Is the Health App Challenge approach of patient-led application conception, development, and review worthwhile?

Abstract

Objectives A Health App Challenge, supporting young people with diabetes to develop and review their own Internet applications (apps) had previously been shown feasible. We aimed to clarify whether such patient-developed apps fill 'app gaps' and can be sustained, and if the approach can be generalized to other conditions. We asked, 'Is it worth trying to run further Health App Challenges or elements of Health App Challenges?' Methods Two Health App Challenges, one for diabetes and one for weight loss surgery, were run simultaneously. Each Challenge (i) invited patient review of existing apps, (ii) supported patient-led teams to design and/or develop their own apps for better health self-management and (iii) invited patient review of the patient-designed or developed apps. Results In the diabetes Challenge, 130 patient reviews were written for existing apps, five designs for new apps submitted and reviewed 17 times. Participants took account of the reviews and designs appeared to fill 'app gaps' in the market, but the designs were not developed as apps. In the bariatric Challenge, only 13 reviews were given for existing apps and no designs or developed apps were submitted. Conclusions Supporting patients to develop apps using this approach is not sustainable. However, a website where health apps and websites can be reviewed and prototype designs submitted would be worthwhile, at least for conditions with high prevalence such as diabetes. It remains unclear whether condition specific health charities could take the role of sustaining such review websites.

Methods and Evaluation Criteria for Apps and Digital Interventions for Diabetes Self-Management: Systematic Review

“…A total of 57 articles were eligible for full-text screening, 26 of which were excluded (see Multimedia Appendix 2 ). A total of 31 articles were eventually included in the review [ 26 - 56 ] (see Multimedia Appendix 3 ). The PRISMA diagram in Figure 1 summarizes the selection process.…”

“…The PRISMA diagram in Figure 1 summarizes the selection process. The confidence in the evidence was considered high in 7 articles [ 27 , 33 , 36 , 43 , 51 , 52 , 54 ]; moderate to high in 1 [ 56 ]; moderate in 17 [ 26 , 28 - 32 , 35 , 37 , 39 , 41 , 42 , 45 , 46 , 48 , 49 , 53 , 55 ], and low in 6 [ 34 , 38 , 40 , 44 , 47 , 50 ].…”

“…The number of participants in each study ranged from 7 [ 41 , 50 ] to 1041 [ 43 ]. In addition to including patients with diabetes in their evaluations, some of the studies expanded the participant group to include HCPs (8/31, 26%) [ 26 , 27 , 29 , 37 , 42 , 48 , 53 , 56 ], developers (4/31, 13%) [ 26 , 44 , 51 , 56 ], researchers (3/31, 10%) [ 29 , 38 , 44 ], informal caregivers (eg, parents, family members) (4/31, 13%) [ 29 , 44 , 53 , 56 ], and others (including experts and other unspecified individuals) (8/31, 26%) [ 26 , 29 , 32 , 37 , 38 , 48 , 55 , 56 ].…”

“…Most of the 31 included studies evaluated interventions delivered via apps (18/31, 58%) [ 29 - 34 , 36 - 39 , 41 , 46 - 49 , 52 , 54 , 56 ], followed by web (9/31, 29%) [ 27 , 28 , 35 , 43 , 45 , 50 , 51 , 53 , 55 ] and multiplatform (4/31, 13%) [ 26 , 40 , 42 , 44 ]. In the studies that conducted a randomized controlled trial, the self-management platform was the main mode of intervention compared with a standard paper diary [ 33 ], the intervention plus counseling via telephone call [ 54 ], and a plain text version of the web intervention [ 43 ] as opposed to an interactive version.…”

“…In addition, the same intervention was referred to by some of the studies: Young with Diabetes app [ 29 , 36 ], My Diabetes My Way [ 30 , 55 ], and WellDoc [ 31 , 50 ]. The evaluated digital self-management interventions targeted mostly T2D (12/31, 38%) [ 27 , 31 , 32 , 34 , 43 , 46 - 51 , 54 ], followed by T1D (7/31, 23%) [ 29 , 33 , 36 , 40 , 41 , 44 , 56 ], unspecified diabetes type (5/31, 16%) [ 26 , 37 , 39 , 53 , 55 ], gestational diabetes mellitus (4/31, 13%) [ 35 , 38 , 45 , 52 ], and T1D and T2D (3/31, 10%) [ 28 , 30 , 42 ] ( Figure 2 ).…”