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

2021 ◽  
Author(s):  
Benjamin T Kaveladze ◽  
Akash R Wasil ◽  
John B Bunyi ◽  
Veronica Ramirez ◽  
Stephen M Schueller

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.

2019 ◽  
Author(s):  
Florian Dittrich ◽  
Sascha Beck ◽  
Anna Katharina Harren ◽  
Felix Reinecke ◽  
Sebastian Serong ◽  
...  

BACKGROUND It is undeniable that appropriate smartphone apps offer enormous opportunities for dealing with future challenges in orthopedic surgery and public health, in general. However, it is still unclear how the apps currently available in the two major app stores can be used in daily clinical routine by German orthopedic surgeons. OBJECTIVE This study aimed to gain evidence regarding the quantity and quality of apps available in the two major app stores and their suitability for use by orthopedic surgeons in Germany. METHODS We conducted a systematic, keyword-based app store screening to obtain evidence concerning the quantity and quality of commercially available apps. Apps that met the inclusion criteria were evaluated using the <i>app synopsis–checklist for users</i> and the German Mobile App Rating Scale for secure use, trustworthiness, and quality. RESULTS The investigation revealed serious shortcomings regarding legal and medical aspects. Furthermore, most apps turned out to be useless and unsuitable for the clinical field of application (4242/4249, 99.84%). Finally, 7 trustworthy and high-quality apps (7/4249, 0.16%) offering secure usage in the daily clinical routine of orthopedists were identified. These apps mainly focused on education (5/7). None of them were CE (Conformité Européenne) certified. Moreover, there are no studies providing evidence that these apps have any positive use whatsoever. CONCLUSIONS The data obtained in our study suggest that the number of trustworthy and high-quality apps on offer is extremely low. Nowadays, finding appropriate apps in the fast-moving, complex, dynamic, and rudimentarily controlled app stores is most challenging. Promising approaches, for example, systematic app store screenings, app-rating developments, reviews or app libraries, and the creation of consistent standards have been established. However, further efforts are necessary to ensure that these innovative mobile health apps not only provide the correct information but are also safe to use in daily clinical practice.


2021 ◽  
Author(s):  
Xiaoqian Wu ◽  
Lin Xu ◽  
PengFei Li ◽  
TingTing Tang ◽  
Cheng Huang

BACKGROUND Mental disorders impose varying degrees of burden on patients and their surroundings. However, people are reluctant to take the initiative to seek mental health services because of the uneven distribution of resources and stigmatization. Thus, mobile apps are considered an effective way to eliminate these obstacles and improve mental health awareness. OBJECTIVE This study aimed to evaluate the quality, function, privacy measures, and evidence-based and professional background of multipurpose mental health apps in Chinese commercial app stores. METHODS A systematic search was conducted on iOS and Android platforms in China to identify multipurpose mental health apps. Two independent reviewers evaluated the identified mobile apps using Mobile App Rating Scale (MARS). Each app was downloaded, and the general characteristics, privacy and security measures, development background, and functional characteristics of each app were evaluated. RESULTS A total of 40 apps were analyzed, of which 35 apps (87.5%) were developed by companies and 33 apps (82.5%) provided links to access the privacy policy; 52.5% did not mention the involvement of relevant professionals or the guidance of scientific basis in the app development process. The main built-in functions of these apps include psychological education (38/40, 95%), self-assessment (34/40, 85%), and counseling (33/40, 83%). The overall quality average MARS score of the 40 apps was 3.53 (standard deviation 0.39), and the total score was between 2.96 and 4.30. The total score of MARS was significantly positively correlated with the scores of each subscale (r = 0.62–0.88; P <.001). However, the user score of the app market was not significantly correlated with the total score of MARS (r = 0.23; P =.19). CONCLUSIONS The quality of multipurpose mental health apps in China’s main app market is generally good and provides various functional combinations. However, health professionals are less involved in the development of these apps, and the privacy protection policy of the apps also needs to be described in more detail. This study provides a reference for the development of multipurpose mental health apps.


Author(s):  
Matthias Domhardt ◽  
Eva-Maria Messner ◽  
Anna-Sophia Eder ◽  
Sophie Engler ◽  
Lasse B. Sander ◽  
...  

Abstract Background The access to empirically-supported treatments for common mental disorders in children and adolescents is often limited. Mental health apps might extend service supplies, as they are deemed to be cost-efficient, scalable and appealing for youth. However, little is known about the quality of available apps. Therefore, we aimed to systematically evaluate current mobile-based interventions for pediatric anxiety, depression and posttraumatic stress disorder (PTSD). Methods Systematic searches were conducted in Google Play Store and Apple App Store to identify relevant apps. To be eligible for inclusion, apps needed to be: (1) designed to target either anxiety, depression or PTSD in youth (0–18 years); (2) developed for children, adolescents or caregivers; (3) provided in English or German; (4) operative after download. The quality of eligible apps was assessed with two standardized rating systems (i.e., Mobile App Rating Scale (MARS) and ENLIGHT) independently by two reviewers. Results Overall, the searches revealed 3806 apps, with 15 mental health apps (0.39%) fulfilling our inclusion criteria. The mean overall scores suggested a moderate app quality (MARS: M = 3.59, SD = 0.50; ENLIGHT: M = 3.22, SD = 0.73). Moreover, only one app was evaluated in an RCT. The correlation of both rating scales was high (r = .936; p < .001), whereas no significant correlations were found between rating scales and user ratings (p > .05). Conclusions Our results point to a rather poor overall app quality, and indicate an absence of scientific-driven development and lack of methodologically sound evaluation of apps. Thus, future high-quality research is required, both in terms of theoretically informed intervention development and assessment of mental health apps in RCTs. Furthermore, institutionalized best-practices that provide central information on different aspects of apps (e.g., effectiveness, safety, and data security) for patients, caregivers, stakeholders and mental health professionals are urgently needed.


10.2196/30766 ◽  
2021 ◽  
Author(s):  
Benjamin T Kaveladze ◽  
Akash R Wasil ◽  
John B Bunyi ◽  
Veronica Ramirez ◽  
Stephen M Schueller

10.2196/17085 ◽  
2020 ◽  
Vol 8 (5) ◽  
pp. e17085 ◽  
Author(s):  
Florian Dittrich ◽  
Sascha Beck ◽  
Anna Katharina Harren ◽  
Felix Reinecke ◽  
Sebastian Serong ◽  
...  

Background It is undeniable that appropriate smartphone apps offer enormous opportunities for dealing with future challenges in orthopedic surgery and public health, in general. However, it is still unclear how the apps currently available in the two major app stores can be used in daily clinical routine by German orthopedic surgeons. Objective This study aimed to gain evidence regarding the quantity and quality of apps available in the two major app stores and their suitability for use by orthopedic surgeons in Germany. Methods We conducted a systematic, keyword-based app store screening to obtain evidence concerning the quantity and quality of commercially available apps. Apps that met the inclusion criteria were evaluated using the app synopsis–checklist for users and the German Mobile App Rating Scale for secure use, trustworthiness, and quality. Results The investigation revealed serious shortcomings regarding legal and medical aspects. Furthermore, most apps turned out to be useless and unsuitable for the clinical field of application (4242/4249, 99.84%). Finally, 7 trustworthy and high-quality apps (7/4249, 0.16%) offering secure usage in the daily clinical routine of orthopedists were identified. These apps mainly focused on education (5/7). None of them were CE (Conformité Européenne) certified. Moreover, there are no studies providing evidence that these apps have any positive use whatsoever. Conclusions The data obtained in our study suggest that the number of trustworthy and high-quality apps on offer is extremely low. Nowadays, finding appropriate apps in the fast-moving, complex, dynamic, and rudimentarily controlled app stores is most challenging. Promising approaches, for example, systematic app store screenings, app-rating developments, reviews or app libraries, and the creation of consistent standards have been established. However, further efforts are necessary to ensure that these innovative mobile health apps not only provide the correct information but are also safe to use in daily clinical practice.


2020 ◽  
Vol 26 (3) ◽  
pp. 2042-2066 ◽  
Author(s):  
Felwah Alqahtani ◽  
Rita Orji

Mental health applications hold great promise as interventions for addressing common mental issues. Although many people with mental health issues use mobile app interventions, their adherence level remains low. Low engagement affects the effectiveness of mobile interventions. However, there is still a dearth of research to explain the reasons for low engagement. User experience and usability are two factors that determine the adoption and usage of apps. Analyzing user reviews of mobile apps for mental health issues reveals user experience and what features users liked and disliked in the apps and hence informs future app design and refinements. This research aims to analyze user reviews of publicly available mental health applications to uncover their strengths, weaknesses, and gaps, hence revealing why users are likely to cease using these applications. We mined reviews of 106 mental health apps retrieved from Apple’s App Store and Google Play and employed thematic analysis on 13,549 reviews. The review analysis shows that users placed more emphasis on the user interface and the user-friendliness of the app. Users also appreciated apps that present them with a variety of options, functionalities, and content that they can choose. Again, apps that offer adaptive functionalities that allow users to adapt some app features also received high ratings. In contrast, poor usability emerged as the most common reason for abandoning mental health apps. Other pitfalls include lack of a content variety, lack of personalization, lack of customer service and trust, and security and privacy issues.


2018 ◽  
Vol 52 (5/6) ◽  
pp. 1154-1184 ◽  
Author(s):  
Tom Chen ◽  
Judy Drennan ◽  
Lynda Andrews ◽  
Linda D. Hollebeek

PurposeThis paper aims to propose user experience sharing (UES) as a customer-based initiation of value co-creation pertaining to service provision, which represents customers’ level of effort made for the direct benefit of others in their service network. The authors propose and empirically examine a user experience sharing model (UESM) that explicates customer-to-customer (C2C) UES and its impacts on firm-desired customer-based outcomes in online communities.Design/methodology/ApproachBased on an extensive review, the authors conceptualize UES and UESM. By using online survey data collected from mobile app users in organic online communities, the authors performed structural equation modeling analyses by using AMOS 24.FindingsThe results support the proposed UESM, showing that C2C UES acts as a key driver of both firm-desired customer efforts and customer insights. The results also confirmed that service-dominant (S-D) logic-informed motivational drivers exert a significant impact on C2C UES. Importantly, C2C UES mediates the relationship between S-D logic-informed motivational drivers and firm-desired customer-based outcomes.Originality/valueThis study offers a pioneering attempt to develop an overarching concept, UES, which reflects customers’ initiation of value co-creation, and to empirically examine C2C UES. The empirical evidence supports the key contention that firms should proactively facilitate C2C UES.


2017 ◽  
Vol 48 (4) ◽  
pp. 629-641 ◽  
Author(s):  
T. Ford ◽  
C. Parker ◽  
J. Salim ◽  
R. Goodman ◽  
S. Logan ◽  
...  

BackgroundChildren with poor mental health often struggle at school. The relationship between childhood psychiatric disorder and exclusion from school has not been frequently studied, but both are associated with poor adult outcomes. We undertook a secondary analysis of the British Child and Adolescent Mental Health Surveys from 2004 and its follow-up in 2007 to explore the relationship between exclusion from school and psychopathology. We predicted poorer mental health among those excluded.MethodPsychopathology was measured using the Strengths and Difficulties Questionnaire, while psychiatric disorder was assessed using the Development and Well-Being Assessment and applying Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM IV) criteria. Exclusion from school and socio-demographic characteristics were reported by parents. Multi-variable regression models were used to examine the impact of individual factors on exclusion from school or psychological distress.ResultsExclusion from school was commoner among boys, secondary school pupils and those living in socio-economically deprived circumstances. Poor general health and learning disability among children and poor parental mental health were also associated with exclusion. There were consistently high levels of psychological distress among those who had experienced exclusion at baseline and follow-up.ConclusionsWe detected a bi-directional association between psychological distress and exclusion. Efforts to identify and support children who struggle with school may therefore prevent both future exclusion and future psychiatric disorder.


10.2196/18495 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e18495 ◽  
Author(s):  
Lindsay M Bearne ◽  
Mandeep Sekhon ◽  
Rebecca Grainger ◽  
Anthony La ◽  
Mehrdad Shamali ◽  
...  

Background Rheumatoid arthritis (RA) is a disabling, inflammatory joint condition affecting 0.5%-1% of the global population. Physical activity (PA) and exercise are recommended for people with RA, but uptake and adherence tend to be low. Smartphone apps could assist people with RA to achieve PA recommendations. However, it is not known whether high quality, evidence-informed PA apps that include behavior change techniques (BCTs) previously identified as effective for PA adherence are available for people with RA. Objective This study aims to systematically identify apps that include goals to facilitate PA for adults with RA and assess app quality and content for the inclusion of relevant BCTs against recommendations for cardiorespiratory, resistance, flexibility, and neuromotor PA and exercise. Methods A systematic search of the Apple App Store and Google Play Store in the United Kingdom was conducted to identify English language apps that promote PA for adults with RA. Two researchers independently assessed app quality (mobile app rating scale [MARS]; range 0-5) and content (BCT Taxonomy version 1, World Health Organization, the American College of Sports Medicine, and the European League against Rheumatism recommendations for PA). The completeness of reporting of PA prescription was evaluated using a modified version of the Consensus on Exercise Reporting Template (CERT; range 0-14). Results A total of 14,047 apps were identified. Following deduplication, 2737 apps were screened for eligibility; 6 apps were downloaded (2 on the Apple App Store and 4 on the Google Play Store), yielding 4 unique apps. App quality varied (MARS score 2.25-4.17). Only 1 app was congruent with all aspects of the PA recommendations. All apps completely or partially recommended flexibility and resistance exercises, 3 apps completely or partially advised some form of neuromotor exercise, but only 2 offered full or partial guidance on cardiorespiratory exercise. Completeness of exercise reporting was mixed (CERT scores 7-14 points) and 3-7 BCTs were identified. Two BCTs were common to all apps (information about health consequences and instruction on how to perform behavior). Higher quality apps included a greater number of BCTs and were more closely aligned to PA guidance. No published trials evaluating the effect of the included apps were identified. Conclusions This review identifies 4 PA apps of mixed quality and content for use by people with RA. Higher quality apps were more closely aligned to PA guidance and included a greater number of BCTs. One high-quality app (Rheumatoid Arthritis Information Support and Education) included 7 BCTs and was fully aligned with PA and exercise guidance. The effect of apps on PA adherence should be established before implementation.


2019 ◽  
Author(s):  
Marco Bardus ◽  
Nathalie Awada ◽  
Lilian A Ghandour ◽  
Elie-Jacques Fares ◽  
Tarek Gherbal ◽  
...  

BACKGROUND With thousands of health apps in app stores globally, it is crucial to systemically and thoroughly evaluate the quality of these apps due to their potential influence on health decisions and outcomes. The Mobile App Rating Scale (MARS) is the only currently available tool that provides a comprehensive, multidimensional evaluation of app quality, which has been used to compare medical apps from American and European app stores in various areas, available in English, Italian, Spanish, and German. However, this tool is not available in Arabic. OBJECTIVE This study aimed to translate and adapt MARS to Arabic and validate the tool with a sample of health apps aimed at managing or preventing obesity and associated disorders. METHODS We followed a well-established and defined “universalist” process of cross-cultural adaptation using a mixed methods approach. Early translations of the tool, accompanied by confirmation of the contents by two rounds of separate discussions, were included and culminated in a final version, which was then back-translated into English. Two trained researchers piloted the MARS in Arabic (MARS-Ar) with a sample of 10 weight management apps obtained from Google Play and the App Store. Interrater reliability was established using intraclass correlation coefficients (ICCs). After reliability was ascertained, the two researchers independently evaluated a set of additional 56 apps. RESULTS MARS-Ar was highly aligned with the original English version. The ICCs for MARS-Ar (0.836, 95% CI 0.817-0.853) and MARS English (0.838, 95% CI 0.819-0.855) were good. The MARS-Ar subscales were highly correlated with the original counterparts (<i>P</i>&lt;.001). The lowest correlation was observed in the area of usability (<i>r</i>=0.685), followed by aesthetics (<i>r</i>=0.827), information quality (<i>r</i>=0.854), engagement (<i>r</i>=0.894), and total app quality (<i>r</i>=0.897). Subjective quality was also highly correlated (<i>r</i>=0.820). CONCLUSIONS MARS-Ar is a valid instrument to assess app quality among trained Arabic-speaking users of health and fitness apps. Researchers and public health professionals in the Arab world can use the overall MARS score and its subscales to reliably evaluate the quality of weight management apps. Further research is necessary to test the MARS-Ar on apps addressing various health issues, such as attention or anxiety prevention, or sexual and reproductive health.


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