The German Version of the Mobile App Rating Scale (MARS-G): Development and Validation Study

Abstract

Background The number of mobile health apps (MHAs), which are developed to promote healthy behaviors, prevent disease onset, manage and cure diseases, or assist with rehabilitation measures, has exploded. App store star ratings and descriptions usually provide insufficient or even false information about app quality, although they are popular among end users. A rigorous systematic approach to establish and evaluate the quality of MHAs is urgently needed. The Mobile App Rating Scale (MARS) is an assessment tool that facilitates the objective and systematic evaluation of the quality of MHAs. However, a German MARS is currently not available. Objective The aim of this study was to translate and validate a German version of the MARS (MARS-G). Methods The original 19-item MARS was forward and backward translated twice, and the MARS-G was created. App description items were extended, and 104 MHAs were rated twice by eight independent bilingual researchers, using the MARS-G and MARS. The internal consistency, validity, and reliability of both scales were assessed. Mokken scale analysis was used to investigate the scalability of the overall scores. Results The retranslated scale showed excellent alignment with the original MARS. Additionally, the properties of the MARS-G were comparable to those of the original MARS. The internal consistency was good for all subscales (ie, omega ranged from 0.72 to 0.91). The correlation coefficients (r) between the dimensions of the MARS-G and MARS ranged from 0.93 to 0.98. The scalability of the MARS (H=0.50) and MARS-G (H=0.48) were good. Conclusions The MARS-G is a reliable and valid tool for experts and stakeholders to assess the quality of health apps in German-speaking populations. The overall score is a reliable quality indicator. However, further studies are needed to assess the factorial structure of the MARS and MARS-G.

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“…Two independent reviewers (students and graduates of clinical psychology (JS, KS) trained and supervised by a licenced psychotherapist (LS)) acquired and evaluated the data of the included apps using the German version of the Mobile App Rating Scale (MARS-G) (Messner et al, 2019;Stoyanov et al, 2015). The MARS-G is a reliable and valid scale for the quality assessment of apps (Messner et al, 2019).…”

“…Two independent reviewers (students and graduates of clinical psychology (JS, KS) trained and supervised by a licenced psychotherapist (LS)) acquired and evaluated the data of the included apps using the German version of the Mobile App Rating Scale (MARS-G) (Messner et al, 2019;Stoyanov et al, 2015). The MARS-G is a reliable and valid scale for the quality assessment of apps (Messner et al, 2019). The overall MARS-G score shows a good internal consistency (ω = .82, 95%-confidence interval (CI): .76 to .86) and a high intraclass-correlation (Fleiss, 1999) (ICC: .83, 95%-CI: .82 to .85) (Messner et al, 2019).…”

“…The MARS-G is a reliable and valid scale for the quality assessment of apps (Messner et al, 2019). The overall MARS-G score shows a good internal consistency (ω = .82, 95%-confidence interval (CI): .76 to .86) and a high intraclass-correlation (Fleiss, 1999) (ICC: .83, 95%-CI: .82 to .85) (Messner et al, 2019). The subscales demonstrate internal consistencies ranging from acceptable to excellent (ω = .72 to .93) (Messner et al, 2019).…”

“…In addition to the four subscales used for the quality rating, three additional categories were assessed in accordance with the MARS-G (Messner et al, 2019): (E) therapeutic gain (4 items: gain for patients, gain for therapists, risks and side effects, ease of implementation into routine healthcare), (F) subjective quality (4 items: recommendation, frequency of use, willingness to pay, overall star rating), and (G) perceived impact (6 items: awareness, knowledge, attitudes, intention to change, help seeking, behavioural change).…”

“…Means of the MARS-G(Messner et al, 2019) ratings in descending order of the total mean score (range: 1 to 5).…”