Abstract
Mobile software applications (apps) on health-related topics are among the most popular apps used today. However, concerns have been raised about privacy and security risks of consumer data, and disclosure to third parties. Concerns have also been raised about the content rating of apps and whether it corresponds with in-app advertising. The aim of this project was to explore international regulation of health apps and existing standards for app developers. A literature review was conducted focusing on standards, compliance, guidelines, awareness and technology. A set of assessment criteria was then developed that could be used by parents to evaluate the trustworthiness of maternal and child health apps. In the pilot study the criteria were assessed against ten maternal and child health apps selected from Google play, Apple store, the SocialWellth app library and the former UK National Health Service app library. Only one of the ten maternal and child health apps met all ten assessment criteria; two apps met only five criteria. The least frequently met criteria involved use of a trustmark and government approval, and in-app advertising falling outside the content rating. Our evaluation highlighted issues with the way information is made available to consumers through maternal and child health apps. It also demonstrated that not all app developers and advertisers follow existing relevant international guidelines or technology standards. Given this environment, our proposed assessment criteria are a means by which parents can make their own evaluation of the trustworthiness of maternal and child health apps before downloading them.
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References
Cramer H, Rost M, Belloni N, Bentley F, Chincholle D, editors. Research in the large. using app stores, markets, and other wide distribution channels in Ubicomp research. Proceedings of the 12th ACM international conference adjunct papers on Ubiquitous computing-Adjunct; 2010: ACM.
Boxall A. 2014 is the year of health and fitness apps, says Google 2014. Available from: http://www.digitaltrends.com/mobile/google-play-store-2014-most-downloaded-apps/#ixzz4Rdhp2eqQ. Accessed 15 Jan 2018.
SocialWellth. Intelligence driven curation: shaped by science. In: Curation. 2016. http://socialwellth.com/our-approach/curation/. Accessed 2/12/2016].
Hamel MB, Cortez NG, Cohen IG, Kesselheim AS. FDA regulation of mobile health technologies. N Engl J Med. 2014;371(4):372–9.
Jain AK, Shanbhag D. Addressing security and privacy risks in mobile applications. IT Prof. 2012;14(5):28–33.
Burke KB, Onugha N. iPresenting complaint: two cases of children referred due to parental use of iphone applications. Arch Dis Child. 2012;2012:A11–2. https://doi.org/10.1136/archdischild-2012-301885.27.
Handel MJ. mHealth (Mobile Health): using apps for health and wellness. Explore: J Sci Healing. 2011;7(4):256–61. https://doi.org/10.1016/j.explore.2011.04.011.
Leroux E, Rivas H. Evidence-based mHealth 2014. https://novoed.com/mhealth/reports/52109. Accessed 2/12/2016.
McCartney M. How do we know whether medical apps work? Br Med J. 2013;346:f1974. https://doi.org/10.1136/bmj.f1974.
Scott KM, Gome GA, Richards D, Caldwell PHY. How trustworthy are apps for maternal and child health? Health Technol. 2015;4(4):329–36. https://doi.org/10.1007/s12553-015-0099-x.
McCarthy M. Experts warn on data security in health and fitness apps. Br Med J. 2013;347:1.
Scher D. The big problem with mobile health apps: security and privacy issues. Medscape: Medscape Business of Medicine; 2015.
Scott K, Richards D, Adhikari R. A review and comparative analysis of security risks and safety measures of mobile health apps. Australas J Inf Syst. 2015;19 https://doi.org/10.3127/ajis.v19i0.1210.
Chen Y, Xu H, Zhou Y, Zhu S, editors. Is this app safe for children?: a comparison study of maturity ratings on Android and iOS applications. Proceedings of the 22nd international conference on World Wide Web; 2013: International World Wide Web Conferences Steering Committee.
Apple. App store reviewer guidelines. Apple. 2016. https://developer.apple.com/app-store/review/guidelines/. Accessed 2/12/2016.
Chen Y, Zhu S, Xu H, Zhou Y, editors. Children’s Exposure to Mobile In-App Advertising: An Analysis of Content Appropriateness. Social Computing (SocialCom), 2013 International Conference on; 2013: IEEE.
Baek Y, Ohk K. The determinants of increasing privacy concerns in the mobile apps. Int J Contents. 2012;8(2):43–51.
Grace MC, Zhou W, Jiang X, Sadeghi A-R, editors. Unsafe exposure analysis of mobile in-app advertisements. Proceedings of the fifth ACM conference on Security and Privacy in Wireless and Mobile Networks; 2012: ACM.
Meyenn A, editor. A proposed methodology for the teaching of information technology ethics in schools. Selected papers from the second Australian Institute conference on Computer ethics; 2000: Australian Computer Society, Inc.
Apple. Use restrictions on your iPhone, iPad, and iPod touch. 2016. https://support.apple.com/en-au/HT201304. Accessed 2/12/2016.
Welivesecurity.com. How parents can assess the suitability of apps for their kids. Welivesecurity.com. 2015. http://www.welivesecurity.com/2015/12/04/how-parents-can-assess-the-suitability-of-apps-for-their-children/. Accessed 2 Dec 2016.
StandardsAustralia. Standards Australia e-health website. 2016. http://www.e-health.standards.org.au/. Accessed 2/12/2016.
HL7Systems&Services. HL7 tutorial. 2016. http://www.hl7.com.au/FAQ.htm. Accessed 2/12/2016.
EuropeanCommission. Medical devices. In: Growth: Internal market, industry, entrepreneurship and SMEs. 2016. http://ec.europa.eu/growth/single-market/european-standards/harmonised-standards/medical-devices/. Accessed 2/12/2016.
Dolan B. First mobile medical app to get CE Mark in UK. mobihealthnews 2012.
EuropeanCommision. Public consultation on the Green Paper on mobile Health. 2016. https://ec.europa.eu/digital-single-market/en/public-consultation-green-paper-mobile-health. Accessed 2/12/2016].
EuropeanCommision. Sstaff working document on "Progress on 'GDP and beyond' actions". In: Beyond GDP: Measuring progress, true wealth, and well-being. 2013. http://ec.europa.eu/environment/beyond_gdp/staffworkingdoc_en.html. Accessed 2/12/2016.
Evenstad L. NHS Health Apps Library to close. ComputerWeekly.com Computer Weekly; 2015.
NHS. National Health Services Health Apps Library. 2016. http://www.nhs.uk/pages/healthappslibrary.aspx. Accessed 2/12/2016.
Developer. Downloads & data. NHS. 2016. http://developer.nhs.uk/downloads-data/. Accessed 2/12/2016.
Pai A. NHS England to relaunch its recommended health apps library as condition-focused "app stores". mobihealthnews 2015.
FDA. DA mobile applications: guidance for industry and food and drug administration staff. In: eHealth Initiative. 2013. https://ehi-rails-app.s3.amazonaws.com/uploads/article/file/373/2013-09-23_-_eHI_-_FDA_Mobile_Medical_App_Guidance_-_pdf.pdf. Accessed 2/12/2016.
ANSI. ANSI/AAMI/ISO 13485 / ANSI/AAMI/IEC 62304 / ANSI/AAMI/ISO 14971 - Medical devices package. American National Standards Institute. 2016. https://webstore.ansi.org/RecordDetail.aspx?sku=ANSI%2fAAMI%2fISO+13485+%2f+ANSI%2fAAMI%2fIEC+62304+%2f+ANSI%2fAAMI%2fISO+14971+-+Medical+Devices+Package&source=package_landing_page. Accessed 2/12/2016.
HON. Health On the Net. Health On the Net Foundation. 2016. https://www.healthonnet.org/. Accessed 2/12/2016.
Dan L. The rise and fall of Happtique, mHealth’s first app prescribing platform. HIStalk Connect. 2016. http://histalkmobile.com/the-rise-and-fall-of-happtique-mhealths-first-app-prescribing-platform/. Accessed 2/12/2016.
PRNewswire. Happtique releases draft app certification program standards for public comment. CISION. 2012. http://www.prnewswire.com/news-releases/happtique-releases-draft-app-certification-program-standards-for-public-comment-162076225.html. Accessed 2/12/2016.
Boulos MNK, Brewer AC, Karimkhani C, Buller DB, Dellavalle RP. Mobile medical and health apps: state of the art, concerns, regulatory control and certification. Online J Public Health Inform. 2014;5(3):229.
FTC. Mobile privacy disclosures: building trust through transparency. In: FTC Staff Report. 2013. www.ftc.gov/os/2013/02/130201mobileprivacyreport.pdf. Accessed 2/12/2016.
NHS. App development: an NHS guide for developing mobile healthcare applications. 2014. http://innovationssoutheast.nhs.uk/files/4214/0075/4193/98533_NHS_INN_AppDevRoad.pdf. Accessed 2/12/2016.
ICO. Privacy in mobile apps: guidance for app developers. International Commissioner's Office. 2013. Accessed 2/12/2016.
BabyCentre. My pregnancy today. 2015. https://my-pregnancy-today.en.softonic.com/android?ex=TOP-481.0. Accessed 2/12/2016.
HealthandParenting. Parenting++. 2015. https://itunes.apple.com/au/app/pregnancy-++/id505862554?mt=8. Accessed 2/12/2016.
MedHelp. I'm expecting. 2015. http://www.medhelp.org/healthy-living/pages/Im-Expecting/1166. Accessed 2/12/2016.
Sevenlogics I. Baby Countdown. 2015. https://play.google.com/store/apps/details?id=com.cg.android.babycountdown; http://www.sevenlogics.com/. Accessed 18/11 2014.
AAPA. Healthy children. American Academy of Pediatrics Apps. 2015. https://play.google.com/store/apps/details?id=org.healthy.children. Accessed 2/12/2016].
APE. Child development milestones. AcademyforProfessionalExcellence. 2015. https://play.google.com/store/apps/details?id=com.andromo.dev88207.app92302. Accessed 2/12/2016.
Movinapp. Child BMI Calculator 2015. https://play.google.com/store/apps/details?id=com.movinapp.cbmi. Accessed 2/12/2016.
TabTale. Happy teeth, healthy kids. 2015. https://play.google.com/store/apps/details?id=com.tabtale.happyteeth. Accessed 2/12/2016.
Practo. Practo: your health app. 2015. https://play.google.com/store/apps/details?id=com.practo.fabric. Accessed 2/12/2016.
CPtoys HB. 2015. http://www.cptoys.org. Accessed 2/12/2016.
Burke KB, Sargant N, Marden B. Smartphone technology in the paediatric setting. Arch Dis Child. 2012;97:1007–8.
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Scott, K.M., Richards, D. & Londos, G. Assessment criteria for parents to determine the trustworthiness of maternal and child health apps: a pilot study. Health Technol. 8, 63–70 (2018). https://doi.org/10.1007/s12553-018-0216-8
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DOI: https://doi.org/10.1007/s12553-018-0216-8