and internal consistency was examined with Cronbach’s coefficient alpha.ResultsThe self-administration version of the ALSFRS-R demonstrated excellent inter-rater and intra-rater reliability. The assessment of inter-rater agreement demonstrated small systematic differences between patients and raters and acceptable limits of agreement. The assessment of intra-rater agreement demonstrated no systematic changes between time points; limits of agreement were 4.3 points for the total score and ranged from 1.6 to 2.4 points for the domain scores. Coefficient alpha values were acceptable.DiscussionThe self-administration version of the ALSFRS-R demonstrates high reproducibility and can be used in apps and online portals for both individual comparisons, facilitating the management of clinical care and group comparisons in clinical trials.

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