An Integrated mHealth App for Dengue Reporting and Mapping, Health Communication, and Behavior Modification: Development and Assessment of Mozzify

Abstract

Background For the last 10 years, mobile phones have provided the global health community with innovative and cost-effective strategies to address the challenges in the prevention and management of dengue fever. Objective The aim is to introduce and describe the design and development process of Mozzify, an integrated mobile health (mHealth) app that features real-time dengue fever case reporting and mapping system, health communication (real-time worldwide news and chat forum/timeline, within-app educational videos, links to local and international health agency websites, interactive signs and symptoms checker, and a hospital directions system), and behavior modification (reminders alert program on the preventive practices against dengue fever). We also aim to assess Mozzify in terms of engagement and information-sharing abilities, functionality, aesthetics, subjective quality, and perceived impact. Methods The main goals of the Mozzify app were to increase awareness, improve knowledge, and change attitudes about dengue fever, health care-seeking behavior, and intention-to-change behavior on preventive practices for dengue fever among users. It was assessed using the Mobile Application Rating Scale (MARS) among 50 purposively sampled individuals: public health experts (n=5), environment and health-related researchers (n=23), and nonclinical (end users) participants (n=22). Results High acceptability and excellent satisfaction ratings (mean scores ≥4.0 out of 5) based on the MARS subscales indicate that the app has excellent user design, functionality, usability, engagement, and information among public health experts, environment and health-related researchers, and end users. The app’s subjective quality (recommending the app to other people and the app’s overall star rating), and specific quality (increase awareness, improve knowledge, and change attitudes about dengue fever; health care-seeking behavior; and intention-to-change behavior on preventive practices for dengue fever) also obtained excellent satisfaction ratings from the participants. Some issues and suggestions were raised during the focus group and individual discussions regarding the availability of the app for Android devices, language options limitations, provision of predictive surveillance, and inclusion of other mosquito-borne diseases. Conclusions Mozzify may be a promising integrated strategic health intervention system for dengue fever case reporting and mapping; increase awareness, improve knowledge, and change attitude about dengue fever; and disseminating and sharing information on dengue fever among the general population and health experts. It also can be an effective aid in the successful translation of knowledge on preventive measures against dengue fever to practice.

Sociodemographic Characteristics and Interests of FeverApp Users

“…The FeverApp is a documentation tool for the FeverApp registry, which also provides parents with guideline information on the subject of fevers to increase parental knowledge and confidence. While other health apps with a focus on fevers emphasize on surveillance of specific illnesses in specific seasons, such as influenza [ 23 , 24 ], Dengue fever [ 25 ], or malaria [ 26 ], the FeverApp registry concentrates on pediatric fever as a symptom and a common reason of parental anxiety and overuse of antibiotics, antipyretics, and health services. To the best of our knowledge, there are very few research-based mobile applications that focus both on educating parents and include a diary-function to record fever episodes and the way parents manage fever.…”

Early Detection of Dengue Fever Outbreaks Using a Surveillance App (Mozzify): Cross-sectional Mixed Methods Usability Study

“…Mozzify is a noncommercial app that features real-time reporting and mapping of dengue cases, comprehensive health communication, and an evidence-based behavior modification system tailored for members of the general public and health care professionals [ 11 ] ( Figure 1 ). It is an integrated mHealth app that combines appropriate surveillance methods in the early detection of disease outbreaks: indicator-based surveillance (IBS), event-based surveillance (EBS), and behavior modification [ 3 ].…”

“…It is an integrated mHealth app that combines appropriate surveillance methods in the early detection of disease outbreaks: indicator-based surveillance (IBS), event-based surveillance (EBS), and behavior modification [ 3 ]. The app includes health care professionals in reporting laboratory-confirmed dengue fever cases, which is the provision of IBS [ 3 , 9 , 11 ]. It also uses ArcGIS’s spatial analysis feature (Environmental Systems Research Institute) to identify hotspots, which is also an IBS method (sentinel surveillance) [ 3 , 11 , 12 ].…”

“…The app includes health care professionals in reporting laboratory-confirmed dengue fever cases, which is the provision of IBS [ 3 , 9 , 11 ]. It also uses ArcGIS’s spatial analysis feature (Environmental Systems Research Institute) to identify hotspots, which is also an IBS method (sentinel surveillance) [ 3 , 11 , 12 ]. The reporting and mapping of patients with probable or suspected (with clinical symptoms) dengue fever through its interactive symptoms checker (syndromic surveillance, also an IBS method) is another app feature [ 3 , 9 , 11 , 13 ].…”

“…It also uses ArcGIS’s spatial analysis feature (Environmental Systems Research Institute) to identify hotspots, which is also an IBS method (sentinel surveillance) [ 3 , 11 , 12 ]. The reporting and mapping of patients with probable or suspected (with clinical symptoms) dengue fever through its interactive symptoms checker (syndromic surveillance, also an IBS method) is another app feature [ 3 , 9 , 11 , 13 ]. Mozzify also includes media reports and news, social media (timeline/chat forum), and links to websites of international and local health agencies to detect and monitor outbreaks which is the provision of the EBS method [ 3 , 11 , 14 ].…”