Validation of the Mobile Application Rating Scale (MARS)

Terhorst, Yannik; Philippi, Paula; Sander, Lasse; Schultchen, Dana; Paganini, Sarah; Bardus, Marco; Santo, Karla; Knitza, Johannes; Machado, Gustavo C; Schöeppe, Stephanie; Bauereiß, Natalie; Portenhauser, Alexandra; Domhardt, Matthias; Walter, Benjamin; Krusche, Martin; Baumeister, Harald; Meßner, Eva-Maria

doi:10.1371/journal.pone.0241480

Cited by 179 publications

(157 citation statements)

References 48 publications

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“…Average user ratings in the stores showed a significantly small correlation with the MARS ratings, which is in line with that reported in previous research [ 30 , 36 ]. However, several studies (including apps for weight management and chronic pain) could not identify an association [ 29 , 44 ].…”

Section: Discussionsupporting

confidence: 92%

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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: Discussionsupporting

confidence: 92%

“…In terms of quality, user ratings seem to be a questionable indicator as they seem to be mostly influenced by usability and functionality [ 26 , 29 ]. However, a recent evaluation revealed a positive correlation between a broad range of app quality ratings and user star ratings [ 30 ].…”

Section: Introductionmentioning

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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“…One strength of this study is the use of traditional systematic review methodology, such as systematic search, independent screening, and quality evaluation of the included mobile apps on a reliable scale. The multidimensional MARS-G enabled an objective, reliable, and valid rating [ 35 , 41 ]. The categorization, according to Cunha et al [ 42 ], made it possible to classify the mobile apps specifically for older adults independently of the app stores.…”

Section: Discussionmentioning

confidence: 99%

“…The MARS-G evaluation tool is a reliable and valid scale for the quality assessment of mobile apps [ 35 , 41 ]. The MARS-G shows a good to very good internal consistency for all subdimensions (ω=.72-.90) as well as for the overall score (ω=.82, 95% CI .76-.86) and a high ICC (2-way mixed ICC .84, 95% CI .82-.85) [ 35 ].…”

Section: Methodsmentioning

confidence: 99%

Mobile Apps for Older Adults: Systematic Search and Evaluation Within Online Stores

Portenhauser¹,

Terhorst²,

Schultchen³

et al. 2021

JMIR Aging

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Background Through the increasingly aging population, the health care system is confronted with various challenges such as expanding health care costs. To manage these challenges, mobile apps may represent a cost-effective and low-threshold approach to support older adults. Objective This systematic review aimed to evaluate the quality, characteristics, as well as privacy and security measures of mobile apps for older adults in the European commercial app stores. Methods In the European Google Play and App Store, a web crawler systematically searched for mobile apps for older adults. The identified mobile apps were evaluated by two independent reviewers using the German version of the Mobile Application Rating Scale. A correlation between the user star rating and overall rating was calculated. An exploratory regression analysis was conducted to determine whether the obligation to pay fees predicted overall quality. Results In total, 83 of 1217 identified mobile apps were included in the analysis. Generally, the mobile apps for older adults were of moderate quality (mean 3.22 [SD 0.68]). Four mobile apps (5%) were evidence-based; 49% (41/83) had no security measures. The user star rating correlated significantly positively with the overall rating (r=.30, P=.01). Obligation to pay fees could not predict overall quality. Conclusions There is an extensive quality range within mobile apps for older adults, indicating deficits in terms of information quality, data protection, and security precautions, as well as a lack of evidence-based approaches. Central databases are needed to identify high-quality mobile apps.

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“…MARS is one of the most widely used multidimensional tools for evaluating the quality and content of mobile health applications [ 19 , 20 ]. It consists of 23 items grouped into the following five dimensions: engagement, functionality, aesthetics, information, and subjective quality.…”

Section: Methodsmentioning

confidence: 99%

Diet-Related Mobile Apps to Promote Healthy Eating and Proper Nutrition: A Content Analysis and Quality Assessment

Choi

Chung

Woo

2021

IJERPH

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Dietary mobile applications (apps) continue to hold promise for facilitating a healthy diet and managing nutrition. However, few studies have objectively evaluated the content and quality of such apps in Korea. The present study assessed the content and quality of dietary mobile apps using the Mobile App Rating Scale (MARS). We selected 29 dietary apps based on keywords and eligibility criteria for inclusion in the analyses. We conducted regression analyses to examine the association between app content and MARS scores. Most of the apps featured a tracking tool, while few featured rewards or follow-up management. Our quality assessment revealed that the top-rated apps have distinct levels of quality in terms of MARS scores. The regression analyses showed that the ways in which the apps provide information and motivate the users are statistically significant predictors of app quality. Our findings may facilitate the selection of dietary apps in Korea and provide guidelines for app developers regarding potential improvements in terms of content and quality.

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Validation of the Mobile Application Rating Scale (MARS)

Cited by 179 publications

References 48 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 Apps for Older Adults: Systematic Search and Evaluation Within Online Stores

Diet-Related Mobile Apps to Promote Healthy Eating and Proper Nutrition: A Content Analysis and Quality Assessment

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