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      Commercially Available Mobile Apps With Family Behavioral Goal Setting and Tracking for Parents: Review and Quality Evaluation

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          Abstract

          Background

          Goal setting and tracking are well established behavior change techniques. Little is known about the extent to which commercially available mobile apps are designed to guide parents in using these strategies, their evidence base, and their quality.

          Objective

          This study aims to review commercially available apps that target parents in relation to setting and tracking behavioral goals for their children. The objectives were to classify the apps’ general characteristics, features, evidence base, and target behaviors and assess app quality overall and separately for apps that target health-related behaviors (HRBs) and apps without a health-related behavior (WHRB).

          Methods

          Apps were identified using keyword searches in the Apple App Store and Google Play in the United States. Apps were included if their primary purpose was to assist with setting goals, tracking goals, tracking behaviors, or giving feedback pertaining to goals for children by parents. App characteristics and common features were documented and summarized. Two reviewers assessed app quality using the Mobile App Rating Scale (MARS). Descriptive statistics summarized the MARS total score, 4 quality subscales, and 6 app-specific items that reflect the perceived impact of the app on goal setting and tracking, overall and with subgroup analysis for HRB and WHRB apps.

          Results

          Of the 21 apps identified, 16 (76%) met the review criteria. Overall, 9 apps defined and targeted the following HRBs: nutrition and mealtime (6/16, 38%), physical activity and screen time (5/16, 31%), sleep (7/16, 44%), and personal hygiene (6/16, 38%). Three apps targeted specific age groups (2 apps were for children aged 6-13 years and 1 app was for children aged ≥4 years). None of the apps provided tailored assessments or guidance for goal setting. None of the apps indicated that they were intended for the involvement of a health professional or had been tested for efficacy. The MARS total score indicated moderate app quality overall (mean 3.42, SD 0.49) and ranged from 2.5 to 4.2 out of 5 points. The Habitz app ranked highest on the MARS total score among HRB apps (score=4.2), whereas Thumsters ranked highest (score=3.9) among the WHRB apps. Subgroup analysis revealed a pattern of higher quality ratings in the HRB group than the WHRB group, including the mean MARS total score (mean 3.67, SD 0.34 vs mean 3.09, SD 0.46; P=.02); the engagement and information subscales; and the app-specific items about perceived impact on knowledge, attitudes, and behavior change.

          Conclusions

          Several high-quality commercially available apps target parents to facilitate goal setting and tracking for child behavior change related to both health and nonhealth behaviors. However, the apps lack evidence of efficacy. Future research should address this gap, particularly targeting parents of young children, and consider individually tailored guided goal setting and involvement of health professionals.

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          Most cited references68

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          Mobile App Rating Scale: A New Tool for Assessing the Quality of Health Mobile Apps

          Background The use of mobile apps for health and well being promotion has grown exponentially in recent years. Yet, there is currently no app-quality assessment tool beyond “star”-ratings. Objective The objective of this study was to develop a reliable, multidimensional measure for trialling, classifying, and rating the quality of mobile health apps. Methods A literature search was conducted to identify articles containing explicit Web or app quality rating criteria published between January 2000 and January 2013. Existing criteria for the assessment of app quality were categorized by an expert panel to develop the new Mobile App Rating Scale (MARS) subscales, items, descriptors, and anchors. There were sixty well being apps that were randomly selected using an iTunes search for MARS rating. There were ten that were used to pilot the rating procedure, and the remaining 50 provided data on interrater reliability. Results There were 372 explicit criteria for assessing Web or app quality that were extracted from 25 published papers, conference proceedings, and Internet resources. There were five broad categories of criteria that were identified including four objective quality scales: engagement, functionality, aesthetics, and information quality; and one subjective quality scale; which were refined into the 23-item MARS. The MARS demonstrated excellent internal consistency (alpha = .90) and interrater reliability intraclass correlation coefficient (ICC = .79). Conclusions The MARS is a simple, objective, and reliable tool for classifying and assessing the quality of mobile health apps. It can also be used to provide a checklist for the design and development of new high quality health apps.
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            Health promotion from the perspective of social cognitive theory

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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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                Author and article information

                Contributors
                Journal
                JMIR Pediatr Parent
                JMIR Pediatr Parent
                JPP
                JMIR Pediatrics and Parenting
                JMIR Publications (Toronto, Canada )
                2561-6722
                2023
                13 October 2023
                : 6
                : e41779
                Affiliations
                [1 ] Markey Cancer Center University of Kentucky Lexington, KY United States
                [2 ] School of Nursing Vanderbilt University Nashville, TN United States
                [3 ] Department of Biomedical Informatics Vanderbilt University Medical Center Nashville, TN United States
                [4 ] Department of Health and Clinical Sciences University of Kentucky Lexington, KY United States
                [5 ] Department of Biostatistics Vanderbilt University Medical Center Nashville, TN United States
                [6 ] College of Medicine University of Kentucky Lexington, KY United States
                [7 ] Department of Behavioral Science College of Medicine University of Kentucky Lexington, KY United States
                Author notes
                Corresponding Author: Pamela Carmen Hull pam.hull@ 123456uky.edu
                Author information
                https://orcid.org/0000-0002-5051-7919
                https://orcid.org/0000-0003-1622-6744
                https://orcid.org/0000-0002-7733-5947
                https://orcid.org/0000-0001-6546-9676
                https://orcid.org/0000-0002-8908-9165
                https://orcid.org/0000-0002-5112-6389
                https://orcid.org/0000-0002-3163-1505
                https://orcid.org/0000-0003-4412-9087
                Article
                v6i1e41779
                10.2196/41779
                10612003
                37831486
                cb9c90b3-4a1c-41cd-a2e8-468333565e3a
                ©Summer Joy Weber, Shelagh A Mulvaney, Anthony Faiola, Madeline Brown, Tatsuki Koyama, Lili Sun, Susanna Lynn Goggans, Pamela Carmen Hull. Originally published in JMIR Pediatrics and Parenting (https://pediatrics.jmir.org), 13.10.2023.

                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 Pediatrics and Parenting, is properly cited. The complete bibliographic information, a link to the original publication on https://pediatrics.jmir.org, as well as this copyright and license information must be included.

                History
                : 1 March 2023
                : 4 May 2023
                : 31 July 2023
                : 29 August 2023
                Categories
                Original Paper
                Original Paper

                goal setting,goal tracking,nutrition,health behavior,parents,children,mobile apps

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