Chinese Version of the mHealth App Usability Questionnaire: Cross-Cultural Adaptation and Validation

Abstract

BackgroundMobile health (mHealth) apps have shown the advantages of improving medication compliance, saving time required for diagnosis and treatment, reducing medical expenses, etc. The World Health Organization (WHO) has recommended that mHealth apps should be evaluated prior to their implementation to ensure their accuracy in data analysis.ObjectiveThis study aimed to translate the patient version of the interactive mHealth app usability questionnaire (MAUQ) into Chinese, and to conduct cross-cultural adaptation and reliability and validity tests.MethodsThe Brislin’s translation model was used in this study. The cross-cultural adaptation was performed according to experts’ comments and the results of prediction test. The convenience sampling method was utilized to investigate 346 patients who used the “Good Doctor” (“Good Doctor” is the most popular mHealth app in China), and the reliability and validity of the questionnaire were evaluated as well.ResultsAfter translation and cross-cultural adaptation, there were a total of 21 items and 3 dimensions: usability and satisfaction (8 items), system information arrangement (6 items), and efficiency (7 items). The content validity index was determined to be 0.952, indicating that the 21 items used to evaluate the usability of the Chinese version of the MAUQ were well correlated. The Cronbach’s α coefficient of the total questionnaire was 0.912, which revealed that the questionnaire had a high internal consistency. The values of test-retest reliability and split-half reliability of the Chinese version of the MAUQ were 0.869 and 0.701, respectively, representing that the questionnaire had a good stability.ConclusionThe translated questionnaire has good reliability and validity in the context of Chinese culture, and it could be used as a usability testing tool for the patient version of interactive mHealth apps.

Chinese Version of the Mobile Health App Usability Questionnaire: Translation, Adaptation, and Validation Study

“…In terms of profession, being a student-100% (322/322) in this study and Mustafa et al [13], 31.4% in Zhou et al [9], and 1.56% in Zhao et al [14]-also likely impacted the questionnaire's internal consistency and reliability, with the rate of students participating positively proportional to the degree of reliability and internal consistency.…”

“…All informants in this study and Mustafa et al [ 13 ] were college students at the undergraduate or graduate level, but those in Zhao et al [ 14 ] and Zhou et al [ 9 ] had different levels of education: 33.24% and 67.2% held an undergraduate or above in Zhao et al [ 14 ] and Zhou et al [ 9 ], respectively. The overall higher level of respondent education may explain the relatively higher degree of questionnaire’s internal consistency and reliability in our study and Mustafa et al [ 13 ], in comparison with that in Zhao et al [ 14 ] and Zhou et al [ 9 ]. However, the vast gap in participant education at or above the undergraduate level between Zhao et al [ 14 ] and Zhou et al [ 9 ] merely resulted in a considerably minor difference in questionnaire reliability (Cronbach α=.912 vs .914).…”

“…By contrast, Zhao et al [ 14 ] adopted the Good Doctor app, which was not equipped with the chatbot function. This difference in apps may somewhat explain the notable discrepancy in the questionnaire’s internal consistency and reliability between this study (Cronbach α=.988) and that by Zhao et al [ 14 ] (Cronbach α=.912). The mHealth apps used in Krebs and Duncan [ 7 ] and Mustafa et al [ 13 ] did not have the chatbot function.…”

“…Two more recent studies translated and adapted the MAUQ into Chinese [ 13 ] and Malay [ 14 ], respectively, finding that the Chinese and Malay versions exhibited high reliability and validity similar to those of the original English version [ 13 , 14 ]. The Chinese version of the MAUQ (C-MAUQ; interactive for patients) was testified to be reliable and valid, with content validity index of 0.952, Cronbach α of .912, value of test-retest reliability of 0.896, and value of the split-half reliability of 0.701 [ 14 ]. The Malay version of the MAUQ (standalone for patients) was proved to be reliable for evaluating the usability of the mHealth apps (Cronbach α=.946) [ 13 ].…”

“…The Malay version of the MAUQ (standalone for patients) was proved to be reliable for evaluating the usability of the mHealth apps (Cronbach α=.946) [ 13 ]. Considering the painstaking efforts and considerable time and cost investment involved in developing new questionnaires [ 14 ], Marzuki et al [ 12 ] strongly recommended that established, accessible, and reliable questionnaires should be adapted, validated, and recorded cross-linguistically.…”