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The Characteristics and Quality of Mobile Phone Apps Targeted at Men Who Have Sex With Men in China: A Window of Opportunity for Health Information Dissemination?

ABSTRACT: BACKGROUND:A number of mobile phone apps has been developed specifically for men who have sex with men (MSM). We will call these mobile phone apps MSM apps for simplicity. At present, the characteristics and quality and purpose of these MSM apps are unclear. OBJECTIVE:The aim of this study was to objectively and comprehensively evaluate the characteristics and quality of the MSM apps to assess whether they disseminated health information among the MSM in China. METHODS:We searched 2 dominant mobile phone app stores (Apple Store and Android Market) to obtain MSM apps using the keywords MSM, gay, lesbian, gay, bisexual, and transgender (LGBT), ，，，，, and . Apps were excluded if they did not have a Chinese language interface or if their target population was not MSM. Basic information about the eligible apps for this study, such as app name, app store category, and date of last update was gathered from the specified app stores. The quality of apps was rated by 2 independent raters using Mobile App Rating Scale (MARS). The intraclass correlation coefficient (ICC) between raters was computed as a measure for interrater reliability of the MARS. All analyses were conducted using SPSS version 20.0 (SPSS Inc). RESULTS:A total of 575 apps were reviewed between September 15, 2018 and September 30, 2018, out of which, 532 apps were excluded. Finally, 43 apps were included. Of the 43 apps, 16 were from the Apple Store, 10 were from Android Market, and 17 were available in both app stores. In addition, 39 out of 43 apps were for social and sexual networking, whereas 10 contained sexual health information, for example, HIV/sexually transmitted diseases knowledge, HIV test, and condom use. The average rating was 4 stars. The number of downloads for 21 apps exceeded 10,000. A total of 31 apps had acceptable quality (as defined by a MARS score of >3), with functionality as the highest scoring domain, followed by information quality, esthetics, and engagement. Interrater reliability was excellent for the overall mean app quality scores (ICC=.946; 95% CI 0.904-0.970) and the subjective quality scores (ICC=.910; 95% CI 0.841-0.950). CONCLUSIONS:By reviewing the available apps, we found that MSM apps are popular. The majority of MSM apps are for dating, whereas few of them contain HIV prevention and health information. The overall quality of the apps is acceptable. The utilization of mobile phone technologies is a promising way for delivering HIV prevention messages to MSM. We recommend that researchers and app developers should work together to disseminate health information for MSM via mobile technologies.

SUBMITTER: Yang G

PROVIDER: S-EPMC6456822 | biostudies-other | 2019 Mar

REPOSITORIES: biostudies-other

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The Characteristics and Quality of Mobile Phone Apps Targeted at Men Who Have Sex With Men in China: A Window of Opportunity for Health Information Dissemination?

Yang Guoli G Long Jian J Luo Dan D Xiao Shuiyuan S Kaminga Atipatsa Chiwanda AC

JMIR mHealth and uHealth 20190327 3

<h4>Background</h4>A number of mobile phone apps has been developed specifically for men who have sex with men (MSM). We will call these mobile phone apps MSM apps for simplicity. At present, the characteristics and quality and purpose of these MSM apps are unclear.<h4>Objective</h4>The aim of this study was to objectively and comprehensively evaluate the characteristics and quality of the MSM apps to assess whether they disseminated health information among the MSM in China.<h4>Methods</h4>We s ...[more]

PMID: 30916658

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Project description:BackgroundeHealth interventions based on risk stratification have not been extensively applied for HIV behavioral interventions among HIV-negative men who have sex with men (MSM).ObjectiveThis study aimed to evaluate the efficacy of a mobile phone intervention based on an HIV risk prediction tool in promoting HIV testing and reducing high-risk behavior among HIV-negative MSM in China.MethodsWe performed a mobile phone-based randomized controlled clinical trial for 12 weeks. A comprehensive intervention package deployed on Jinshuju-an online survey platform-was developed and consisted of 4 components: (1) a validated HIV risk prediction tool that provides information on personalized risk reduction interventions; (2) a map of individualized HIV testing facilities based on their geographic location; (3) a QR code for free resources on HIV prevention, including condoms and HIV self-testing kits; and (4) general resources for HIV health education. MSM participants recruited from WeChat/QQ groups were randomly assigned to the intervention or control group at a 1:1 ratio. The staff sent the QR code for the comprehensive intervention package to MSM in the intervention group over WeChat and sent the QR code only for the resources on HIV health education to those in the control group. At baseline and 12-week follow-up, data on HIV-related risk behavior and HIV testing behavior were collected through the Jinshuju online survey platform.ResultsIn total, 192 MSM were recruited and assigned to the intervention or control group (n=96 each). At week 12, the total clinical trial retention rate was 87.5%. The number of male sexual partners of the MSM in the past 3 months was significantly lower in the intervention group than in the control group (3.51, SD 4.1 vs 6.01, SD 11.4, respectively; mean difference -2.5; 95% CI -5.12 to 0.12; P=.05); the rate of condom use with casual sexual partners was higher in the intervention group than in the control group (87%, n=66/76 vs 70%, n=54/77 respectively; odds ratio 2.81, 95% CI 1.23-6.39; P=.01). The proportion of individuals intending to undergo HIV testing after in the following 30 days was marginally higher in the intervention group than in the control group (90%, n=77/86 vs 79%, n=65/82 respectively; odds ratio 2.20, 95% CI 0.90-5.35; P=.07). The incremental cost-effectiveness ratio of eHealth intervention was US $131.60 on reducing 1 sexual partner and US $19.70 for a 1% increment in condom usage with casual partners.ConclusionsA comprehensive intervention based on an HIV risk prediction tool can reduce the number of male sexual partners among MSM and increase the rate of condom use with casual partners. Hence, this intervention is a very promising preventive strategy for HIV among MSM, especially in areas with a prominent HIV epidemic.Trial registrationChinese Clinical Trial Registry ChiCTR1800017268; http://www.chictr.org.cn/showprojen.aspx?proj=29271.

Project description:BackgroundMobile apps are a popular strategy for reducing mobile phone use and preventing maladaptive mobile phone use (MMPU). Previous research efforts have been made to understand the features of apps that have the potential to reduce mobile phone use and MMPU. However, there has been a lack of a comprehensive examination of the effectiveness of such apps and their features.ObjectiveThis paper investigated existing apps designed to reduce mobile phone use and prevent MMPU and examined the evidence of their effectiveness. The research aimed to provide a comprehensive analysis of app features that can reduce mobile phone use and MMPU, while also assessing their effectiveness. In addition, we explored users' perceptions of these apps and the various features the apps offer to understand potential adoption issues and identify opportunities.MethodsThis study used 3 methods: a review of scientific evidence, content analysis, and sentiment analysis.ResultsOur study comprehensively examine the common features of 13 apps designed to reduce mobile phone use. We extracted and classified the features into 7 types: self-tracking, social tracking, goal setting, blocking, gamification, simplification, and assessment. The effectiveness of these apps in reducing mobile phone use and MMPU varied from weak to strong. On the basis of content analysis, self-tracking and goal setting were the most frequently used features, whereas gamification and assessment were used the least frequently. The intervention strategies that effectively reduce mobile phone use and MMPU included using grayscale mode, app limit features, and mixed interventions. Overall, users tended to accept these apps, as indicated by sentiment scores ranging from 61 to 86 out of 100.ConclusionsThis study demonstrates that app-based management has the potential to reduce mobile phone use and MMPU. However, further research is required to evaluate the effectiveness of app-based interventions. Collaborations among researchers, app developers, mobile phone manufacturers, and policy makers could enhance the process of delivering, evaluating, and optimizing apps aimed at reducing mobile phone use and MMPU.

Project description:BackgroundAround 90% of melanomas are caused by ultraviolet (UV) exposure and are therefore eminently preventable. Unhealthy tanning behavior is mostly initiated in early adolescence, often with the belief that it increases attractiveness; the problems related to skin atrophy and malignant melanoma are too far in the future to fathom. Photoaging desktop programs, in which an image is altered to predict future appearance, have been successful in positively influencing behavior in adiposity or tobacco prevention settings.ObjectiveTo develop and test a photoaging app designed for melanoma prevention.MethodsWe harnessed the widespread availability of mobile phones and adolescents' interest in appearance to develop a free mobile app called Sunface. This app has the user take a self-portrait (ie, a selfie), and then photoages the image based on Fitzpatrick skin type and individual UV protection behavior. Afterward, the app explains the visual results and aims at increasing self-competence on skin cancer prevention by providing guideline recommendations on sun protection and the ABCDE rule for melanoma self-detection. The underlying aging algorithms are based on publications showing UV-induced skin damage by outdoor as well as indoor tanning. To get a first impression on how well the app would be received in a young target group, we included a total sample of 25 students in our cross-sectional pilot study with a median age of 22 (range 19-25) years of both sexes (11/25, 44% female; 14/25, 56% male) attending the University of Essen in Germany.ResultsThe majority of enrolled students stated that they would download the app (22/25, 88%), that the intervention had the potential to motivate them to use sun protection (23/25, 92%) and that they thought such an app could change their perceptions that tanning makes you attractive (19/25, 76%). Only a minority of students disagreed or fully disagreed that they would download such an app (2/25, 8%) or that such an app could change their perceptions on tanning and attractiveness (4/25, 16%).ConclusionsBased on previous studies and the initial study results presented here, it is reasonable to speculate that the app may induce behavioral change in the target population. Further work is required to implement and examine the effectiveness of app-based photoaging interventions within risk groups from various cultural backgrounds.

Project description:BackgroundGlobally, mobile phones have achieved wide reach at an unprecedented rate, and mobile phone apps have become increasingly prevalent among users. The number of health-related apps that were published on the two leading platforms (iOS and Android) reached more than 100,000 in 2014. However, there is a lack of synthesized evidence regarding the effectiveness of mobile phone apps in changing people's health-related behaviors.ObjectiveThe aim was to examine the effectiveness of mobile phone apps in achieving health-related behavior change in a broader range of interventions and the quality of the reported studies.MethodsWe conducted a comprehensive bibliographic search of articles on health behavior change using mobile phone apps in peer-reviewed journals published between January 1, 2010 and June 1, 2015. Databases searched included Medline, PreMedline, PsycINFO, Embase, Health Technology Assessment, Education Resource Information Center (ERIC), and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Articles published in the Journal of Medical Internet Research during that same period were hand-searched on the journal's website. Behavior change mechanisms were coded and analyzed. The quality of each included study was assessed by the Cochrane Risk of Bias Assessment Tool.ResultsA total of 23 articles met the inclusion criteria, arranged under 11 themes according to their target behaviors. All studies were conducted in high-income countries. Of these, 17 studies reported statistically significant effects in the direction of targeted behavior change; 19 studies included in this analysis had a 65% or greater retention rate in the intervention group (range 60%-100%); 6 studies reported using behavior change theories with the theory of planned behavior being the most commonly used (in 3 studies). Self-monitoring was the most common behavior change technique applied (in 12 studies). The studies suggest that some features improve the effectiveness of apps, such as less time consumption, user-friendly design, real-time feedback, individualized elements, detailed information, and health professional involvement. All studies were assessed as having some risk of bias.ConclusionsOur results provide a snapshot of the current evidence of effectiveness for a range of health-related apps. Large sample, high-quality, adequately powered, randomized controlled trials are required. In light of the bias evident in the included studies, better reporting of health-related app interventions is also required. The widespread adoption of mobile phones highlights a significant opportunity to impact health behaviors globally, particularly in low- and middle-income countries.

Project description:BackgroundIn HIV treatment program, gaps in the "cascade of care" where patients are lost between diagnosis, laboratory evaluation, treatment initiation, and retention in HIV care, is a well-described challenge. Growing access to internet-enabled mobile phones has led to an interest in using the technology to improve patient engagement with health care.ObjectiveThe objectives of this trial were: (1) to assess whether a mobile phone-enabled app could provide HIV patients with laboratory test results, (2) to better understand the implementation of such an intervention, and (3) to determine app effectiveness in improving linkage to HIV care after diagnosis.MethodsWe developed and tested an app through a randomized controlled trial carried out in several primary health care facilities in Johannesburg. Newly diagnosed HIV-positive patients were screened, recruited, and randomized into the trial as they were giving a blood sample for initial CD4 staging. Trial eligibility included ownership of a phone compatible with the app and access to the internet. Trial participants were followed for a minimum of eight months to determine linkage to HIV care indicated by an HIV-related laboratory test result.ResultsThe trial outcome results are being prepared for publication, but here we describe the significant operational and technological lessons provided by the implementation. Android was identified as the most suitable operating system for the app, due to Android functionality and communication characteristics. Android also had the most significant market share of all smartphone operating systems in South Africa. The app was successfully developed with laboratory results sent to personal smartphones. However, given the trial requirements and the app itself, only 10% of screened HIV patients successfully enrolled. We report on issues such as patient eligibility, app testing in a dynamic phone market, software installation and compatibility, safe identification of patients, linkage of laboratory results to patients lacking unique identifiers, and present lessons and potential solutions.ConclusionsThe implementation challenges and lessons of this trial may assist future similar mHealth interventions to avoid some of the pitfalls. Ensuring sufficient expertise and understanding of the programmatic needs by the software developer, as well as in the implementation team, with adequate and rapid piloting within the target groups, could have led to better trial recruitment. However, the majority of screened patients were interested in the study, and the app was installed successfully in patients with suitable smartphones, suggesting that this may be a way to engage patients with their health care data in future.Trial registrationClinicalTrials.gov NCT02756949; https://clinicaltrials.gov/ct2/show/NCT02756949 (Archived by WebCite at http://www.webcitation.org/6z1GTJCNW).

Project description:BackgroundWith an explosive growth in mobile health, an estimated 500 million patients are potentially using mHealth apps for supporting health and self-care of chronic diseases. Therefore, this review focused on mHealth apps for use among patients with heart failure.ObjectiveThe aim of this integrative review was to identify and assess the functionalities of mHealth apps that provided usability and efficacy data and apps that are commercially available without supporting data, all of which are to support heart failure self-care management and thus impact heart failure outcomes.MethodsA search of published, peer-reviewed literature was conducted for studies of technology-based interventions that used mHealth apps specific for heart failure. The initial database search yielded 8597 citations. After filters for English language and heart failure, the final 487 abstracts was reviewed. After removing duplicates, a total of 18 articles that tested usability and efficacy of mobile apps for heart failure self-management were included for review. Google Play and Apple App Store were searched with specified criteria to identify mHealth apps for heart failure. A total of 26 commercially available apps specific for heart failure were identified and rated using the validated Mobile Application Rating Scale.ResultsThe review included studies with low-quality design and sample sizes ranging from 7 to 165 with a total sample size of 847 participants from all 18 studies. Nine studies assessed usability of the newly developed mobile health system. Six of the studies included are randomized controlled trials, and 4 studies are pilot randomized controlled trials with sample sizes of fewer than 40. There were inconsistencies in the self-care components tested, increasing bias. Thus, risk of bias was assessed using the Cochrane Collaboration's tool for risk of selection, performance, detection, attrition, and reporting biases. Most studies included in this review are underpowered and had high risk of bias across all categories. Three studies failed to provide enough information to allow for a complete assessment of bias, and thus had unknown or unclear risk of bias. This review on the commercially available apps demonstrated many incomplete apps, many apps with bugs, and several apps with low quality.ConclusionsThe heterogeneity of study design, sample size, intervention components, and outcomes measured precluded the performance of a systematic review or meta-analysis, thus introducing bias of this review. Although the heart failure-related outcomes reported in this review vary, they demonstrated trends toward making an impact and offer a potentially cost-effective solution with 24/7 access to symptom monitoring as a point of care solution, promoting patient engagement in their own home care.

Dataset Information

The Characteristics and Quality of Mobile Phone Apps Targeted at Men Who Have Sex With Men in China: A Window of Opportunity for Health Information Dissemination?

Publications

The Characteristics and Quality of Mobile Phone Apps Targeted at Men Who Have Sex With Men in China: A Window of Opportunity for Health Information Dissemination?

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