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Evaluation of diabetes mobile applications for health literate designs and functionality
The expansion and growth of mobile health technologies, particularly in the area of diabetes-related apps, has grown exponentially in the last decade. A recent Institute of Medicine (IOM) Roundtable discussion paper suggested specific health literacy- and usability-improving strategies for the development of health literate apps, however, they have not yet been used to evaluate existing diabetes-related mHealth apps specifically.
Objectives
1) To examine the extent to which mobile applications for diabetes have features of health literate mHealth applications based on the IOM discussion paper.
2) To compare the health literate features of diabetes apps by app cost (free/not), to determine whether higher frequencies of health literate features is related to higher cost.
Methods
Diabetes-related key words were used to identify diabetes-related apps for iOS devices. A random sample of 110 apps (23% of total) was selected for coding. The coding scheme was adapted from the IOM discussion paper.
Results
Results showed that diabetes apps in this sample were rated slightly higher than average and most were classified as appropriate for children and adults and addressed diabetes management and therapeutics. There were no significant differences between free apps and paid apps among the public health variables coded, but they emerged when examining the use of health literate design strategies. Compared to free apps, paid diabetes apps were significantly more likely to use common, everyday words (92% vs. 75%; P=.05); avoid undefined technical or medical terms (85% vs. 66%; P=.036); and use active voice (88% vs. 68%; P=.03), action words (88% vs. 70%; P=.04), and present tense (94% vs. 75%; P=.02).
Conclusion
The cost of paid apps may be prohibitive for individuals with low health literacy who are also more likely to have a lower income. Future work can investigate ways to make free diabetes mobile apps more user-friendly and accessible.
Learning Areas:
Communication and informaticsPlanning of health education strategies, interventions, and programs
Public health or related education
Learning Objectives:
Identify recommended app design features for low-literacy users.
List strategies recommended by the IOM Roundtable on Health Literacy’s Collaborative on New Technologies for health literacy- and usability-improving strategies for the development of health literate apps.
Explain whether the health literate design of diabetes-related apps varies by cost of the app.
Keyword(s): Diabetes, Health Literacy
Qualified on the content I am responsible for because: I have been the principal investigator of multiple federally funded grants utilizing content analytic methods in order to better understand the health information and health communication messages from various tools, technologies, and materials.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.