Quality assurance assessment of downloadable applications in health promotion and preventive healthcare

For over a decade, the Internet has been an important consumer education tool for those seeking to improve their health literacy. In recent years, there has been a proliferation of over 7,000 downloadable applications in health promotion and preventive health care for smart phones. Concerns remain within the field of consumer health informatics regarding the quality of these downloadable applications, and the ramifications for consumer health literacy. This study used an instrument developed by Godin (2005; 2009) that assessed quality of 60 apps providing health promotion in the areas of ‘healthy diet', ‘obesity', ‘smoking cessation', and ‘cancer prevention'. Two raters, with high Kappa inter-rater reliability coefficients found the following: 1) Only 13% of the apps provided information on the author(s) professional credentials; 2) Less than 5% of the apps indicated the educational material was "peer reviewed" by appropriate parties; 3) Approximately 15% of the apps provided references to support educational narrative; and 4) While about 35% of the apps allow users to interact and provide personal information, only 10% provide assurances that their information shared will remain confidential, or that privacy would be maintained. Numerous significant chi-square comparisons were made demonstrating that free applications were superior in quality compared to those costing in the $1 to $4 range. Results of this study are discussed within the context of efforts being made within federal public health organizations (i.e., NIH; FDA) to oversee and regulate websites and downloadable applications that originate within the US.