Framework to assess the quality of mHealth apps: a mixed-method international case study protocol

Abstract

IntroductionHealthcare professionals (HCPs) often recommend their patients to use a specific mHealth app as part of health promotion, disease prevention and patient self-management. There has been a significant growth in the number of HCPs downloading and using mobile health (mHealth) apps. Most mHealth apps that are available in app stores employ a ‘star rating’ system. This is based on user feedback on an app, but is highly subjective. Thus, the identification of quality mHealth apps which are deemed fit for purpose can be a difficult task for HCPs. Currently, there is no unified, validated standard guidelines for assessment of mHealth apps for patient safety, which can be used by HCPs. The Modified Enlight Suite (MES) is a quality assessment framework designed to provide a means for HCPs to evaluate mHealth apps before they are recommended to patients. MES was adapted from the original Enlight Suite for international use through a Delphi method, followed by preliminary validation process among a population predominantly consisting of medical students. This study aims to evaluate the applicability and validity of the MES, by HCPs, in low, middle and high income country settings.Methods and analysisMES will be evaluated through a mixed-method study, consisting of qualitative (focus group) and quantitative (survey instruments) research, in three target countries: Malaŵi (low income), South Africa (middle income) and Ireland (high income). The focus groups will be conducted through Microsoft Teams (Microsoft, Redmond, Washington, USA) and surveys will be conducted online using Qualtrics (Qualtrics International, Seattle, Washington, USA). Participants will be recruited through the help of national representatives in Malawi (Mzuzu University), South Africa (University of Fort Hare) and Ireland (University College Cork) by email invitation. Data analysis for the focus group will be by the means of thematic analysis. Data analysis for the survey will use descriptive statistics and use Cronbach alpha as an indicator of internal consistency of the MES. The construct validity of the mHealth app will be assessed by computing the confirmatory factor analysis using Amos.Ethics and disseminationThe study has received ethical approval from the Social Research Ethics Committee (SREC) SREC/SOM/03092021/1 at University College Cork, Ireland, Malaŵi Research Ethics Committee (MREC), Malaŵi MZUNIREC/DOR/21/59 and Inter-Faculty Research Ethics Committee (IFREC) of University of Fort Hare (REC-2 70 710-028-RA). The results of the study will be disseminated through the internet, peer-reviewed journals and conference presentations.

Applying the Participatory Slow Design Approach to a mHealth Application for Family Caregivers in Pediatric Ear, Nose, and Throat Surgery

“…Within this context, there is a growing and increasingly widespread impetus from the mHealth app industry for the development of systems and tools to support HCPs to optimize the services provided to users and improve customer satisfaction [8]. However, authors in the literature warn that the quality and reliability of the mHealth apps currently available on the market should be evaluated with caution [36]. Today, to ensure high-quality and safe care through the support of mHealth apps, the adoption of a patient-centered approach and an evidence-based design is indeed essential.…”

Improving health literacy using the power of digital communications to achieve better health outcomes for patients and practitioners

“…These technologies have shown effectiveness in improving diagnostic accuracy, treatment planning and patient management ( 51 , 57 – 59 , 65 ). As digital tools continue to advance, it is essential for healthcare providers and researchers to harness their potential and integrate them into clinical practice to enhance patient outcomes and optimise healthcare delivery ( 53 , 56 ).…”

“…App certification organisations, such as the Organisation for the Review of Care and Health Apps (ORCHA) (52), play a pivotal role in evaluating and rating health apps based on stringent criteria. ORCHA assesses apps across multiple domains, including clinical effectiveness, data privacy, usability and accessibility, providing users with reliable information to make informed choices (53). Another example is the mHealth App Certification Program by the UK National Health Service (NHS) Digital (54), which evaluates apps against defined technical, clinical and regulatory standards.…”