The mobile health app trustworthiness checklist: Usability assessment


van Haasteren A, Vayena E, Powell J. (2020). The mobile health app trustworthiness checklist: Usability assessment. JMIR Mhealth and Uhealth. 8(7): e16844. doi: 10.2196/16844

Researchers recruited 49 stakeholders to assess the feasibility of a user-generated mobile health app trustworthiness (mHAT) checklist. Informed by user focus groups (n = 20), the mHAT checklist presents 41 attributes of trustworthy mHealth apps reflecting 5 major themes: (1) informational content (e.g. is app content backed by robust research?) (2) attributes of the organization (e.g. are there clear policies on how the company handles user data?), (3) societal influences (e.g. has the app received positive reviews?), (4) technology-related features (e.g. are app features customizable?), and (5) user control (e.g. does the app seek explicit user permission before sharing data with third parties?). Stakeholder recruitment occurred through email and social media posts with a link to an online survey. Eligible stakeholders included researchers, health professionals, and programmers with professional experience in mHealth app development. In the online survey, stakeholders rated the validity of each checklist item on a 5-point scale, from complete disagreement (1) to complete agreement (5). Over half of the stakeholders agreed or completely agreed with 37 of the 41 checklist items (90%). No checklist item received a majority of negative ratings (i.e. disagree or completely disagree). The highest-rated item was “The app can be easy to use and have a friendly end-user interface” (79% agree or completely agree). The most negatively reviewed items were “The app can inform end users about errors in measurements” (38% disagree or completely disagree) and “The app can highlight potential risks or side effects resulting from its use” (31% disagree or completely disagree). Stakeholders appear to undervalue user safety concerns. User concerns about mHealth app trustworthiness will persist until developers increase transparency around potential errors, risks, and side effects of app use. Overall, stakeholder responses suggest that the mHAT checklist may be a valid, useful guide for the development of more trustworthy mHealth apps.