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      Critical Criteria and Countermeasures for Mobile Health Developers to Ensure Mobile Health Privacy and Security: Mixed Methods Study


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          Despite the importance of the privacy and confidentiality of patients’ information, mobile health (mHealth) apps can raise the risk of violating users’ privacy and confidentiality. Research has shown that many apps provide an insecure infrastructure and that security is not a priority for developers.


          This study aims to develop and validate a comprehensive tool to be considered by developers for assessing the security and privacy of mHealth apps.


          A literature search was performed to identify papers on app development, and those papers reporting criteria for the security and privacy of mHealth were assessed. The criteria were extracted using content analysis and presented to experts. An expert panel was held for determining the categories and subcategories of the criteria according to meaning, repetition, and overlap; impact scores were also measured. Quantitative and qualitative methods were used for validating the criteria. The validity and reliability of the instrument were calculated to present an assessment instrument.


          The search strategy identified 8190 papers, of which 33 (0.4%) were deemed eligible. A total of 218 criteria were extracted based on the literature search; of these, 119 (54.6%) criteria were removed as duplicates and 10 (4.6%) were deemed irrelevant to the security or privacy of mHealth apps. The remaining 89 (40.8%) criteria were presented to the expert panel. After calculating impact scores, the content validity ratio (CVR), and the content validity index (CVI), 63 (70.8%) criteria were confirmed. The mean CVR and CVI of the instrument were 0.72 and 0.86, respectively. The criteria were grouped into 8 categories: authentication and authorization, access management, security, data storage, integrity, encryption and decryption, privacy, and privacy policy content.


          The proposed comprehensive criteria can be used as a guide for app designers, developers, and even researchers. The criteria and the countermeasures presented in this study can be considered to improve the privacy and security of mHealth apps before releasing the apps into the market. Regulators are recommended to consider an established standard using such criteria for the accreditation process, since the available self-certification of developers is not reliable enough.

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          Health App Use Among US Mobile Phone Owners: A National Survey

          Background Mobile phone health apps may now seem to be ubiquitous, yet much remains unknown with regard to their usage. Information is limited with regard to important metrics, including the percentage of the population that uses health apps, reasons for adoption/nonadoption, and reasons for noncontinuance of use. Objective The purpose of this study was to examine health app use among mobile phone owners in the United States. Methods We conducted a cross-sectional survey of 1604 mobile phone users throughout the United States. The 36-item survey assessed sociodemographic characteristics, history of and reasons for health app use/nonuse, perceived effectiveness of health apps, reasons for stopping use, and general health status. Results A little over half (934/1604, 58.23%) of mobile phone users had downloaded a health-related mobile app. Fitness and nutrition were the most common categories of health apps used, with most respondents using them at least daily. Common reasons for not having downloaded apps were lack of interest, cost, and concern about apps collecting their data. Individuals more likely to use health apps tended to be younger, have higher incomes, be more educated, be Latino/Hispanic, and have a body mass index (BMI) in the obese range (all P<.05). Cost was a significant concern among respondents, with a large proportion indicating that they would not pay anything for a health app. Interestingly, among those who had downloaded health apps, trust in their accuracy and data safety was quite high, and most felt that the apps had improved their health. About half of the respondents (427/934, 45.7%) had stopped using some health apps, primarily due to high data entry burden, loss of interest, and hidden costs. Conclusions These findings suggest that while many individuals use health apps, a substantial proportion of the population does not, and that even among those who use health apps, many stop using them. These data suggest that app developers need to better address consumer concerns, such as cost and high data entry burden, and that clinical trials are necessary to test the efficacy of health apps to broaden their appeal and adoption.
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            A Review of Scale Development Practices in the Study of Organizations

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              Design and Implementation Content Validity Study: Development of an instrument for measuring Patient-Centered Communication.

              The importance of content validity in the instrument psychometric and its relevance with reliability, have made it an essential step in the instrument development. This article attempts to give an overview of the content validity process and to explain the complexity of this process by introducing an example.

                Author and article information

                JMIR Mhealth Uhealth
                JMIR Mhealth Uhealth
                JMIR mHealth and uHealth
                JMIR Publications (Toronto, Canada )
                2 March 2023
                : 11
                [1 ] Department of Health Information Technology Shiraz University of Medical Sciences Shiraz Iran
                [2 ] Clinical Education Research Center Shiraz University of Medical Sciences Shiraz Iran
                [3 ] Health Human Resources Research Center Shiraz University of Medical Sciences Shiraz Iran
                [4 ] Student Research Committee Shiraz University of Medical Sciences Shiraz Iran
                [5 ] Department of Computer Engineering and Information Technology Shiraz University of Technology Shiraz Iran
                [6 ] Health Information Management Research Center (HIMRC) Kashan University of Medical Sciences Kashan Iran
                Author notes
                Corresponding Author: Sahar Zare zare.sahar89@ 123456gmail.com
                ©Rita Rezaee, Mahboobeh Khashayar, Saeed Saeedinezhad, Mahdi Nasiri, Sahar Zare. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 02.03.2023.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mHealth and uHealth, is properly cited. The complete bibliographic information, a link to the original publication on https://mhealth.jmir.org/, as well as this copyright and license information must be included.

                Original Paper
                Original Paper

                telemedicine,mobile apps,privacy,computer security, confidentiality,mhealth,mobile health


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