User Experience, Engagement, and Popularity in Mental Health Apps: Secondary Analysis of App Analytics and Expert App Reviews (Preprint)

Abstract

BACKGROUND User experience and engagement are critical to mental health apps’ abilities to support users. However, limited work has examined the relationship between user experience, engagement, and app popularity. Given that apps vary immensely in their popularity, understanding why some mental health apps are more appealing or engaging to users can inform efforts to develop better apps. OBJECTIVE We aimed to examine relationships between user experience, engagement, and popularity. To do so, we examined links between subjective measures of user experience and objective measures of app popularity and engagement. METHODS We conducted a pre-registered secondary data analysis in a sample of 56 mental health apps. To measure user experience, we used expert ratings on the Mobile App Rating Scale (MARS) and consumer ratings from the Apple app store and Google Play app store. To measure engagement, we acquired estimates of measures of monthly active users (MAU) and user retention. To measure app popularity, we used download count, total app revenue, and MAU again. RESULTS MARS total score was significantly and positively correlated with app-level revenue (T=0.30, P=.002), MAU (T= 0.39, P<.001), and downloads (T=0.41, P<.001). However, neither the MARS total score nor any of its subscales (Engagement, Functionality, Aesthetics, nor Information) were significantly correlated with user retention 1, 7, or 30 days after downloading. Also, MARS total score was not significantly correlated with app store rating. CONCLUSIONS Popular mental health apps receive better ratings of user experience than less popular ones. However, user experience (as operationalized by the MARS) does not predict sustained engagement with mental health apps. Collaboration between industry and academic teams may better advance a science of engagement and help to make mental health apps more effective and appealing.

Perspectives on Mental Health Digital Platforms: A Usability Study with Ergonomics Design Students

“…This suggests that when mental health apps are well-designed and user-friendly, they can be powerful tools for mental health support 67 . It has also been shown that poor usability can lead to reduced user satisfaction, decreased engagement, and increased abandonment rates in mental health apps 55,56 . These findings underscore the importance of ensuring excellent usability in such technology and highlight the need to focus on user engagement in mental health apps, emphasizing the need for robust measurement, reporting, and validity assessment in the development of effective mental health apps 55 .…”

“…Engagement with mental health apps is influenced by several factors, including content, user experience, and the degree of usercenteredness. This is particularly evident where engagement is crucial for the effectiveness of the intervention [55][56][57][58] . The significance of usability is multifaceted.…”

Perspectives on Mental Health Digital Platforms: A Usability Study with Ergonomics Design Students

“…This suggests that when mental health apps are well-designed and user-friendly, they can be powerful tools for mental health support 68 . It has also been shown that poor usability can lead to reduced user satisfaction, decreased engagement, and increased abandonment rates in mental health apps 56,57 . These findings underscore the importance of ensuring excellent usability in such technology and highlight the need to focus on user engagement in mental health apps, emphasizing the need for robust measurement, reporting, and validity assessment in the development of effective mental health apps 56 .…”

“…Engagement with mental health apps is influenced by several factors, including content, user experience, and the degree of usercenteredness. This is particularly evident where engagement is crucial for the effectiveness of the intervention [56][57][58][59] . The significance of usability is multifaceted.…”