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YOUR PRIVACY CHOICES We and our partners store and access non-sensitive information from your device, like cookies, and process personal data, like IP addresses and unique identifiers to personalize content and ads, measure performance, and analyze audiences. By clicking Accept, you consent to this data collection and processing by us and our 200 partners. You can select Reject to continue with only strictly necessary cookies or Customize to manage your preferences. Some processing of your personal data may not require your consent, but you have a right to object to such processing. You can withdraw your consent at any time from the consent preferences link in the footer of any ResearchGate page. For more information, see our Privacy Policy. We and our partners process data for the following purposesPersonalised advertising and content, advertising and content measurement, audience research and services development , Precise geolocation data, and identification through device scanning, Store and/or access information on a device CustomizeRejectAccept * Home * Mobile Development * Software Development * Software * Computer Science and Engineering * Mobile Applications ArticlePDF Available EVALUATING AND RATING HIV/AIDS MOBILE APPS USING THE FEATURE-BASED APPLICATION RATING METHOD AND MOBILE APP RATING SCALE * October 2022 * BMC Medical Informatics and Decision Making 22(1) DOI:10.1186/s12911-022-02029-8 * License * CC BY 4.0 Authors: Ahmad Raeesi * Mashhad University of Medical Sciences Reza Khajouei * Kerman University of Medical Sciences Leila Ahmadian * Kerman University of Medical Sciences Download full-text PDFRead full-text Download full-text PDF Read full-text Download citation Copy link Link copied -------------------------------------------------------------------------------- Read full-text Download citation Copy link Link copied Citations (11) References (63) Figures (1) ABSTRACT AND FIGURES Background The purpose of this study was to evaluate HIV/AIDS mobile applications using the Mobile App Rating Scale (MARS) and rate the features of these applications using the new tool called the Feature-based Application Rating Method (FARM). Methods In this study, all available HIV/AIDS apps in Iran from Cafe Bazaar and Google Play Store due to inclusion criteria were studied. The evaluation of the quality of applications was done using the MARS tool and the FARM tool. The FARM, which was developed in this study, was applied to rank the features of the applications. Results In this study, 79 applications were included. The mean score of all apps using both tools was 3.58 (SD = 0.95) out of 5. The overall mean quality score based on the MARS was 3.14 (SD = 0.84), and the mean score of features based on FARM was 3.81 (SD = 1.23). This study showed a higher than moderate correlation between the scores assigned to apps based on the MARS and FARM tools (r > 0.4). Conclusions The HIV/AIDS mobile applications available in Iran had the "acceptable" ranking. Also, our study results showed that to evaluate mobile apps, using a single tool may not provide good insight to evaluators about the assessed apps. However, using more than one tool may provide more details about the evaluated apps. To improve the quality of mobile health apps and help users select the most desirable app, we suggested using tools like FARM for ranking apps based on the features of each app in the app stores. Flow chart of the selection process for inclusion of the Apps … Figures - available from: BMC Medical Informatics and Decision Making This content is subject to copyright. Terms and conditions apply. Discover the world's research * 25+ million members * 160+ million publication pages * 2.3+ billion citations Join for free Publisher Full-text 1 Public Full-text 1 Access to this full-text is provided by Springer Nature. Learn more Content available from BMC Medical Informatics and Decision Making This content is subject to copyright. Terms and conditions apply. Raeesietal. BMC Medical Informatics and Decision Making (2022) 22:281 https://doi.org/10.1186/s12911-022-02029-8 RESEARCH Evaluating andrating HIV/AIDS mobile apps using thefeature-based application rating method andmobile app rating scale Ahmad Raeesi1,2 , Reza Khajouei3 and Leila Ahmadian4* Abstract Background: The purpose of this study was to evaluate HIV/AIDS mobile applications using the Mobile App Rating Scale (MARS) and rate the features of these applications using the new tool called the Feature-based Application Rat- ing Method (FARM). Methods: In this study, all available HIV/AIDS apps in Iran from Cafe Bazaar and Google Play Store due to inclusion criteria were studied. The evaluation of the quality of applications was done using the MARS tool and the FARM tool. The FARM, which was developed in this study, was applied to rank the features of the applications. Results: In this study, 79 applications were included. The mean score of all apps using both tools was 3.58 (SD = 0.95) out of 5. The overall mean quality score based on the MARS was 3.14 (SD = 0.84), and the mean score of features based on FARM was 3.81 (SD = 1.23). This study showed a higher than moderate correlation between the scores assigned to apps based on the MARS and FARM tools (r > 0.4). Conclusions: The HIV/AIDS mobile applications available in Iran had the "acceptable" ranking. Also, our study results showed that to evaluate mobile apps, using a single tool may not provide good insight to evaluators about the assessed apps. However, using more than one tool may provide more details about the evaluated apps. To improve the quality of mobile health apps and help users select the most desirable app, we suggested using tools like FARM for ranking apps based on the features of each app in the app stores. Keywords: HIV/AIDS, Mobile app rating scale, MARS, Feature-based application rating method, FARM © The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http:// creat iveco mmons. org/ licen ses/ by/4. 0/. The Creative Commons Public Domain Dedication waiver (http:// creat iveco mmons. org/ publi cdoma in/ zero/1. 0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Background e high penetration rate of mobile phones worldwide makes mobile applications one of the fastest-growing technologies [1]. Approximately 70% of mobile phones use the Android operating system [2]. During the sec- ond quarter of 2022, almost 3.5 million Android apps were available in the Google Play Store [3]. Of these, 54,603 are mobile health apps [4]. Mobile health apps have many uses in preventing and treating chronic dis- eases like HIV/AIDS [5–8]. HIV/AIDS is one of the most serious socio-economic threats to public health due to its chronic nature, the possibility of its prevalence among individuals, and the absence of a cure for this disease [9]. Approximately 38.4 million and 53 thousand people were living with HIV/AIDS in the world and Iran, respectively [10, 11]. Mobile applications related to HIV/AIDS can help communicate with care providers and reduce hospital care. ese applications can be used to provide self-care and help patients achieve compliance with antiretroviral Open Access *Correspondence: l.ahmadian@kmu.ac.ir; ahmadianle@yahoo.com 4 HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Haft-Bagh Highway, Kerman, Iran Full list of author information is available at the end of the article Content courtesy of Springer Nature, terms of use apply. Rights reserved. Page 2 of 11 Raeesietal. BMC Medical Informatics and Decision Making (2022) 22:281 therapy. Moreover, these mobile applications can be used to send alerts and reminders, collect data, provide real-time audio and video communication, deliver edu- cational information, and provide requested information to the community to prevent the disease and control its transmission to others [7, 12, 13]. e number of these apps and their features change over time [3, 14]. Despite the high number of mobile health apps and their features, the quality and validity of many apps are unknown [15, 16]. erefore, there is a need for tools to continuously review and evaluate these apps to determine their quality and validity. Several tools have been used to evaluate mobile apps [17–22]. ese tools evaluate mobile apps based on qual- ity and trustworthy health information [18, 19], some objective and subjective components [20], functionality scoring [21], and usability [22]. One of these tools is the Mobile Application Rating Scale (MARS), which evalu- ates and rates mobile apps in terms of qualitative, objec- tive, and subjective aspects that were developed in the previous study by Stoyanov etal. [17]. e MARS tool consists of 23 questions in four objective dimensions (A_D), including Engagement (5 questions), Functional- ity (4 questions), Aesthetics (3 questions), Information Quality (7 questions), and a Subjective dimension (E) (4 questions) [17, 23]. e MARS tool is a comprehensive and reliable tool that is widely used to rate the quality of mobile health apps like Epilepsy, COVID-19, self-man- agement mobile health apps, Spine disorders, and Alz- heimer’s disease [24–28]. is tool has been widely translated and validated into other languages, including French [29], Italian [30], Korean [16], Spanish [31], Japa- nese [32], Arabic [33], and German [34]. Although the MARS tool can evaluate various aspects of a mobile application, it has limitations in assessing the mobile application’s features [35, 36]. In an app, a feature is typically an essential function or a service provided by the app for users [14]. Features may be desirable or undesirable to users. If the existence of a feature is positive and useful for the users, that is a desirable or positive feature. If the existence of a fea- ture is negative for users, such as advertisements, or its presence is irritating for users, such as the presence of corrupted and misleading links, that is an undesir- able or negative feature [37–39]. Some previous stud- ies [35, 40–44] that used the MARS tool to evaluate the apps also reviewed the existence of features with- out reviewing the quality of each feature separately. e only tool that was developed to rate the mobile app features is the IQVIA functionality score (previ- ously known as the IMS functionality score) [26]. is tool is based on seven functionality criteria and four functional subcategories detailed in the report of the IQVIA Institute for Healthcare Informatics [21, 45]. In some previous studies [26, 43, 45], this tool was used along with the MARS tool to rate mobile health app features. e IQVIA functionality score focuses on the availability of the 11 previously determined functionali- ties, and finally, each mobile app gives a score between 0 and 11. e MARS functionality score is an over- all score on a five-point Likert scale that is measured based on the quality of performance, navigation, ease of use, and gestural design of that app [17, 21, 45]. e IQVIA evaluates the availability of functionality of each feature without considering quality, and the functional- ity section of the MARS tool evaluates the overall qual- ity of functionality of each app. e functionality score range of IQVIA differs from the functionality score of MARS, so their scores are not comparable. e IQVIA feature lists are predetermined and not flexible for each app. Also, in these two tools, undesirable features are not considered. Due to the high number of mobile apps in app stores, it is difficult for users to find their desired applications [46]. Currently, users choose a mobile application based on the application’s popularity, star rating, comments on app stores, and the number of downloads, regard- less of the quality of the application [47]. Identifying and rating the quality of mobile apps and their features can help users find and select an app based on the fea- tures they need [14, 37]. Mobile apps may have differ- ent features compared to each other. e previously developed evaluation tools [17–19, 21, 48, 49] have not adequately addressed the evaluation of each mobile app feature. When users are faced with an abundance of similar apps with many functionalities or features, they tend to choose apps with their desired features [14]. erefore, it is necessary to develop a tool that has flex- ibility based on the availability of each feature on a cer- tain app to evaluate and rate mobile apps. Some mobile apps related to HIV/AIDS exist in app stores [50]. e literature review showed that few stud- ies [50–53] evaluated the quality of HIV/AIDS-related mobile applications, and none of these studies had rated these applications’ features. Despite the impor- tant role of mobile apps in HIV/AIDS prevention and treatment, no study has been conducted to review HIV/ AIDS mobile apps in Iran. erefore, the purpose of this study was to (1) evaluate the quality of HIV/AIDS- related mobile applications in the Google Play and Café Bazaar stores available in Iran using the Mobile Appli- cation Rating Scale (MARS); and (2) to evaluate and rate that applications’ features (desirable and undesira- ble) using the new tool called the Feature-Based Appli- cation Rating Method (FARM). Content courtesy of Springer Nature, terms of use apply. Rights reserved. Page 3 of 11 Raeesietal. BMC Medical Informatics and Decision Making (2022) 22:281 Methods is article is the second part of a two-part series regard- ing evaluating HIV/AIDS-related applications in vari- ous terms, including their features and content [15]. is study was a cross-sectional descriptive-analytical study carried out on HIV/AIDS mobile applications in the Persian or English language available in Iran from May 6, 2021, to September 23, 2021. All HIV/AIDS-related mobile apps in the following two app stores were evalu- ated: e Google Play Store, the world’s largest app store of mobile apps[3], and Café Bazaar, the most prominent Iranian app store for Persian mobile applications [54]. More than 3500 Android mobile applications in the Café Bazaar are related to the health and medical fields [55]. Given the small population size, all HIV/AIDS-related applications were included in the study. Mobile apps are searched using the keywords "HIV", "AIDS", "Human Immunodeficiency Virus", "Acquired Immunodeficiency Syndrome", and the Persian keywords with similar meanings in the Google Play Store and Café Bazaar store. en, the downloaded apps were installed on the Android smartphone (SAMSUNG Galaxy A51). e inclusion criteria to enter into this study are: (1) the mobile application can be installed on the Android oper- ating system (Android 11.0); (2) it is written in Persian or English; (3) it is available in Iran, and (4) the focus of the mobile app is on HIV/AIDS. Two evaluators with a background in health informa- tion technology independently evaluated all mobile apps using the MARS and FARM tools. Before evaluation, evaluators watched the MARS training video [56] and were trained about using the FARM tool. ey are not the HIV/AIDS mobile app’s real users. ese two evaluators passed the related courses on the evaluation of mobile health apps. e first evaluator performed the evalua- tion after downloading and installing the included apps on the smartphone. When the evaluation was completed by the first evaluator, the stored data during the evalua- tion of the first evaluator inside of the apps was deleted, and then the second evaluator started the evaluation of the apps. Both evaluators first evaluated the HIV/AIDS apps using the MARS tool and then used the FARM. e evaluation sessions were limited to a maximum of 45min per each session. We also asked the evaluators to spend sufficient time to gather the required information before assigning the scores. e evaluation was done when the evaluators were mentally prepared to perform the evalu- ation, and if the evaluators were tired, the evaluation stopped and continued to another time when the evalu- ators had sufficient mental preparation. e differences between the scores of the two evaluators were resolved by discussion between them. If the differences were not resolved through discussion between them, we used the third evaluator (supervisor) to resolve the discrep- ancy. e collected data was recorded on a paper form and then entered into a Microsoft Excel spreadsheet and SPSS for analysis. In this study, all apps were downloaded directly from the Google Play Store and Cafe Bazaar. Our searches in the Google Play Store showed that all HIV/AIDS avail- able mobile apps in Iran are free of charge. Also, the pre- vious study [50] stated that all HIV/AIDS-related apps are available free of charge. In this study, the paid apps of Cafe Bazaar were included and evaluated. Data collection tools e MARS and FARM tools were used to rate the mobile apps. is study was conducted to apply the FARM tool to evaluate the apps based on their features. In this study, we used the MARS tool to compare the results of the FARM with a previously developed tool and also to get a better view of the existing HIV/AIDS apps. Since the MARS and other previously developed mobile app evaluation tools [17–19, 21, 48, 49] have not adequately addressed the evaluation of mobile app features, to address this issue in this study, a tool called the Feature- Based App Rating Method (FARM) was developed to rate mobile apps based on their features. e FARM evalu- ates and rates mobile apps based on both the availabil- ity and quality of each feature. e items of this tool are not predetermined; they are flexible based on each app’s features. To develop the FARM tool, all HIV/AIDS-related mobile apps in the Google Play Store and the Café Bazaar that were included in this study were reviewed, and all of their features were extracted, and a list of these features was prepared. is list was considered as the desirable features for the FARM. e list of undesirable features was also prepared based on a previous study [38] and the opinions of four experts who had checked the validity of the FARM. e FARM is available in Additional file1. In total, 33 desirable features and nine undesirable fea- tures were identified and added to the FARM. To deter- mine a ranking method for the features of the mobile apps and create a ranking method in line with previously developed tools. e ranking methods of the previously developed tools [17–20, 45, 48, 57] were reviewed. In the FARM, we used the standard 5-point Likert ranking method to compare apps with other tools that used the 5-point ranking method to rank the apps (such as star rating and the MARS tool). Two medical informatics specialists confirmed the ranking method used in the FARM tool. A score of zero was assigned to the app to rank the applications based on the FARM tool for the absence of each desirable feature. If the app contained a desirable feature, the evaluators Content courtesy of Springer Nature, terms of use apply. Rights reserved. Page 4 of 11 Raeesietal. BMC Medical Informatics and Decision Making (2022) 22:281 checked its functionalities and assigned a score of one to five (1-inappropriate, 2-poor, 3-acceptable, 4-good, and 5-excellent) to that feature based on the extent to which the feature met its expected function. Moreover, to rank an undesirable feature, a score between one (the undesir- able feature is very annoying) and five (the absence of the undesirable feature) was assigned to that feature. e validity of MARS and FARM was confirmed by two Medical Informatics specialists and two Health Informa- tion Management specialists. To investigate the reliability of the MARS and FARM tools, the first 20 mobile apps retrieved from the Google Play Store were evaluated using these tools, and Cronbach’s alpha was calculated for each tool. e internal reliability of the MARS tool was 0.94 for all questions. e internal reliability of the MARS dimensions was between 0.63 and 0.93. e inter- nal reliability of the FARM tool was 0.85 for the desirable features and 0.76 for undesirable features. Data analysis is study used descriptive statistics, including mean and standard deviation, to calculate the app ratings. To calculate the mean scores, the zero scores of the FARM tool and the N/A score of the MARS tool were not con- sidered. e mean scores for the MARS and FARM tools were classified as the scores between 1 to 2 being considered as "inappropriate", 2 to 3 as "poor", 3 to 4 as "acceptable", 4 to 5 as "good", and 5 as "excellent". e Kolmogorov–Smirnov normalization test did not con- firm the normality of variables related to the MARS and FARM tools. erefore, the Spearman correlation test was used to examine the relationship between the dimen- sions of the MARS and FARM tools. e internal validity and consistency of the evaluators were calculated using the two-way mixed internal correlation coefficient (ICC) [58]. Microsoft Excel version 2019 was used to analyze the descriptive data, and SPSS version 24 was used to analyze the analytical statistics. Results A total of 971 apps were retrieved from the two app stores, of which 79 apps based on the inclusion criteria were included in the study. Of these, 29 apps were in the Café Bazaar and 50 were in the Google Play Store. All HIV/AIDS apps available in the Google Play Store are free. Five of 29 (17%) Café Bazaar applications are paid apps, and 14 (48%) are in-app purchases. e process uti- lized to identify the apps is shown in Fig.1. e mean rating score of apps in stores was 4.37 (SD = 0.60). e organizational affiliations of 19 apps (38%) in the Google Play Store were unknown; one app (2%) was commercial, 14 apps (28%) were governmen- tal, non-governmental organizations developed ten apps (20%), and the affiliations of 6 apps (12%) were universi- ties. e organizational affiliations of 13 apps (45%) in the Café Bazaar were unknown; thirteen apps (45%) were commercial; three apps (7%) were non-governmental organizations, and the university developed one app (3%). The results oftheevaluation ofthemobile app e results of evaluating HIV/AIDS-related apps using the MARS and FARM tools are shown in Table 1. e average score of all apps using both tools was 3.53 (SD = 0.68) out of 5. As Table1 shows, the overall mean score for Google Play Store apps was 3.74 (SD = 0.68), and for Café Bazaar apps it was 3.15 (SD = 0.52). Among all the dimensions of both tools, "undesirable features" was the highest-scoring domain (4.67 ± 0.42). e lowest score was related to "Engagement" (2.85 ± 0.93). Fourteen apps (28%) out of 50 apps in the Google Play Store give a score above 4: "Every Dose, Every Day" (4.76 ± 0.29), "HIV Oral PrEP Implementation Tool" (4.75 ± 0.40), "inPractice HIV" (4.71 ± 0.30), "HIV Cli- ent Treatment Preparedness" (4.70 ± 0.24), "HIV Care Tools" (4.65 ± 0.30), "WHO HIV Tx" (4.59 ± 0.38), "Liver- pool HIV iChart" (4.55 ± 0.27), "YourPrEP" (4.53 ± 0.34), "WHO HTS Info" (4.51 ± 0.39), "HIV-HCV Drug erapy Guide" (4.51 ± 0.39), "ClinicalInfo HIV/AIDS Guide- lines" (4.45 ± 0.40), "life4me + " (4.24 ± 0.53), "E ACS" (4.08 ± 0.79), and "HIV-Rx DDI Check" (4.02 ± 0.66). Also, two apps (7%) out of 29 Cafe Bazaar apps give scores above 4: "Pishgiriye Pas az Tamas (PEP)" (4.49 ± 0.44), and "Agahi Bakshi AIDS" (4.18 ± 0.60). e lowest score among all apps was taken by the Cafe Bazaar app named "AIDS va Darman" (2.02 ± 1.31). Among all of the Google Play Store HIV/AIDS rated apps, 14 apps (28%) scored above 4, 23 apps (46%) scored between 3 and 4, and 13 apps (26%) scored between 2 and 3. Among all of the Cafe Bazaar HIV/AIDS rated apps, two apps (7%) scored above 4, nine apps (31%) scored 3 to 4, and 18 apps (62%) scored between 2 and 3. The MARS tool results e MARS total mean score for all apps was 3.13 ± 0.83. e highest rank was related to the Functionality dimen- sion (4.00 ± 0.59), and the lowest was related to the Subjective dimension (2.50 ± 1.26) (Table 1). Fifteen apps (19%) scored above 4 out of 5. e highest three scored apps were "HIV Oral PrEP Implementation Tool" (4.82 ± 0.66), "inPractice HIV" (4.74 ± 0.45), and "Every Dose, Every Day" (4.71 ± 0.56). Also, 23 apps (29%) scored 3, 38 apps (48%) scored 2, and only three apps (4%) scored 1. e lowest three scored apps were "HIV AIDS Awareness" (1.77 ± 0.92), "AIDS va Darman" (1.80 ± 1.06), and "AIDS va Moghabele ba an" (1.86 ± 0.96). Content courtesy of Springer Nature, terms of use apply. Rights reserved. Page 5 of 11 Raeesietal. BMC Medical Informatics and Decision Making (2022) 22:281 The results ofranking mobile app features using theFARM tool e results of the ranking of HIV/AIDS mobile app fea- tures using the FARM tool are shown in Table1. e FARM mean score of all apps was (3.92 ± 0.69) out of 5. e apps retrieved from Cafe Bazaar did not have 21 (63%) of the 33 evaluated features in this study. All the Cafe Bazaar apps had a textual content. e features "app description inside of the app" (3.50 ± 1.29), the "search functionality" (3.16 ± 0.71), and the "Bookmark feature" (3.12 ± 0.83), respectively, scored the highest rank. e ranking of the Cafe Bazaar HIV/AIDS apps based on undesirable features showed that features such as "being a free app but requiring payment for basic fea- tures" (3.86 ± 1.16), "advertising" (4.00 ± 0.80), and "the existence of unrelated information" (4.28 ± 0.84) had the lowest score for Café Bazaar apps. e features "Difficulties to login into the app" (5.0 ± 0), "Inactive and misleading buttons" (4.97 ± 0.19), and "stopping the app after execution" (4.97 ± 0.19) had the highest ranking. In Google Play Store apps, evaluators assigned the highest scores to the features "Collect medication data" (4.37 ± 0.51), "medication management and medication reminder" (4.28 ± 1.49), and "documentation and pres- entation of the disease progression" (4.00 ± 1.73). e lowest scores were assigned to desirable features such as "direct interaction and visual contact" (1.14 ± 0.35), "direct audio contact" (1.38 ± 0.49), and "communication with people with similar conditions" (1.40 ± 0.49). According to the ranking results of the Google Play Store apps based on the absence of undesirable fea- tures, the lowest scores were assigned to "corrupted and misleading links" (4.50 ± 0.91), "inactive and misleading The total number of retrieved apps from Google Play Store: n= 913 The total number of retrieved apps from Café Bazaar: n=58 Identified apps in two app stores: n=971 Screening apps Irrelevant and duplicate apps were excluded from the study in the first phase: n=774 The total number of included apps in the study after removing irrelevant apps: n=197 Excluded and Irrelevant apps: (n=118) •congress app: n=28 •Games: n=3 •Social network: n=11 •Problem in downloading the content of app: n=9 •No focus on HIV: n=21 •Trouble in logging into the app: n=12 •Other languages: n=19 •All infectious diseases: n=12 •Relevant journals: n=3 The total included apps: n=79 Café Bazaar: n=29 Google Play Store: n=50 Screening Included relevant Apps Reviewing the relevant Apps Identification of Apps Fig. 1 Flow chart of the selection process for inclusion of the Apps Content courtesy of Springer Nature, terms of use apply. Rights reserved. Page 6 of 11 Raeesietal. BMC Medical Informatics and Decision Making (2022) 22:281 Table 1 The results of the evaluation of HIV/AIDS apps based on MARS and FARM tools FARM dimensions FARM total score MARS dimensions MARS total score Total score Desirable Features Absence of undesirable feature Engagement Functionality Aesthetics Information Quality Subjective dimension Mean (SD) Mean (SD) Mean (SD) Mean (SD) Mean (SD) Mean (SD) Mean (SD) Mean (SD) Mean (SD) Mean (SD) Cafe Bazaar apps 2.53 (0.74) 4.60 (0.32) 3.59 (0.47) 2.64 (0.67) 3.99 (0.47) 3.10 (0.98) 2.32 (0.74) 1.80 (0.73) 2.71 (0.62) 3.15 (0.52) Google Play Store apps 3.22 (1.10) 4.71 (0.47) 4.12 (0.73) 2.98 (1.04) 4.01 (0.66) 3.38 (0.81) 3.55 (0.97) 2.92 (1.32) 3.37 (0.85) 3.74 (0.68) Mean of all apps 2.93 (1.02) 4.67 (0.42) 3.92 (0.69) 2.85 (0.93) 4.00 (0.59) 3.28 (0.88) 3.10 (1.07) 2.50 (1.26) 3.13 (0.83) 3.53 (0.68) Content courtesy of Springer Nature, terms of use apply. Rights reserved. Page 7 of 11 Raeesietal. BMC Medical Informatics and Decision Making (2022) 22:281 buttons" (4.60 ± 0.78), and "taking a long time to load the content of the app after executing the program" (4.66 ± 0.89). e highest ratings in this regard were related to "being a free app but requiring payment for basic features" (4.88 ± 0.44), "difficulties in logging into the app" (4.84 ± 0.51), and "advertising" (4.82 ± 0.48). e agreement rate between the two evaluators regarding the app’s rating based on FARM and MARS tools is shown in Table2. e agreement rate between the two evaluators for the overall MARS score, calcu- lated using the ICC, was 0.947 (CI 95% = 0.919–0.965). e agreement between the two evaluators for the overall FARM score was 0.882 (CI 95% = 0.819–0.922). e relationship between the dimensions of the MARS tool and the FARM tool was calculated using the Spearman correlation test, and the results are shown in Table3. e lowest correlation was found between the score of the Subjective dimension and the functional- ity score of the MARS tool (r = 0.450). e highest cor- relation was found between the score of the Subjective dimension and the Information quality score of the MARS tool (r = 0.832). Discussion e results of this study showed that there is a higher than the moderate correlation between the scores assigned to apps based on the MARS and FARM tools. erefore, the high MARS score somewhat indicates the existence of desirable and the absence of undesirable fea- tures in the app. So, evaluating mobile apps by using a single tool may not provide good insight about the evalu- ated apps. However, using more than one tool provides more details about the evaluated apps. According to the results of this study, the HIV/AIDS mobile applications available in Iran had an "acceptable" ranking. However, the overall ranking score of the MARS tool and desired features for Cafe Bazaar apps scored "poor". In previous studies [27, 44, 59–62] conducted on health applications using the MARS tool, evaluated apps were ranked as "acceptable". Moreover, the results of the study done by Young etal. [63] showed that the overall quality of the apps for men who have sex with men (MSM) in China is "acceptable". In this study, we evaluated all HIV/AIDS mobile applications available in Iran, including mobile applications related to HIV pre- exposure prophylaxis. Sharpe et al. [64], in 2018, only evaluated 11 mobile apps for HIV pre-exposure prophy- laxis using the MARS tool. Just one mobile app (PreP4U) reviewed in the study by Sharpe etal. [64] was available in Iran in 2021 and was also reviewed in our study. e results of the average ratings of this mobile app were almost the same as in our study. e FARM does not check the quality of informa- tion. In this study, the quality of information is checked with the "information quality" section of the MARS tool. e Google Play Store apps were ranked "acceptable" in terms of "information quality", but the Cafe Bazaar apps were rated "poor". e first published part of our study rated the HIV/AIDS mobile apps based on the evidence showed that the Cafe Bazaar apps were rated as "inap- propriate" and the Google Play Store applications were Table 2 The agreement rate between the two evaluators regarding the rating based on FARM and MARS Tools Dimensions ICC Condence interval of 95% for ICC MARS Engagement 0.916 0.871–0.945 Functionality 0.930 0.893–0.954 Aesthetics 0.840 0.756–0.895 Information quality 0.944 0.913–0.964 Subjective dimension 0.919 0.866–0.950 FARM Desirable features 0.931 0.892–0.955 Absence of undesirable feature 0.537 0.296–0.696 Table 3 The correlation between the FARM dimensions and The MARS dimensions Tools and dimensions FARM dimensions MARS dimensions Desirable Features Absence of Engagement Functionality Aesthetics Information quality Subjective dimension FARM dimensions Desirable feature 1.0 0.574 0.734 0.461 0.615 0.753 0.745 Absence of undesirable features 0.574 1.0 0.555 0.499 0.514 0.538 0.524 MARS dimensions Engagement 0.734 0.555 1.0 0.620 0.713 0.684 0.802 Functionality 0.461 0.499 0.620 1.0 0.603 0.464 0.450 Aesthetics 0.615 0.514 0.713 0.603 1.0 0.660 0.643 Information quality 0.753 0.538 0.684 0.464 0.660 1.0 0.832 Subjective dimension 0.745 0.524 0.802 0.450 0.643 0.832 1.0 Content courtesy of Springer Nature, terms of use apply. Rights reserved. Page 8 of 11 Raeesietal. BMC Medical Informatics and Decision Making (2022) 22:281 rated as "good" [15]. Due to the importance of the infor- mation content of an app [65], it is necessary to evaluate and, if possible, eliminate apps with inappropriate infor- mation from app stores. e results of our study confirm the results of the Robustillo Cortés etal. [53] study con- ducted in 2013. eir study indicates that the quality of the evaluated apps on HIV is limited, and only one app (inPractice HIV) is categorized in Class A. is app, in our study, was ranked as "good". According to the results of our study, of all the Café-Bazaar apps, only one has been written by health organizations. Also, the affiliation of more than half of the apps was not determined, and they may not be reliable. is is in line with the results of a study by Rosa etal. [52], which showed that more than half of the apps were not written by health professionals. In this study, the mean FARM score for all desirable features was low. Most apps were ranked with a low score in terms of their desirable features. However, the high number of features considered in the FARM tool may affect the total desirable score results. Also, the Function- ality dimension of the MARS tool had the highest score among all other dimensions of the MARS tool. According to the Functionality dimension, all apps ranked higher than the "acceptable" score, but most ranked as "inad- equate" in terms of desirable features. In most previous studies using the MARS tool [26, 28, 30, 60, 66], the func- tionality score was the highest compared to the scores of the other dimensions of the MARS tool. erefore, rank- ing apps with the Functionality dimension of the MARS tool and its general questions cannot conclude that the apps contain desirable features. In the study of Schnall etal. [50], only nine features of HIV/AIDS-related mobile apps were evaluated, and the results had not been com- pared with other valid tools, nor had the evaluated fea- tures been ranked. Our study confirmed the results of the Schnall etal. study [50], which showed that a small number of HIV/AIDS-related apps have the desired functionalities. In this study, the best features of the HIV/AIDS mobile apps were collecting medication data, medication man- agement and medication reminders, and documentation and presentation of the disease progression. A previous study [67] showed that the most interesting features for HIV/AIDS patients’ needs are the reminders/alerts fea- ture, collecting lab data and lab results tracking, and notes about health status. ese features were better designed than other features, but they need to be given more attention and designed better. Based on our results, the lowest undesirable feature score of the Cafe Bazaar apps was assigned to the "being a free app, but requiring payment for basic features" and "advertising" features. e Cafe Bazaar apps did not have a good status in terms of the existence of undesirable features. Although an app may have rich content, it’s very annoying for users to face a lot of advertising and unwanted features. e FARM evaluates and rates mobile apps based on the availability and quality of each feature. e items of the FARM are flexible based on each app’s features. In this study, we included all the features available at the time of the study. e features of the apps may change with each update, and apps may contain different features compared to each other. Feature lists also differ from one disease to another. e list of FARM features may change over time with app updates and with a decrease or increase in the number of included apps. e FARM has flexibility and can be used to rank mobile apps to help users choose the app they want. Currently, most of the features of mobile apps in the App Store are unknown to users, a few apps have men- tioned the features in the app description section, but the quality of these features is unknown. So, the results of evaluated HIV/AIDS mobile apps in this study can be helpful for these app users to choose their desired apps. e desirable and undesirable features extracted in the FARM can help mobile app developers to develop new applications for HIV/AIDS patients. Furthermore, the tools used in this study to rate the desirable and undesir- able features of mobile apps can be used by researchers to evaluate mobile apps in future works. Further research is required to investigate the implications of the FARM tool. For future work, we recommend mobile app evalua- tors use and test the FARM tool to evaluate other mobile health apps. For studies that use the FARM, it is sug- gested to first prepare a list of the features of the mobile apps that they want to evaluate, then rank the quality of each feature of a mobile app using the FARM, and finally, the mean of these scores is the mobile app’s overall score. e FARM can be used for just one app. Mobile app developers can use the FARM to rate their mobile apps. It is also suggested to divide the features into sub-features, first assign a score to the sub-features, and then calcu- late the feature score based on the average score of the features. Moreover, we recommend using quantitative methods like quantitative usability methods for each fea- ture instead of qualitative methods. Also, for qualitative evaluations, use more than two evaluators or real users. Strengths andlimitations ofthestudy Using the five-choice ranking in the developed tool in this study for rating app features is one of the strengths of this study because this made the results comparable with the results of the evaluations done with the other tools with the same ranking [17, 19]. Moreover, in this study, we ranked the desirable and undesirable features Content courtesy of Springer Nature, terms of use apply. Rights reserved. Page 9 of 11 Raeesietal. BMC Medical Informatics and Decision Making (2022) 22:281 available in the apps and compared the rankings with the MARS tool. is study has several limitations. First, this study was conducted on mobile applications available in Iran. Since not all applications are available in Iran due to the sanc- tions against the country and regional restrictions, this study was conducted in a country with limited access to mobile apps, and therefore the results may not be gen- eralizable to other HIV/AIDS-related mobile apps avail- able in other countries. However, in terms of the number of evaluated HIV/AIDS apps, this study has the highest number of apps being assessed compared to the previous studies [50–53]. Second, in this study, mobile apps running on the IOS operating system were not evaluated due to sanctions against the country and the removal of Iranian apps from this store. To deal with this issue, the researcher wrote to Apple Company to access the mobile apps for conducting this research but failed to obtain the necessary permis- sion. According to the findings of a previous study [50], more than 60% of HIV/AIDS mobile apps are available on the IOS and Android platforms. ird, another limitation of this study was using two evaluators to rate 79 mobile apps with many features using FARM and MARS. We used two evaluators because most of the previous studies that used the MARS tool for evaluating mobile health apps used two evaluators [16, 17, 29–33, 36, 42, 44, 45, 64]. e evaluation process may be affected by evaluator bias, fatigue bias, experi- ence bias, and familiarity bias with using two evaluators. To reduce the above mentioned biases in this study, the evaluators were trained about biases before conducting the evaluation. e evaluation was performed when the evaluators were mentally prepared to complete the evalu- ation, and if the evaluators were tired, the evaluation was stopped and continued until another time when the eval- uators had sufficient mental preparation. Fourth, according to similar studies [15–20, 26, 35], we applied a subjective approach to evaluate HIV/AIDS mobile apps. Given to limitations of subjective evaluation methods, using quantitative methods is recommended for future studies. Conclusions In this study, we used the MARS tool and a new tool called the FARM to evaluate desirable and undesirable features of HIV/AIDS mobile apps. is study showed that the rank of HIV/AIDS-related available apps in Iran is "acceptable". According to the results of the MARS tool and desirable features, Cafe Bazaar apps were ranked as "poor" and lacked a third of the desirable features. e developers of the Cafe Bazaar apps should add some fea- tures based on users’ needs to their apps. The FARM can determine the desirable and undesir- able features of mobile apps and the quality of those features and then rank mobile apps based on their fea- tures. Our study results also showed that using a sin- gle tool to evaluate mobile apps may not provide good insight to evaluators about the assessed apps. However, using more than one tool provides more details about the evaluated apps. The FARM is a new tool. There- fore, further studies are needed to test the FARM on mobile health apps in different health domains. Abbreviations FARM: Feature-based Application Rating Method; MARS: Mobile Apps Rating Scale; HIV: Human Immunodeficiency Virus; AIDS: Acquired Immune Defi- ciency Syndrome; ICC: Internal Correlation Coefficient; SD: Standard Deviation; WHO: World Health Organization; CI: Confidence Interval; IOS: IPhone Operat- ing System. Supplementary Information The online version contains supplementary material available at https:// doi. org/ 10. 1186/ s12911- 022- 02029-8. Additional le1: The Feature-Based Application Rating Method (the FARM) Tool. Acknowledgements We would like to thank Fatemeh Tabatabaei for her contribution to the app’s evaluation. Also, we would like to thank Dr. Mohammad Reza Safaei for his consultation about HIV/AIDS disease. The authors would like to thank Felix Holl, a researcher working at the Neu-Ulm University of Applied Sciences, Germany, for his valuable comments and insights on the manuscript. Author contributions LA, RK, and AR designed the study. LA and RK supervised the project. AR contributed to the app’s evaluation. AR and LA analyzed and interpreted the data. LA and AR wrote the final manuscript. All authors read and approved the final manuscript. Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Availability of data and materials Data sharing is not applicable to this article as no datasets were generated or analysed during the current study. Declarations Ethics approval and consent to participate In this study, all apps were downloaded directly from the Google Play Store and Cafe Bazaar, and no apps were downloaded illegally. This study was approved by the Research Ethics Committee of the Kerman University of Medical Sciences (I.D. approved: IR.KMU.REC.1397.246). We confirm that all methods were performed in accordance with the relevant guidelines and regulations. We did not include individuals as study participants, so there was no requirement for informed consent. Consent for publication Not applicable. Competing interests The authors declare no competing interests. Content courtesy of Springer Nature, terms of use apply. Rights reserved. Page 10 of 11 Raeesietal. BMC Medical Informatics and Decision Making (2022) 22:281 Author details 1 Student Research Committee, Mashhad University of Medical Sciences, Mash- had, Iran. 2 Department of Health Information Sciences, Kerman University of Medical Sciences, Kerman, Iran. 3 Department of Health Information Sciences, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran. 4 HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Haft-Bagh Highway, Kerman, Iran. Received: 11 October 2021 Accepted: 21 October 2022 References 1. Ericsson Mobility Report- June 2022 report edition. Ericsson. 2022. https:// www. erics son. com/ en/ repor ts- and- papers/ mobil ity- report/ repor ts/ june- 2022. Accessed 7 Sep 2022. 2. Mobile operating systems’ market share worldwide from January 2012 to August 2022 | Statista. 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Telemedicine applications have the potential to provide convenient, accessible, and personalized care to individuals living with HIV, addressing various aspects of their healthcare needs [1]. However, a study conducted by Raeesi et al. found that existing HIV apps frequently fall short in meeting the diverse and specific needs of users [2]. This paper focuses on a telemedicine app designed to support HIV patients. ... ... German examples include Prepared (only for PrEP users), MyTherapy (no communication between clinician and patient), Life4me+ (no symptom diary), and Lifetime (no symptom diary). As indicated in brackets and described in Raeesi et al. [2], many apps do not cover the full range of user needs. ... Enhancing HIV Patient Support Through Telehealth: Exploring Design Solutions Chapter Full-text available * Oct 2023 * Richard Noll * Alexander Voigt * Susanne Maria Köhler * Jannik Schaaf In recent years, telemedicine has advanced significantly, offering new possibilities for improving healthcare and patient outcomes. This paper presents a telemedicine app for HIV patients, developed using a human-centered design approach. Designed to meet the diverse and specific needs of Pre-Exposure Prophylaxis (PrEP) users and Late Presenters (LP), the app is part of the COMTRAC-HIV Project at the University Hospital Frankfurt. Through interviews with HIV experts and healthcare professionals, initial design solutions were derived. The paper explores the app’s design process, core functionalities, and future directions, aiming to provide comprehensive support for individuals living with HIV. View Show abstract ... A validated and reliable Persian language version of MARS was used to collect the HAC app quality data [42]. -The subjective quality subscale of MARS focuses on the overall rating of the app, its benefits, and its value. ... Evaluating the Usability and Quality of a Clinical Mobile Application for Assisting Physicians in Head CT Scan Ordering: A Think Aloud and Mobile Apps Rating Scale (MARS) Study (Preprint) Article Full-text available * Sep 2024 * Shiva Meidani * Aydine Omidvar * Hossein Akbari * Felix Holl Background Among the numerous factors contributing to health care providers’ engagement with mobile apps, including user characteristics (eg, dexterity, anatomy, and attitude) and mobile features (eg, screen and button size), usability and quality of apps have been introduced as the most influential factors. Objective This study aims to investigate the usability and quality of the Head Computed Tomography Scan Appropriateness Criteria (HAC) mobile app for physicians’ computed tomography scan ordering. Methods Our study design was primarily based on methodological triangulation by using mixed methods research involving quantitative and qualitative think-aloud usability testing, quantitative analysis of the Mobile Apps Rating Scale (MARS) for quality assessment, and debriefing across 3 phases. In total, 16 medical interns participated in quality assessment and testing usability characteristics, including efficiency, effectiveness, learnability, errors, and satisfaction with the HAC app. Results The efficiency and effectiveness of the HAC app were deemed satisfactory, with ratings of 97.8% and 96.9%, respectively. MARS assessment scale indicated the overall favorable quality score of the HAC app (82 out of 100). Scoring 4 MARS subscales, Information (73.37 out of 100) and Engagement (73.48 out of 100) had the lowest scores, while Aesthetics had the highest score (87.86 out of 100). Analysis of the items in each MARS subscale revealed that in the Engagement subscale, the lowest score of the HAC app was “customization” (63.6 out of 100). In the Functionality subscale, the HAC app’s lowest value was “performance” (67.4 out of 100). Qualitative think-aloud usability testing of the HAC app found notable usability issues grouped into 8 main categories: lack of finger-friendly touch targets, poor search capabilities, input problems, inefficient data presentation and information control, unclear control and confirmation, lack of predictive capabilities, poor assistance and support, and unclear navigation logic. Conclusions Evaluating the quality and usability of mobile apps using a mixed methods approach provides valuable information about their functionality and disadvantages. It is highly recommended to embrace a more holistic and mixed methods strategy when evaluating mobile apps, because results from a single method imperfectly reflect trustworthy and reliable information regarding the usability and quality of apps. View Show abstract ... Previous research has demonstrated the effectiveness of eHealth services in enhancing outcomes in HIV care [10][11][12]. Germany suffers a lack of mobile health (mHealth) solutions and related studies on HIV patient care, underscoring the need for developing and evaluating mHealth apps tailored to this patient group's requirements [13][14][15]. The objective of our Communication and Tracing App HIV (COMTRAC-HIV) project is to develop a digital health application (Digitale Gesundheitsanwendung or DiGA). ... Exploring patient-centered design solutions of a telehealth app for HIV − A qualitative study Article Full-text available * Jun 2024 * INT J MED INFORM * Jannik Schaaf * Timm Weber * Michael von Wagner * Angelina Müller View ... This scale serves as a straightforward, objective, and dependable tool for researchers, developers, and health professionals to assess app quality [14]. Since its inception in 2015, the MARS has been translated into multiple languages [15][16][17] and used to assess a wide range of mobile apps [18][19][20][21][22][23][24][25][26]. It comprises 23 items organized into distinct sections, covering engagement, functionality, aesthetics, information quality, and subjective quality [14]. ... The Most Popular Commercial Weight Management Mobile Apps in the Chinese App Store: Analysis of Quality, features, and Behavior Change Techniques (Preprint) Article Full-text available * Jun 2023 * Lan Geng * Genyan Jiang * Lingling Yu * Mei Zhao Background Many smartphone apps designed to assist individuals in managing their weight are accessible, but the assessment of app quality and features has predominantly taken place in Western countries. Nevertheless, there is a scarcity of research evaluating weight management apps in China, which highlights the need for further investigation in this area. Objective This study aims to conduct a comprehensive search for the most popular commercial Chinese smartphone apps focused on weight management and assess their quality, behavior change techniques (BCTs), and content-related features using appropriate evaluation scales. Additionally, the study sought to investigate the associations between the quality of various domains within weight management apps and the number of incorporated BCTs and app features. Methods In April 2023, data on weight management apps from the iOS and Android app stores were downloaded from the Qimai Data platform. Subsequently, a total of 35 weight management apps were subjected to screening and analysis by 2 researchers. The features and quality of the apps were independently assessed by 6 professionals specializing in nutrition management and health behavioral change using the Mobile Application Rating Scale (MARS). Two registered dietitians, who had experience in app development and coding BCTs, applied the established 26-item BCT taxonomy to verify the presence of BCTs. Mean (SD) scores and their distributions were calculated for each section and item. Spearman correlations were used to assess the relationship between an app’s quality and its technical features, as well as the number of incorporated BCTs. Results The data set included a total of 35 apps, with 8 available in the Android Store, 10 in the Apple Store, and 17 in both. The overall quality, with a mean MARS score of 3.44 (SD 0.44), showed that functionality was the highest scoring domain (mean 4.18, SD 0.37), followed by aesthetics (mean 3.43, SD 0.42), engagement (mean 3.26, SD 0.64), and information (mean 2.91, SD 0.52), which had the lowest score. The mean number of BCTs in the analyzed apps was 9.17 (range 2-18 BCTs/app). The most common BCTs were “prompt review of behavioral goals” and “provide instruction,” present in 31 apps (89%). This was followed by “prompt self-monitoring of behavior” in 30 apps (86%), “prompt specific goal setting” in 29 apps (83%), and “provide feedback on performance” in 27 apps (77%). The most prevalent features in the analyzed apps were the need for web access (35/35, 100%), monitoring/tracking (30/35, 86%), goal setting (29/35, 83%), and sending alerts (28/35, 80%). The study also revealed strong positive correlations among the number of BCTs incorporated, app quality, and app features. This suggests that apps with a higher number of BCTs tend to have better overall quality and more features. Conclusions The study found that the overall quality of weight management apps in China is moderate, with a particular weakness in the quality of information provided. The most prevalent BCTs in these apps were reviewing behavioral goals, providing guidance, self-monitoring of behavior, goal setting, and offering performance feedback. The most common features were the need for web access, monitoring and tracking, goal setting, and sending alerts. Notably, higher-quality weight management apps in China tended to incorporate more BCTs and features. These findings can be valuable for developers looking to improve weight management apps and enhance their potential to drive behavioral change in weight management. View Show abstract ... These tools evaluate mobile apps based on quality and trustworthy health information. One of these tools is the Mobile Application Rating Scale (MARS), which evaluates and rates mobile apps in terms of qualitative, objective, and subjective aspects [14]. By Using this tool, it is possible to evaluate and compare user engagement, functionality, aesthetics, and information quality [15]. ... A review and content analysis of hemophilia applications: Mobile Application Rating Scale (MARS) Approach Preprint Full-text available * Jul 2023 * Erfan Esmaeeli * Elham Ataee * Hasan Sajjadi * Niloofar Mohammadzadeh Background Mobile health technology has the potential to break down conventional boundaries in the healthcare industry by providing healthcare in any environment, reducing distance, time, and cost, and bringing comfort and peace to patients. Despite the increasing availability of mobile health applications for hemophilia management, no study has yet used a valid tool to evaluate these applications. Therefore, the aim of this study was to evaluate the quality and content of hemophilia-related mobile applications using the Mobile App Rating Scale (MARS) scale. Methods In March 2023, two app stores, namely, the Apple App Store (iOS) and Google Play (Android), were searched for applications related to hemophilia self-care. Based on MeSH terms, the search keywords used included "hemophilia", "haemophilia", "hemophilia A", and "hemophilia B". The inclusion criteria included applications developed for hemophilia sufferers, being related to hemophilia, being in the English language, being free, and being available in the mentioned app stores. After determining the final number of applications based on the inclusion and exclusion criteria, they were independently reviewed, rated, and evaluated by three reviewers using the MARS tools. Results A total of 69 applications were initially found, with 30 from Google Play and 39 from the Apple App Store. Following the exclusion process, seven selected applications were downloaded and analyzed. Based on their contents and interactive capabilities, all applications were divided into three groups. In the domains of engagement, functionality, aesthetics, information, and app subjective quality, MicroHealth Hemophilia and Robust Health (5 out of 5), my WAPPS and HaemActive and MicroHealth Hemophilia and Robust Health (4.75 out of 5), Robust Health (5 out of 5), my WAPPS (4.28 out of 5), and my WAPPS (5 out of 5) applications received the highest points, respectively. Conclusions This study compiled a list of seven mobile applications intended to improve access to hemophilia-related information, patient care management, teleconsultation, and self-assessment. The findings indicate that very few applications meet the prespecified criteria for quality, content, or functionality. This highlights the need for further refinement and mapping to evidence-based guidelines, as well as overall quality improvement in hemophilia symptom monitoring and self-care-related applications. View Show abstract ... However, a further success factor for such apps is a high rate of usability and acceptance by the users [24][25][26][27]. A study by Raeesi et al. indicated that HIV/AIDS apps often do not meet user requirements [28]. ... Interviews with HIV Experts for Development of a Mobile Health Application in HIV Care—A Qualitative Study Article Full-text available * Aug 2023 * Jannik Schaaf * Timm Weber * Michael von Wagner * Angelina Müller The Communication and Tracing App HIV (COMTRAC-HIV) project aims to develop a mobile health application for integrated care of HIV patients due to the low availability of those apps in Germany. This study addressed organizational conditions and necessary app functionalities, especially for the care of late diagnosed individuals (late presenters) and those using pre-exposure prophylaxis. We followed a human-centered design approach and interviewed HIV experts in Germany to describe the context of use of the app. The interviews were paraphrased and analyzed with a qualitative content analysis. To define the context of use, user group profiles were defined and tasks derived, which will represent the functionalities of the app. A total of eight experts were included in the study. The results show that the app should include a symptom diary for entering symptoms, side effects, and their intensity. It offers chat/video call functionality for communication with an HIV expert, appointment organization, and sharing findings. The app should also provide medication overview and reminders for medications and appointments. This qualitative study is a first step towards the development of an app for HIV individuals in Germany. Further research includes involving patients in the initial app design and test design usability. View Show abstract Enhancing Agricultural Practices through ICT: The Diffusion and Impact of the Among Tani Application in Batu City, Indonesia Article Full-text available * Aug 2024 * Syahirul Alim * Angga Sukmara Christian Permadi * Verdy Firmantoro This study examines the implementation and impact of the Among Tani application, a digital platform designed to support farmers in Batu City, Indonesia, as part of a broader smart city initiative. Utilizing a qualitative approach, the research investigates the diffusion process of the application, its role as a virtual communication medium, and its effects on organizational structures within farmer groups. The study reveals a staged adoption process influenced by factors such as farmer age and crop vulnerability. While the application has enhanced access to agricultural information and improved pest management, challenges including the digital divide and integration with traditional practices persist. The findings highlight the complex interplay between digital innovation and existing agricultural systems, emphasizing the need for context-sensitive approaches in implementing agricultural technologies. This research contributes to the understanding of digital agriculture's potential in supporting sustainable rural development and provides insights for future smart city initiatives in agricultural contexts. View Show abstract Evaluation of the quality of oral Hygiene mobile apps for children using the mobile app rating scale Article * Sep 2024 * INT J MED INFORM * Ezgi Meriç View Feasibility and Acceptability of a Mobile Health Application Among Adolescents and Young Adults Living with HIV in Fako Division, South West, Cameroon: Guidance for Development Preprint Full-text available * Apr 2024 * Charles Njumkeng * Tendongfor Nicholas * Prudence Tatiana Nti Mvilongo * Patrick A. Njukeng Mobile health applications have emerged as promising tools for improving healthcare delivery and patient outcomes, particularly in the context of HIV care. Adolescents and young adults living with HIV face unique challenges in accessing and adhering to treatment, making them a vulnerable population that could greatly benefit from mobile health interventions. In this study, we assessed the feasibility and acceptability of a mobile health application among adolescents and young adults living with HIV. This study was conducted from February to April 2023 in the four health districts within Fako Division. The study utilized a mixed-methods approach to gather comprehensive insights from HIV clients and their healthcare provider. Quantitative data were collected using a structured questionnaire, while qualitative data collection was conducted through focus group discussions (FGDs). Qualitative data was analyzed with Atlas.ti Version9 while the quantitative data analyzed with SPSS Version 25. Among the 119 participants enrolled, 102 (85.7%) demonstrated the ability to read and write while 111 (93.3%) were able to use social media platform. The proportion of participates aged ≤ 19 years who didn’t own a mobile phone was significantly higher (55.4%) among participants, compared to those aged 20–24 years (7.41%) (p = 0.001). Majority (86.6%) expressed the desire to use a mobile health application to facilitate the care and treatment services they receive. Participants expressed desired that software should be able to provide reminders and prevention tips, social corner, drug side effects and appointments. However, they had concerns about the confidentiality of their health information. This study reveals evidence of high proficiency in using mobile applications making it promising for mhealth application to be accepted. However, it also emphasizes the need to prioritize and implement a robust system to ensure privacy and confidentiality during the use of a mobile health application. View Show abstract Evaluation of the Smartphone Applications in Antibiotic Prescription Article * May 2023 * Ehsan Nabovati * Soroush Bijani * Behzad Bijani Introduction: One of the important challenges for physicians is the choic e of the right antibiotics for various diseases. In this regard, a mobile application could be helpful. The main purpose of this study was to compare the quality of mobile applications designed for an antibiotic prescription to help physicians in choosing the right antibiotic . Method : In this study, English non -commercial apps from the Apple App Store and the Google Play Store were searched using relevant keywords. The apps were selected and independently scored by an infectious disease specialist and a pharmacist using the Mobile Application Rating Scale (MARS ). Kendall’s coefficient of concordance was used to assess inter -rater agreement. The Kolmogorov -Smirnov test was used to verify the normal distribution of the quantitative variables. Spearman's rank -order correlation was applied to determine the relationship between MARS scores and quantitative background variables and Mann -Whitney U tests for dichotomous variables. Results: In the initial search until August 2022, 13 apps were eligible for evaluation. The MARS score obtained by applications without in -app advertisements (median: 3.9, IQR: 3.4 -6. 1) was significantly higher than applications containing advertisements (median: 2.9, IQR: 2.3 - 8 . 1) (P=0.029). In the objective domain of MARS, The highest mean domain score belonged to the engagement section (3.9±0.4) and the lowest mean domain score belonged to the functionality section (3.5±0.5). Conclusion: This study indicated that apps designed to help physicians prescribe antibiotics meet acceptable criteria. Considering objective scores of MARS, lower score s in the "engagement" section demonstrated that designers have paid less attention to this section in comparison to the "information quality" section. View Show abstract Show more Functional and Technical Aspects of Self-management mHealth Apps: Systematic App Search and Literature Review Article Full-text available * May 2022 * Lyan A Alwakeel * Kevin Lano Background Although the past decade has witnessed the development of many self-management mobile health (mHealth) apps that enable users to monitor their health and activities independently, there is a general lack of empirical evidence on the functional and technical aspects of self-management mHealth apps from a software engineering perspective. Objective This study aims to systematically identify the characteristics and challenges of self-management mHealth apps, focusing on functionalities, design, development, and evaluation methods, as well as to specify the differences and similarities between published research papers and commercial and open-source apps. Methods This research was divided into 3 main phases to achieve the expected goal. The first phase involved reviewing peer-reviewed academic research papers from 7 digital libraries, and the second phase involved reviewing and evaluating apps available on Android and iOS app stores using the Mobile Application Rating Scale. Finally, the third phase involved analyzing and evaluating open-source apps from GitHub. Results In total, 52 research papers, 42 app store apps, and 24 open-source apps were analyzed, synthesized, and reported. We found that the development of self-management mHealth apps requires significant time, effort, and cost because of their complexity and specific requirements, such as the use of machine learning algorithms, external services, and built-in technologies. In general, self-management mHealth apps are similar in their focus, user interface components, navigation and structure, services and technologies, authentication features, and architecture and patterns. However, they differ in terms of the use of machine learning, processing techniques, key functionalities, inference of machine learning knowledge, logging mechanisms, evaluation techniques, and challenges. Conclusions Self-management mHealth apps may offer an essential means of managing users’ health, expecting to assist users in continuously monitoring their health and encourage them to adopt healthy habits. However, developing an efficient and intelligent self-management mHealth app with the ability to reduce resource consumption and processing time, as well as increase performance, is still under research and development. In addition, there is a need to find an automated process for evaluating and selecting suitable machine learning algorithms for the self-management of mHealth apps. We believe that these issues can be avoided or significantly reduced by using a model-driven engineering approach with a decision support system to accelerate and ameliorate the development process and quality of self-management mHealth apps. View Show abstract Monitoring Symptoms of COVID-19: A Review of Mobile Applications (Preprint) Article Full-text available * Jan 2022 * Suzanna Schmeelk * Alison Davis * Qiaozheng Li * Ruth Masterson Creber Background: Mobile health (mHealth) apps have facilitated symptom monitoring of COVID-19 symptoms globally and have been used to share data with healthcare professionals, support disease prediction, prevention, management, diagnostics, and improvements in treatments and patient education. Objective: The aim of this review was to evaluate the quality and functionality of COVID-19 mHealth apps that support tracking acute and long-term symptoms of COVID-19. Methods: We systematically reviewed commercially available mHealth apps for COVID-19 symptom monitoring by searching Google Play and Apple iTunes using search terms such as: "COVID-19," "Coronavirus," and "COVID-19 and symptoms." All apps underwent three rounds of screening. The final apps were independently assessed using the Mobile Application Rating Scale (MARS), an informatics functionality scoring system, and Center for Disease Control and World Health Organization symptom guidelines. The MARS is a 19-item standardized tool to evaluate the quality of mHealth apps on engagement, functionality, aesthetics, and information quality. Functionality was quantified across the following criteria: inform, instruct, record (collect, share, evaluate, intervene), display, guide, remind/alert, and communicate. Interrater reliability between the reviewers was calculated. Results: A total of 1,017 mobile apps were reviewed and 20 met the inclusion criteria. The majority of the apps (90%, n=18) were designed to track acute COVID-19 symptoms, and only two addressed long-term symptoms. Overall, the apps scored high on quality, with an overall MARS rating of 3.89 out of 5, and the highest domain score for functionality (4.2). The most common functionality among all apps was the instruct function (95%, n=19). The most common symptoms included in the apps for tracking were: fever and dry cough (n=18), aches and pains (n=17), difficulty breathing (n=17), tiredness, sore throat, headache, loss of taste, or smell (n=16), and diarrhea (n=15). Only two applications (10%) specifically tracked long-term symptoms of COVID-19. The top four rated apps overall were state-specific apps developed and deployed for public use. Conclusions: Overall, mHealth apps designed to monitor symptoms of COVID-19 were high quality, but the majority of apps focused almost exclusively on acute symptoms. Future apps should also incorporate monitoring long-term symptoms of COVID-19, evidence-based educational materials, and include a feature that would allow patients to communicate their symptoms to specific caregivers or their own healthcare team. App developers should also follow updated technical and clinical guidelines from the CDC and WHO. Clinicaltrial: N/a. View Show abstract Validation of a Korean version of mobile app rating scale (MARS) for apps targeting disease management Article Full-text available * Apr 2022 * Health Informat J * Kimmi Keumhee Ko * Sun Kyung Kim * Youngho Lee * Stoyan R Stoyanov The mobile app rating scale (MARS) is a widely used instrument for evaluating smartphone app quality. We aimed to examine the reliability and validity of the Korean version of MARS (MARS-K). Two independent raters performed the assessment using the translated 23-item questionnaire. We applied intraclass correlation coefficient analysis (ICC) to examine inter-rater reliability, Omega, and item-total correlation for internal consistency, and Pearson’s r for test–retest reliability and correlation between subscales and the total score of MARS-K. Most items showed moderate to good ICC (0.447–1.000). The MARS-K showed excellent internal consistency and all subscales exceeded the acceptable level of omega. Results indicated MARS-K to be a valid and reliable instrument for evaluating disease management apps offered in the Korean app store. However, upgrades are recommended to further improve MARS-K’s rating accuracy and reliability. View Show abstract Improving online clinical sexual and reproductive health information to support self-care: A realist review Article Full-text available * Mar 2022 * Thomas Courtenay * Paula Baraitser Self-care is the ability of individuals, families and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a healthcare provider. In the field of sexual and reproductive health options for self-care predominantly include ordering contraceptives online, or testing and treating genital infections outside a healthcare setting. The shift to digitally facilitated self-care consequently requires information that was previously used by clinicians to be made available to those managing their own sexual and reproductive health. This review was specifically interested in how to optimise this informational enabling environment as self-care becomes more complex. Using a realist approach to facilitate collation, analysis and synthesis of research from multiple disciplines this review sought to enable the generation of a programme theory to inform service development. The majority of research we identified studied information to support the choice to self-care and access to self-care. In contrast to established areas of self-care, for example, the management of diabetes or hypertension, studies of the self-care process in sexual and reproductive health are lacking. There is significant potential to expand digital information resources to support sexual and reproductive health self-care, however, there are currently significant unmet informational needs. This review proposes six key recommendations for providers and key stakeholders involved with sexual and reproductive healthcare for the improvement of digital self-care services. View Show abstract Development and validation of a Japanese version of the Mobile App Rating Scale (MARS) (Preprint) Article Full-text available * Sep 2021 * Kazumichi Yamamoto * Masami Ito * Masatsugu Sakata * Toshiaki A Furukawa Background: The number of mobile health apps (mHealth apps) continues to rise each year. Widespread use of the Mobile Application Rating Scale (MARS) has allowed objective and multidimensional evaluation of the quality of these apps. However, no Japanese version of MARS has been made available to date. Objective: The purpose of this study is (1) to develop a Japanese version of MARS and (2) to assess the translated version's reliability and validity in evaluating mHealth apps. Methods: To develop the Japanese version of MARS, cross-cultural adaptation was adopted using a universalist approach. A total of 50 mental health apps were evaluated by two independent raters. Internal consistency and inter-rater reliability were then calculated. Convergent and divergent validity were assessed using multi-trait scaling analysis and concurrent validity. Results: After cross-cultural adaptation, all 23 items from the original MARS were included in the Japanese version. Following translation, back-translation, and review by the author of the original MARS, a Japanese version of MARS was finalized. Internal consistency was acceptable by all subscales of objective and subjective quality with a Cronbach's alpha of 0.78-0.89. Inter-rater reliability was deemed acceptable with intraclass correlation coefficients (ICC) ranging from 0.61-0.79 in all subscales, except for "Functionality" with an ICC of 0.40. Convergent/divergent validity and concurrent validity were also considered acceptable. The rate of missing responses was high in several items in the "Information" subscale. Conclusions: A Japanese version of MARS was developed and shown to be reliable and valid, comparable to the original MARS. This Japanese version of MARS can be used as a standard to evaluate the quality and credibility of mHealth apps. View Show abstract Identifying Key Quality Features of mHealth Applications: Unsupervised Feature Selection Approach: MARS Case Study Chapter Full-text available * Jan 2022 * Rolando Armas * Carlos Montenegro * Andrés Larco * Cesar Yanez View Analysis of Apps With a Medication List Functionality for Older Adults With Heart Failure Using the Mobile App Rating Scale and the IMS Institute for Healthcare Informatics Functionality Score: Evaluation Study Article Full-text available * Nov 2021 * Maria Yohanca * Diaz-Skeete * David McQuaid * Yohanca Maria Diaz - Skeete View Promoting Health via mHealth Applications Using a French Version of the Mobile App Rating Scale: Adaptation and Validation Study Article Full-text available * Sep 2021 * Ina Saliasi * Prescilla Martinon * Emily Darlington * Laurie Fraticelli View An Analysis of Apps with a Medication List Functionality for Older Adults with Heart Failure: Evaluation using the Mobile Application Rating Scale (MARS) and the IMS Institute for Healthcare Informatics Functionality Score (Preprint) Article Full-text available * May 2021 * Yohanca Maria Diaz - Skeete * David McQuaid * Adewale Samuel Akinosun * Lucia Carragher Background Managing the care of older adults with heart failure (HF) largely centers on medication management. Because of frequent medication or dosing changes, an app that supports these older adults in keeping an up-to-date list of medications could be advantageous. During the COVID-19 pandemic, HF outpatient consultations are taking place virtually or by telephone. An app with the capability to share a patient’s medication list with health care professionals before consultation could support clinical efficiency, for example, by reducing consultation time. However, the influence of apps on maintaining an up-to-date medication history for older adults with HF in Ireland remains largely unexplored. Objective The aims of this review are twofold: to review apps with a medication list functionality and to assess the quality of the apps included in the review using the Mobile App Rating Scale (MARS) and the IMS Institute for Healthcare Informatics functionality scale. Methods A systematic search of apps was conducted in June 2019 using the Google Play Store and iTunes App Store. The MARS was used independently by 4 researchers to assess the quality of the apps using an Android phone and an iPad. Apps were also evaluated using the IMS Institute for Healthcare Informatics functionality score. Results Google Play and iTunes App store searches identified 483 potential apps (292 from Google Play and 191 from iTunes App stores). A total of 6 apps (3 across both stores) met the inclusion criteria. Of the 6 apps, 4 achieved an acceptable MARS score (3/5). The Medisafe app had the highest overall MARS score (4/5), and the Medication List & Medical Records app had the lowest overall score (2.5/5). On average, the apps had 8 functions based on the IMS functionality criteria (range 5-11). A total of 2 apps achieved the maximum score for number of features (11 features) according to the IMS Institute for Healthcare Informatics functionality score, and 2 scored the lowest (5 features). Peer-reviewed publications were identified for 3 of the apps. Conclusions The quality of current apps with medication list functionality varies according to their technical aspects. Most of the apps reviewed have an acceptable MARS objective quality (ie, the overall quality of an app). However, subjective quality (ie, satisfaction with the apps) was poor. Only 3 apps are based on scientific evidence and have been tested previously. A total of 2 apps featured all the IMS Institute for Healthcare Informatics functionalities, and half did not provide clear instructions on how to enter medication data, did not display vital parameter data in an easy-to-understand format, and did not guide users on how or when to take their medication. View Show abstract Mobile health technologies for the management of spine disorders: A systematic review of mHealth applications in Brazil Article * Apr 2022 * Cristiano Carvalho * Beatriz Prando * Lucas Ogura Dantas * Paula Regina Mendes da Silva Serráo Background Spine disorders are conditions that affect a growing number of individuals, and mobile health (mHealth) applications (apps) offer potential to assist the self-management of these conditions. Objectives To perform a systematic review of the availability of mHealth apps for patients with spine disorders at Brazilian online stores and evaluate the apps in terms of engagement, user interface, experience, and quality of the information. Design Systematic review. Method A search for spine disorders mHealth apps from the Google Play Store and AppStore in Brazil was performed by two independent reviewers on June 2021. Only smartphone apps in Brazilian Portuguese directed at spine disorders that provided information about education, counseling, exercise, or monitoring of patient health were included. The quality of eligible mHealth apps was assessed using the Mobile App Rating Scale (MARS). Results Of the 2775 mHealth apps found, 10 were eligible for inclusion. All apps offered exercise programs. Three apps also offered tools to track patient-reported symptoms, nutritional orientation, or educational content in addition to the exercise program. Using MARS, the apps scored poorly in terms of quality, with an overall mean score ±standard deviation of 2.75 ± 0.63 on a scale of 1–5 points. Most apps scored poorly for credibility, user interface, and engagement. Conclusions The mHealth apps for spine disorders currently available in Brazil are of poor quality and limited functionality. Effective collaboration between industry and researchers is needed to develop better user-centered mHealth apps that can empower patients with these conditions. View Show abstract Show more RECOMMENDED PUBLICATIONS Discover more about: Mobile Applications Article Full-text available EVALUATION OF HIV/AIDS-RELATED MOBILE HEALTH APPLICATIONS CONTENT USING AN EVIDENCE-BASED CONTENT RA... April 2021 · BMC Medical Informatics and Decision Making * Ahmad Raeesi * Reza Khajouei * Leila Ahmadian Background Despite the increasing number of mobile health applications, the validity of their content is understudied. The objective of this study was to rate the content of HIV/AIDS-related mobile applications and to determine the extent to which evidence-based medicine is being incorporated into their content using a new tool called the Evidence-based content rating tool of mobile health ... [Show full abstract] applications (EBCRT-mHealth). Methods All available HIV/AIDS-related applications in Iran from Cafe Bazaar and Google Play Store were evaluated. This study was first conducted in 2018, then after almost two years in 2021 was done again. In this study, researchers developed the EBCRT-mHealth tool to rate the content of applications based on the evidence-based medicine pyramid. Its reliability was calculated (α = 0.78), and five specialists confirmed its validity. Two reviewers independently reviewed all HIV/AIDS applications directly downloaded and installed from the Google Play Store and Cafe Bazaar. Results Out of 980 retrieved applications, in 2018, 85, and in 2021, 78 applications were included in the study. Only in 17 (28%) out of the 60 in 2018, and 25 (51%) in 2021 Google Play store applications the source of content information was mentioned. All Cafe Bazaar mobile applications mentioned the source of information. The mean rating of all application content in 2018 was 2.38 (SD = 0.74), and in 2021 was 2.90 (SD = 1.35) out of 5. The mean rating of the content of Cafe Bazaar applications in 2018 was 2.10 (SD = 0.49), and in 2021 was 1.94 (SD = 0.29). The mean content rating of Google Play store applications in 2018 was 2.50 (SD = 0.80) and in 2021 was 3.86 (SD = 1.18). Conclusion After two years, the rating of the content of HIV/AIDS-related applications available in Iran that existed in Cafe Bazaar decreased from "poor" to "inappropriate". Also, the content score of the Google Play Store applications increased from "poor" to "good". It is critical to ensure the credibility of the sources used in developing their content and removing applications with inappropriate and unreliable content from the App Stores. Also, mobile health application developers should use the highest quality information in their applications. View full-text Article Full-text available THE PERSIAN VERSION OF THE MOBILE APPLICATION RATING SCALE (MARS-FA): TRANSLATION AND VALIDATION STU... August 2022 · JMIR Formative Research * Saeed Barzegari * Ali Sharifi Kia * Marco Bardus * [...] * Mouna Rafizadeh Background Approximately 110 million Farsi speakers worldwide have access to a growing mobile app market. Despite restrictions and international sanctions, Iran’s internal mobile health app market is growing, especially for Android-based apps. However, there is a need for guidelines for developing health apps that meet international quality standards. There are also no tools in Farsi that assess ... [Show full abstract] health app quality. Developers and researchers who operate in Farsi could benefit from such quality assessment tools to improve their outputs. Objective This study aims to translate and culturally adapt the Mobile Application Rating Scale in Farsi (MARS-Fa). This study also evaluates the validity and reliability of the newly developed MARS-Fa tool. Methods We used a well-established method to translate and back translate the MARS-Fa tool with a group of Iranian and international experts in Health Information Technology and Psychology. The final translated version of the tool was tested on a sample of 92 apps addressing smartphone addiction. Two trained reviewers completed an independent assessment of each app in Farsi and English. We reported reliability and construct validity estimates for the objective scales (engagement, functionality, aesthetics, and information quality). Reliability was based on the evaluation of intraclass correlation coefficients, Cronbach α and Spearman-Brown split-half reliability indicators (for internal consistency), as well as Pearson correlations for test-retest reliability. Construct validity included convergent and discriminant validity (through item-total correlations within the objective scales) and concurrent validity using Pearson correlations between the objective and subjective scores. Results After completing the translation and cultural adaptation, the MARS-Fa tool was used to assess the selected apps for smartphone addiction. The MARS-Fa total scale showed good interrater reliability (intraclass correlation coefficient=0.83, 95% CI 0.74-0.89) and good internal consistency (Cronbach α=.84); Spearman-Brown split-half reliability for both raters was 0.79 to 0.93. The instrument showed excellent test-retest reliability (r=0.94). The correlations among the MARS-Fa subdomains and the total score were all significant and above r=0.40, suggesting good convergent and discriminant validity. The MARS-Fa was positively and significantly correlated with subjective quality (r=0.90, P<.001), and so were the objective subdomains of engagement (r=0.85, P<.001), information quality (r=0.80, P<.001), aesthetics (r=0.79, P<.001), and functionality (r=0.57, P<.001), indicating concurrent validity. Conclusions The MARS-Fa is a reliable and valid instrument to assess mobile health apps. This instrument could be adopted by Farsi-speaking researchers and developers who want to evaluate the quality of mobile apps. While we tested the tool with a sample of apps addressing smartphone addiction, the MARS-Fa could assess other domains or issues since the Mobile App Rating Scale has been used to rate apps in different contexts and languages. View full-text Article DEVELOPMENT AND VALIDATION OF THE JAPANESE VERSION OF THE UMARS (USER VERSION OF THE MOBILE APP RATI... June 2022 · International Journal of Medical Informatics * Kazumichi Yamamoto * Masami Ito * Toshiaki A Furukawa * [...] * Yoshikazu Shinohara Background Although the global market of Mobile Health Apps (mHealth apps) continues to grow dramatically, most mHealth apps still not only lack evidence base but have even not been evaluated for the basic usability or functionality. The User Version of the Mobile App Rating Scale (uMARS) was developed to allow end users to assess mHealth apps objectively and subjectively. However, there is no ... [Show full abstract] Japanese version of uMARS to date. Objective The purpose of this study is (1) to develop a validated Japanese version of uMARS and (2) to assess the translated version’s reliability and validity in evaluating mHealth apps. Methods The original uMARS was adapted for Japanese use by four specialists using universalist cross-cultural methods. Translation/back-translation was reviewed by the author of the original version of uMARS, and confirmed. Its reliability and validity were further evaluated as part of a prospective cohort study of postoperative patients using a new mHealth app. Results Conceptual equivalence was analyzed and all items in all subcategories of the original uMARS were included in the Japanese version. Internal consistency was deemed acceptable for all subscales of objective and subjective quality with a Cronbach's alpha of 0.75–0.85. Test-retest reliability of all subscales was also acceptable with intraclass correlation coefficients (ICCs) of 0.57–0.88. Convergent/divergent validity and concurrent validity were also considered acceptable. Conclusion A Japanese version of uMARS was cross-culturally validated and found to be as reliable as the original uMARS. This Japanese version of uMARS is expected to become a standard tool in assessing the quality of mHealth apps in Japan. Read more Preprint THE PERSIAN VERSION OF THE MOBILE APPLICATION RATING SCALE (MARS-FA): DEVELOPMENT AND VALIDATION STU... August 2022 * Saeed Barzegari * Ali Sharifi Kia * Marco Bardus * [...] * Mouna Rafizadeh BACKGROUND There are 110 million Farsi speakers worldwide who have access to a growing mobile app market. Despite restrictions and international sanctions, the internal mHealth app market in Iran is growing, especially for Android-based apps. However, there are no guidelines for developing health apps that meet international quality standards. There are also no tools in Farsi that assess health ... [Show full abstract] app quality. Developers and researchers who operate in Farsi could benefit from such quality assessment tools to improve their outputs. OBJECTIVE This study aimed to translate and culturally adapt the Mobile App Rating Scale in Farsi (MARS-Fa). This study also evaluated the validity and reliability of the newly developed MARS-Fa tool. METHODS We used a well-established method to translate and back-translate the MARS-Fa tool with a group of Iranian and international experts in Health Information Technology and Psychology. We validated the MARS-Fa with a sample of 92 apps addressing smartphone addiction using two trained reviewers. We reported inter-rater reliability, internal consistency, and convergent and discriminant validity of the validation exercise. RESULTS Cronbach’s alpha coefficient was .84 for the total MARS-Fa and subjective quality, indicating excellent internal consistency. Spearman-Brown split-half reliability indicators were very good and excellent (.79 to .93). The MARS-Fa showed excellent inter-rater reliability (ICC=.91) and test-retest reliability (r=.94). The inter-item correlation coefficients among 18 items were greater than 0.20, suggesting good construct and discriminant validity. CONCLUSIONS The MARS-Fa tool can be reliably used to evaluate health apps by trained reviewers who speak Farsi. Further research should be done to validate the tool with health apps targeting other health problems. Read more Last Updated: 22 Oct 2024 Interested in research on Mobile Applications? Join ResearchGate to discover and stay up-to-date with the latest research from leading experts in Mobile Applications and many other scientific topics. Join for free ResearchGate iOS App Get it from the App Store now. Install Keep up with your stats and more Access scientific knowledge from anywhere or Discover by subject area * Recruit researchers * Join for free * Login Email Tip: Most researchers use their institutional email address as their ResearchGate login PasswordForgot password? Keep me logged in Log in or Continue with Google Welcome back! Please log in. Email · Hint Tip: Most researchers use their institutional email address as their ResearchGate login PasswordForgot password? Keep me logged in Log in or Continue with Google No account? 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