Stay Present with Your Phone: A Systematic Review and Standardized Rating of Mindfulness Apps in European App Stores

Schultchen, Dana; Terhorst, Yannik; Holderied, Tanja; Stach, Michael; Messner, Eva‐Maria; Baumeister, Harald; Sander, Lasse

doi:10.1007/s12529-020-09944-y

Cited by 47 publications

(41 citation statements)

References 78 publications

(113 reference statements)

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“…No randomized controlled trial evaluating the effectiveness of one of the included apps could be identified. This lack of a solid evidence base for the use of health apps is in line with that reported in other systematic reviews of app quality (eg, older adults, mindfulness, depression, rheumatoid arthritis, and posttraumatic stress disorder) [36][37][38][39][40]. These systematic reviews showed that the proportion of the scientifically evaluated apps ranges between 0% and 4.8%.…”

Section: Principal Findingssupporting

confidence: 78%

“…To determine relevant predictors for overall quality, exploratory multiple linear regression analysis was conducted. Price, store, and the number of functions were used as predictors, as they were significant predictors in other systematic app reviews (eg, older adults, mindfulness, depression, posttraumatic stress disorder, rheumatoid arthritis) [36][37][38][39][40]. Dichotomous predictors were dummy coded.…”

Section: Discussionmentioning

confidence: 99%

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Quality of Physical Activity Apps: Systematic Search in App Stores and Content Analysis

Paganini¹,

Terhorst²,

Sander³

et al. 2021

JMIR Mhealth Uhealth

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Background Physical inactivity is a major contributor to the development and persistence of chronic diseases. Mobile health apps that foster physical activity have the potential to assist in behavior change. However, the quality of the mobile health apps available in app stores is hard to assess for making informed decisions by end users and health care providers. Objective This study aimed at systematically reviewing and analyzing the content and quality of physical activity apps available in the 2 major app stores (Google Play and App Store) by using the German version of the Mobile App Rating Scale (MARS-G). Moreover, the privacy and security measures were assessed. Methods A web crawler was used to systematically search for apps promoting physical activity in the Google Play store and App Store. Two independent raters used the MARS-G to assess app quality. Further, app characteristics, content and functions, and privacy and security measures were assessed. The correlation between user star ratings and MARS was calculated. Exploratory regression analysis was conducted to determine relevant predictors for the overall quality of physical activity apps. Results Of the 2231 identified apps, 312 met the inclusion criteria. The results indicated that the overall quality was moderate (mean 3.60 [SD 0.59], range 1-4.75). The scores of the subscales, that is, information (mean 3.24 [SD 0.56], range 1.17-4.4), engagement (mean 3.19 [SD 0.82], range 1.2-5), aesthetics (mean 3.65 [SD 0.79], range 1-5), and functionality (mean 4.35 [SD 0.58], range 1.88-5) were obtained. An efficacy study could not be identified for any of the included apps. The features of data security and privacy were mainly not applied. Average user ratings showed significant small correlations with the MARS ratings (r=0.22, 95% CI 0.08-0.35; P<.001). The amount of content and number of functions were predictive of the overall quality of these physical activity apps, whereas app store and price were not. Conclusions Apps for physical activity showed a broad range of quality ratings, with moderate overall quality ratings. Given the present privacy, security, and evidence concerns inherent to most rated apps, their medical use is questionable. There is a need for open-source databases of expert quality ratings to foster informed health care decisions by users and health care providers.

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Section: Principal Findingssupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Quality of Physical Activity Apps: Systematic Search in App Stores and Content Analysis

Paganini¹,

Terhorst²,

Sander³

et al. 2021

JMIR Mhealth Uhealth

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“…Our quality ratings are in line with the results of previous systematic evaluations deploying the same rating scales on apps for various health conditions and application areas (e.g., depression, PTSD, pain, rheumatism, physical activity, weight management [ 16 , 36 , 38 , 44 – 46 , 52 – 54 ]), all indicating medium overall app qualities with the MARS and ENLIGHT scales. In our study, the categories with the highest ratings were aesthetics and functionality (M = 3.78; M = 3.81), followed by information quality (M = 3.42) and engagement (M = 3.34).…”

Section: Discussionsupporting

confidence: 85%

“…from the stores. The functionality and validity of the program has been proven in previous studies [ 44 – 46 ]. For further technical details please see [ 47 ].…”

Section: Methodsmentioning

confidence: 94%

Mobile-based interventions for common mental disorders in youth: a systematic evaluation of pediatric health apps

Domhardt

Meßner

Eder

et al. 2021

Child Adolesc Psychiatry Ment Health

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Background The access to empirically-supported treatments for common mental disorders in children and adolescents is often limited. Mental health apps might extend service supplies, as they are deemed to be cost-efficient, scalable and appealing for youth. However, little is known about the quality of available apps. Therefore, we aimed to systematically evaluate current mobile-based interventions for pediatric anxiety, depression and posttraumatic stress disorder (PTSD). Methods Systematic searches were conducted in Google Play Store and Apple App Store to identify relevant apps. To be eligible for inclusion, apps needed to be: (1) designed to target either anxiety, depression or PTSD in youth (0–18 years); (2) developed for children, adolescents or caregivers; (3) provided in English or German; (4) operative after download. The quality of eligible apps was assessed with two standardized rating systems (i.e., Mobile App Rating Scale (MARS) and ENLIGHT) independently by two reviewers. Results Overall, the searches revealed 3806 apps, with 15 mental health apps (0.39%) fulfilling our inclusion criteria. The mean overall scores suggested a moderate app quality (MARS: M = 3.59, SD = 0.50; ENLIGHT: M = 3.22, SD = 0.73). Moreover, only one app was evaluated in an RCT. The correlation of both rating scales was high (r = .936; p < .001), whereas no significant correlations were found between rating scales and user ratings (p > .05). Conclusions Our results point to a rather poor overall app quality, and indicate an absence of scientific-driven development and lack of methodologically sound evaluation of apps. Thus, future high-quality research is required, both in terms of theoretically informed intervention development and assessment of mental health apps in RCTs. Furthermore, institutionalized best-practices that provide central information on different aspects of apps (e.g., effectiveness, safety, and data security) for patients, caregivers, stakeholders and mental health professionals are urgently needed.

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“…Suicidal behavior and NSSI-related search terms were identified according to the respective relevant literature (for the complete search term, see Appendix A). The chosen search terms were used to screen the European Apple App Store and Google Play Store systematically for potentially relevant MHA using the automatic search engine of the Mobile Health App Database (MHAD; http://mhad.science) project ( 28), whose functionality and validity have been proven in previous studies (29)(30)(31). The search was conducted in August 2020 with equivalent search terms for suicidal thoughts and behavior in German, English, Dutch, and Spanish languages and for NSSI in German and English languages.…”

Section: Search Strategy and Selection Proceduresmentioning

confidence: 99%

A Systematic Evaluation of Mobile Health Applications for the Prevention of Suicidal Behavior or Non-suicidal Self-injury

Sander

Lemor

Sloot

et al. 2021

Front. Digit. Health

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People with suicidal ideation and non-suicidal self-injury (NSSI) behavior face numerous barriers to help-seeking, which worsened during the COVID-19 pandemic. Mobile health applications (MHA) are discussed as one solution to improve healthcare. However, the commercial app markets are growing unregulated and rapidly, leading to an inscrutable market. This study evaluates the quality, features, functions, and prevention strategies of MHA for people with suicidal ideation and NSSI. An automatic search engine identified MHA for suicidal behavior and NSSI in the European commercial app stores. MHA quality and general characteristics were assessed using the Mobile Application Rating Scale (MARS). MHA of high quality (top 25%) were examined in detail and checked for consistency with established suicide prevention strategies. Of 10,274 identified apps, 179 MHA met the predefined inclusion criteria. Average MHA quality was moderate (M = 3.56, SD = 0.40). Most MHA provided emergency contact, but lacked security features. High-quality MHA were broadly consistent with the best-practice guidelines. The search revealed apps containing potentially harmful and triggering content, and no randomized controlled trial of any included MHA was found. Despite a large heterogeneity in the quality of MHA, high-quality MHA for suicidal behavior and NSSI are available in European commercial app stores. However, a lack of a scientific evidence base poses potential threats to users.

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Stay Present with Your Phone: A Systematic Review and Standardized Rating of Mindfulness Apps in European App Stores

Cited by 47 publications

References 78 publications

Quality of Physical Activity Apps: Systematic Search in App Stores and Content Analysis

Quality of Physical Activity Apps: Systematic Search in App Stores and Content Analysis

Mobile-based interventions for common mental disorders in youth: a systematic evaluation of pediatric health apps

A Systematic Evaluation of Mobile Health Applications for the Prevention of Suicidal Behavior or Non-suicidal Self-injury

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