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BackgroundAmid considerable community concern about the prevalence and harms associated with the use of crystal methamphetamine (“ice”), the increased use of smartphones to access health information and a growing number of available smartphone apps related to crystal methamphetamine, no previous reviews have examined the content and quality of these apps.ObjectiveThis study aims to systematically review existing apps in the iTunes and Google Play Stores to determine the existence, composition, and quality of educational smartphone apps about methamphetamines, including ice.MethodsThe iTunes and Google Play Stores were systematically searched in April 2017 for iOS Apple and Android apps, respectively. English-language apps that provided educational content or information about methamphetamine were eligible for inclusion. Eligible apps were downloaded and independently evaluated for quality by 2 reviewers using the Mobile Application Rating Scale (MARS).ResultsA total of 2205 apps were initially identified, of which 18 were eligible and rated using the MARS. The mean MARS quality total score for all rated apps was 3.0 (SD 0.6), indicating poor to acceptable quality. Overall, mean scores were the highest for functionality (mean 4.0, SD 0.5) and lowest for engagement (mean 2.3, SD 0.7).ConclusionsThis study demonstrates a shortage of high-quality educational and engaging smartphone apps specifically related to methamphetamine. The findings from this review highlight a need for further development of engaging and evidence-based apps that provide educational information about crystal methamphetamine.

BackgroundDespite evidence of increasing harms and community concern related to the drug crystal methamphetamine (“ice”), there is a lack of easily accessible, evidence-based information for community members affected by its use, and to date, no evidence-based mobile apps have specifically focused on crystal methamphetamine.ObjectiveThis study aims to describe the co-design and beta testing of a mobile app to provide evidence-based, up-to-date information about crystal methamphetamine to the general community.MethodsA mobile app about crystal methamphetamine was developed in 2017. The development process involved multiple stakeholders (n=12), including technology and drug and alcohol experts, researchers, app developers, a consumer expert with lived experience, and community members. Beta testing was conducted with Australian general community members (n=34), largely recruited by the Web through Facebook advertising. Participants were invited to use a beta version of the app and provide feedback about the content, visual appeal, usability, engagement, features, and functions. In addition, participants were asked about their perceptions of the app’s influence on awareness, understanding, and help-seeking behavior related to crystal methamphetamine, and about their knowledge about crystal methamphetamine before and after using the app.ResultsThe vast majority of participants reported the app was likely to increase awareness and understanding and encourage help-seeking. The app received positive ratings overall and was well received. Specifically, participants responded positively to the high-quality information provided, usability, and visual appeal. Areas suggested for improvement included reducing the amount of text, increasing engagement, removing a profile picture, and improving navigation through the addition of a “back” button. Suggested improvements were incorporated prior to the app’s public release. App use was associated with an increase in perceived knowledge about crystal methamphetamine; however, this result was not statistically significant.ConclusionsThe Cracks in the Ice mobile app provides evidence-based information about the drug crystal methamphetamine for the general community. The app is regularly updated, available via the Web and offline, and was developed in collaboration with experts and end users. Initial results indicate that it is easy to use and acceptable to the target group.

Background The Cracks in the Ice (CITI) community toolkit was developed to provide evidence-based, up-to-date information and resources about crystal methamphetamine to Australians. Given the high rates of internet use in the community and the potential for misinformation, CITI has the potential to play an important role in improving knowledge and challenging misconceptions surrounding crystal methamphetamine. Objective This study aims to determine (1) whether the CITI toolkit is achieving its aim of disseminating evidence-based information and resources to people who use crystal methamphetamine, their family and friends, health professionals, and the general community and (2) examine the association between the use of CITI and the knowledge and attitudes about crystal methamphetamine. Methods A cross-sectional web-based survey, open to Australian residents (aged ≥18 years), was conducted from November 2018 to March 2019. People who had previously visited the website (referred to as “website visitors” in this study) and those who had not (“naïve”) were recruited. At baseline, knowledge, attitudes, and demographics were assessed. CITI website visitors then completed a series of site evaluation questions, including the System Usability Scale (SUS), and naïve participants were asked to undertake a guided site tour of a replicated version of the site before completing the evaluation questions and repeating knowledge and attitude scales. Results Of a total 2108 participants, 564 (26.7%) reported lifetime use of crystal methamphetamine, 434 (20.6%) were family/friends, 288 (13.7%) were health professionals, and 822 (38.9%) were community members. The average SUS score was 73.49 (SD 13.30), indicating good site usability. Health professionals reported significantly higher SUS scores than community members (P=.02) and people who used crystal methamphetamine (P<.001). Website visitors had significantly higher baseline knowledge than naïve participants (P<.001). Among naïve participants, knowledge scores increased following exposure to the website (mean 15.2, SE 0.05) compared to baseline (mean 14.4, SE 0.05; P<.001). The largest shifts in knowledge were observed for items related to prevalence, legal issues, and the effects of the drug. Stigmatizing attitude scores among the naïve group were significantly lower following exposure to CITI (mean 41.97, SE 0.21) compared to baseline (mean 44.3, SE 0.21; P<.001). Conclusions This study provides an innovative evaluation of a national eHealth resource. CITI is achieving its aim of disseminating evidence-based, nonstigmatizing, and useful information and resources about crystal methamphetamine to key end user groups and has received good usability scores across its target groups. Interaction with CITI led to immediate improvements in knowledge about crystal methamphetamine and a decrease in stigmatizing attitudes. CITI demonstrates the important role of digital information and support platforms for translating evidence into practice and improving knowledge and reducing stigma.

BACKGROUND The Cracks in the Ice Community Toolkit (cracksintheice.org.au) was developed to provide, evidence-based, up-to-date information and resources around crystal methamphetamine to Australians. Given the high rates of Internet use in the community and the potential for misinformation, Cracks in the Ice has the potential to play an important role in improving knowledge and challenging misconceptions surrounding crystal methamphetamine. OBJECTIVE This study aimed to: 1) determine if Cracks in the Ice is achieving its aim of disseminating evidence-based information and resources to people who use crystal methamphetamine, family/friends, health professionals and the general community and 2) to examine the association between use of Cracks in the Ice and knowledge and attitudes about crystal methamphetamine. METHODS A cross-sectional online survey, open to Australian residents (aged 18+ years), was conducted from November 2018 to March 2019. People who had previously visited the website (website visitors) and those who had not (naïve) were recruited. At baseline, knowledge, attitudes and demographics were assessed. Cracks in the Ice website visitors then completed a series of site evaluation questions including system usability scale (SUS) and naïve participants were asked to undertake a guided site tour of a replicated version of the site prior to completing the evaluation questions and repeating knowledge and attitudes scales. RESULTS Of a total 2108 participants, 27% reported lifetime use of crystal methamphetamine, 21% were family/friends, 14% health professionals and 39% community members. Average SUS scores were 73.49 (SD 13.30) indicating good site usability. Health professionals reported significantly higher SUS scores than community member (P=.02) and people who use crystal methamphetamine (P<.01). Website visitors had significantly higher baseline knowledge than naïve participants (P<.001). Among naïve participants, average knowledge scores increased following exposure to the website (Mean = 15.2, SEM = 0.05) compared to baseline (Mean = 14.4, SEM = 0.05, P<.001). Largest shifts in knowledge were observed for items related to prevalence, legal issues and the effects of the drug. Stigmatising attitude scores among the naïve group were significantly lower following exposure to Cracks in the Ice (Mean = 41.97, SEM = 0.21) compared to baseline (Mean =44.3, SEM =0.21; P<.001). CONCLUSIONS This study provides an innovative evaluation of a national e-health resource. Cracks in the Ice is achieving its aim of disseminating evidence-based, non-stigmatising and useful information and resources about crystal methamphetamine to key end-user groups, and received good usability scores across its target groups. Interaction with Cracks in the Ice led to immediate improvements in knowledge about crystal methamphetamine, and a decrease in stigmatising attitudes. Cracks in the Ice demonstrates the important role of digital information and support platforms for translating evidence into practice as well as improving knowledge and reducing stigma.