Mindfulness-Based Symptom and Stress Management Apps for Adults With Chronic Lung Disease: Systematic Search in App Stores (Preprint)

Abstract

Background: Up to 70% of lung cancer survivors are also affected by chronic obstructive pulmonary disease (COPD), a common, debilitating, comorbid disease characterized by symptoms such as breathlessness and fatigue. These distressing symptoms detract from a survivor's quality of life.Objective: To identify and evaluate evidence-based, commercially available apps for promoting mindfulness-based strategies among adults with a COPD or lung cancer history, an interdisciplinary research team used 19 keyword combinations in the search engines of Google and iOS app stores in May 2017. Evaluations were conducted on apps' (1) content, (2) usability heuristics, (3) grade-level readability, and (4) cultural sensitivity. Results:The search resulted in 768 apps (508 in iOS and 260 in Google stores). Nine apps met the inclusion criteria and received further evaluation. Only one app had below an eighth-grade reading level; the ninth did not have enough text to calculate a readability score. None of the 9 apps met the cultural sensitivity evaluation criteria. Conclusions:This systematic review identified critical design flaws that may affect the ease of using the apps in this study. Few mobile apps promote mindfulness-based strategies among adults with a COPD or lung cancer history, but those that exist, overall, do not meet the latest scientific evidence. Recommendations include more stringent regulation of health-related apps; use of evidence-based frameworks and participatory design processes; following evidencebased usability practices; use of culturally sensitive language and images; and ensuring that content is written in plain language.