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How trustworthy are apps for maternal and child health?

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Abstract

Mobile technologies have become important tools for promoting and implementing healthcare. A key feature of smartphones and tablet computers is their ability to run software applications (apps), which can address specific health-related areas, including maternal and child health; however, there is little independent regulation or guidance for the development and publication of health apps in many countries, including Australia. This research examined health apps in two major app stores (Google and Apple) that address maternal and child health. Ten free maternal and child health apps available in Google and Apple stores were examined to evaluate their trustworthiness and technical performance. This was determined based on evidence of health professional involvement and use of evidence-based medical content, as well as an evaluation of functionality, usability and security. Only four of the ten apps examined were developed with the involvement of health professionals and four provided information from evidence-based medical content. Significantly, only four were fully functional, two were fully usable and three adequately implemented security mechanisms to guarantee privacy of user data. Two of the apps were inoperative. In conclusion, this study found great variation in the quality of content, functionality and security of ten maternal and child health apps. These results suggest developers, owners and health providers should work to improve maternal and child health apps, consumers need help to determine the trustworthiness of health apps, and sponsors and regulators should establish standards and endorse compliant health apps.

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Conflict of interest

KS, GG, DR and PC declare that they have no conflict of interest.

Studies with humans and animals

This article does not contain any studies with human participants or animals performed by any of the authors.

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Authors and Affiliations

  1. Discipline of Paediatrics and Child Health, The University of Sydney, Sydney, Australia

    Karen M. Scott & Patrina H. Y. Caldwell

  2. Department of Computing, Macquarie University, Sydney, Australia

    Gastao A. Gome & Deborah Richards

  3. The Children’s Hospital at Westmead, Sydney, Australia

    Patrina H. Y. Caldwell

Authors
  1. Karen M. Scott
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  2. Gastao A. Gome
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  3. Deborah Richards
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  4. Patrina H. Y. Caldwell
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Corresponding author

Correspondence to Karen M. Scott.

Appendices

Appendix 1: User interface design principles to assess usability (Nielsen 1995 [28])

1. Visibility of system status: The system should always inform the user about what is happening in the system, through appropriate feedback within a reasonable amount of time.

2. Match between system and the real world: The system should use the users’ language, “with words, phrases and concepts familiar to the user, rather than system-oriented terms. Follow real-world conventions, making information appear in a natural and logical order” (Nielsen 1995, p.1).

3. User control and freedom: Users should be able to make choices and undo them.

4. Consistency and standards: “Users should not have to wonder whether different words, situations, or actions mean the same thing and follow platform conventions” (Nielsen 1995, p.1).

5. Error prevention: Either reduce error-prone situations or check for them and present users with a confirmation message before they save the transaction.

6. Recognition rather than recall: Diminish the user’s memory load by making objects, actions, and options visible.

7. Aesthetic and minimalist design: “Dialogues should not contain information which is irrelevant or rarely needed” (Nielsen 1995, p.1). Any additional unit of information in a dialogue competes with the relevant units of information and reduces their relative visibility.

8. Help users recognize, diagnose, and recover from errors: Error messages should be presented in simple language (no codes) that make the problem clear and suggest a solution..

9. Help and documentation: “Such information should be easy to search, focused on the user’s task, list concrete steps to be carried out, and not be too large” (Nielsen 1995, p.1).

10. Flexibility and efficiency of use [not used in this study]: Accelerators can speed up the interaction for experienced users, but keyboard key combinations are not applicable for mobile phones or tablets.

Appendix 2: Maternal and child health apps reviewed

Apple stores, My child’s eHealth record,<https://itunes.apple.com/au/app/my-childs-ehealth-record/id648713580?mt=8>, viewed 03/09/2013

Apple stores, Save the date,<https://itunes.apple.com/au/app/save-the-date/id619046535?mt=8>, viewed 03/09/2013

Apple stores, Growth,<https://itunes.apple.com/au/app/growth-charts/id446639811?mt=8>, viewed 03/09/2013

Apple stores, Eat Sleep (Apple stores (4) 2013)<https://itunes.apple.com/au/app/eat-sleep-simple-baby-tracking/id349373050?mt=8>, viewed 03/09/2013

Apple stores, Vaccines tracker Lite (Apple stores (5) 2013)<https://itunes.apple.com/au/app/vaccines-tracker-lite/id492836186?mt=8>, viewed 03/09/2013

Apple stores, MotherKnows (Apple stores (6) 2013)<https://itunes.apple.com/ng/app/motherknows/id465991619?mt=8>, viewed 03/09/2013

Apple stores, Baby Countdown (Apple stores (7) 2013)<https://itunes.apple.com/us/app/baby-countdown!!/id400719305?mt=8>, viewed 03/09/2013

Google play stores, Baby’s motor Milestones, <https://play.google.com/store/apps/details?id=com.paediatricphysiotherapycentre.babysmotormilestone&hl=en>, viewed 03/09/2013

Google play stores, Ngala HYHB,<https://play.google.com/store/apps/details?id=au.net.fortix.ngala&hl=en>, viewed 03/09/2013

Google play stores, Dermatology A-Z,<https://play.google.com/store/apps/details?id=com.semaphoremobile.aad&hl=en>, viewed 03/09/2013

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Scott, K.M., Gome, G.A., Richards, D. et al. How trustworthy are apps for maternal and child health?. Health Technol. 4, 329–336 (2015). https://doi.org/10.1007/s12553-015-0099-x

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