Terms and conditions apply: Critical issues for readability and jargon in mental health depression apps

Abstract

Background Mental health services are turning to technology to ease the resource burden, but privacy policies are hard to understand potentially compromising consent for people with mental health problems. The FDA recommends a reading grade of 8. Objective To investigate and improve the accessibility and acceptability of mental health depression app privacy policies. Methods A mixed methods study using quantitative and qualitative data to improve the accessibility of app privacy policies. Service users completed assessments and focus groups to provide information on ways to improve privacy policy accessibility, including identifying and rewording jargon. This was supplemented by comparisons of mental health depression apps with social media, music and finance apps using readability analyses and examining whether GDPR affected accessibility. Results Service users provided a detailed framework for increasing accessibility that emphasised having critical information for consent. Quantitatively, most app privacy policies were too long and complicated for ensuring informed consent (mental health apps mean reading grade = 13.1 (SD = 2.44)). Their reading grades were no different to those for other services. Only 3 mental health apps had a grade 8 or less and 99% contained service user identified jargon. Mental health app privacy policies produced for GDPR weren't more readable and were longer. Conclusions Apps specifically aimed at people with mental health difficulties are not accessible and even those that fulfilled the FDA's recommendation for reading grade contained jargon words. Developers and designers can increase accessibility by following a few rules and should, before launching, check whether the privacy policy can be understood.

The impact of patient involvement on participant opinions of information sheets

“…Despite previous work finding that mental health documents are too complicated for many people to understand, 1 , 3 , 20 overall ratings of the information sheets were high, indicating good levels of accessibility. The only difference between the patient and control groups was ratings of the description of data protection, which patients rated better than controls.…”

Preferences for and intention to use an app for premenstrual mental health symptoms using the Health Behaviour Model (HBM)

“…Secondly, mental health apps potentially collect and analyse sensitive data, resulting in concerns about data privacy 12 . Few publicly available apps address these concerns, with many mental health and women's health apps not including a privacy policy [42][43][44] , and few seeking consent from user 44 , driving mistrust. Privacy policies in apps that do include them typically score low on readability 42 , reducing users' ability to provide consent 44 .…”

“…Few publicly available apps address these concerns, with many mental health and women's health apps not including a privacy policy [42][43][44] , and few seeking consent from user 44 , driving mistrust. Privacy policies in apps that do include them typically score low on readability 42 , reducing users' ability to provide consent 44 . Given this, app developers should endeavour to provide an accessible privacy policy which provides details on how the data they provide is analysed and stored.…”

Jargon Used in Traditional Cockfighting Ceremony at Cempaga Village

“…Some jargons from experts are defined. Jargons are special words used to communicate within the community by certain individuals or professions (Jilka et al, 2021;Patoko & Yazdanifard, 2014). This means that jargons are special words that some people use and can only be found in some of the spokespersons environment and community.…”

“…This means that jargons are special words that some people use and can only be found in some of the spokespersons environment and community. Jargons are the term used for communication in some profession (Brown et al, 2021;Jilka et al, 2021). One of the islands that has its own jargon is Bali.…”