Developing a Theoretical Framework for Evaluating the Quality of mHealth Apps for Adolescent Users: A Systematic Review

Abstract

OBJECTIVE To assess adolescents' preferred mobile app features and to propose a framework for evaluating health-related mobile apps for adolescents. METHODS PubMed, CINAHL, PsycINFO, ERIC, HealthIT.gov , and ClinicalTrials.gov were systematically searched in August 2017. Studies pertaining to app development, feasibility, or usability that reported preferred app features and rating criteria on mHealth (mobile health) apps intended for adolescents were included. Quality assessment was performed using the Mixed Methods Appraisal Tool. Qualitative synthesis was performed to develop themes reflecting best practices for evaluating the quality of mHealth apps for adolescents. Using a grounded theory approach, we constructed a theoretical framework of rating criteria that can be used to inform development of an evaluation tool for mHealth apps targeted to adolescents. RESULTS Thirteen articles were included. Most commonly preferred features include ability to track test results or self-management progress, connect to social media, and gain points or prizes through app gamification. Common rating criteria include degree of app customizability, ease of use, visual appeal, and interactivity. Five emerging dimensions were used in the theoretical framework: Technical Quality; Engagement; Support System; Autonomy; and Safety, Privacy, and Trust. CONCLUSIONS We found that adolescents prefer mHealth apps that are customizable, offer peer support through social media, sustain engagement via gamification, and support the ability to visualize health trends via simplified graphs. Findings may help in the development of mHealth apps that are preferred by adolescents, as well as the development of a quality evaluation tool for mHealth apps targeted to this population.

Security and Privacy of mHealth Applications: A Scoping Review

“…New evaluation frameworks. Most of the papers in this category 70% (7/10) presented new frameworks developed by the study authors, and the methods adopted in their creation varied: from reviews of related literature and preexisting app evaluation frameworks [84], [86], [89] to more empirical methods such as engaging an expert panel of key stakeholders [87] and analysis of mHealth applications [85].…”

“…Most of the studies in this category 60% (6/10) focused on overall evaluation of mHealth apps, including quality assessment [86], [89], review of official frameworks such as APA [5], and frameworks to support decision-making in choosing mHealth apps for research purposes [87].…”

“…Based on the information extracted, we classified evaluation frameworks by three stages of the mHealth app lifecycle that they could be applied at: development, testing, and adoption or recommendation (Table 3) 11 Early stage, development. Ensuring the security and privacy of sensitive medical data in health apps [85] or providing "a theoretical framework of rating criteria" that can be used to inform development of an evaluation tool for mHealth apps [86] were common objectives of the frameworks (Table 3, green colour). Target users here are app developers.…”

“…Another perspective some of the frameworks adopt is userfocused evaluation. This includes evaluation of apps targeting specific user groups, for instance, adolescents [86] or people with mental health problems [84], or based on user input such as user reviews [64].…”

“…The papers on privacy and security evaluation frameworks also reported on the limitations of these frameworks. Some limitations concern the generalisability of findings, which could be due to specific healthcare settings and problem areas [5], patient populations included in the studies [86], or the categories of apps reviewed [88]. Another limitation is the uniform weighting that might be applied to mHealth evaluation.…”