Availability of orthodontic smartphone apps.

Study question Does mobile applications (apps) developed for infertile couples have a holistic and utility characteristic? Summary answer Many mobil apps developed in the field of fertility have limited features and very few relevant, understandable, and holistic apps were present for infertile individuals. What is known already In an increasingly technological world, mobile apps offer promising alternatives to support couples’ fertility treatment. Infertile couples can use these apps with aim to manage lifestyle, learn about fertility, follow clinical appointments, receive psychological support, or to seek peer support. For increasing efficiency of this applications, holistic approach should be considered. Human is a whole with biological, physiological, psychological, social and spiritual dimensions and in fertility treatment process all dimensions are highly crucial. Thus, the purpose of this study was to evaluate the utility and holistic perspectives of apps developed for infertile couples by using “APPLICATIONS” mobile app scoring system. Study design, size, duration The study was a systematic evaluation of apps related to fertility and it was conducted via mobile applications platform. To determine relevant apps search was conducted on Google Play and Apple App Store by using “infertility”, “fertility”, “in vitro fertilization”, “IVF”, “sterility” and “fecundity” key words.The search was conducted twice in 1-year intervals, in February 2021 and March 2022. In total from 1917 reached apps; 1841 apps were excluded, and 76 eligible app were evaluated. Participants/materials, setting, methods Mobile apps were independently evaluated by two authors via using APPLICATIONS scoring system. The APPLICATIONS scoring system consists objective criteria such as comprehensiveness (holistic approach), fee, subscription, use of evidence-based information, purchasing, connection, advertising, text search area, interplatform suitability, use of images/shapes or videos, and app-specific features are objective scoring criteria and subjective criteria for instance subjective presentation and ease of navigation in the app. Consequently the maximum score of APPLICATIONS scoring system is 17. Main results and the role of chance The study reached 1917 applications from the search with its keywords. Seventy-six mobile applications meeting the inclusion criteria were analyzed according to the “APPLICATIONS” scoring system. Of the 76 applications in the analysis, 18 were available only in the Apple App Store (23%), 28 were available only in the Google Play Store (36%), and 30 were available on both platforms (41%). Among analyzed app, we determined that one app received 16 points out of maximum 17 points, and two apps received 15 points each. Also, the lowest scoring app earned 4 points. According to overall composite scores, evaluable apps in our study showed scores in the middle range of possible scores with an average score of 9 out of 17, indicating insufficient quality in mobile apps. Besides that, only six apps (%7.8) meet all holistic comprehensiveness criteria and received full scores. Of 76 mobile applications, 31.5% were developed by a healthcare professional, 31.5% by a software company, and 38% by an unknown entity. In addition, 48% of the applications evaluated were specific to infertile couples, 45% were specific to infertile women, and 7% were specific to infertile men. Limitations, reasons for caution Because of the nature of the digital environment, mobile apps are in a continuously changing and rapidly developing internet environment, and currently, newly developed mobile apps were not present in the analysis. This was the limitation of our study. Wider implications of the findings Using mobile health apps can help infertile couples to improve treatment outcomes. Healthcare professionals should be aware of the widespread use of apps and correct the faulty practice recommendations that patients may encounter, and couples should be guided to the correct practices. Trial registration number not applicable

BackgroundSmartphone mobile health (mHealth) apps have the potential to enhance access to health care services and address health care disparities, especially in low-resource settings. However, when developed without attention to equity and inclusivity, mHealth apps can also exacerbate health disparities. Understanding and creating solutions for the disparities caused by mHealth apps is crucial for achieving health equity. There is a noticeable gap in research that comprehensively assesses the entire spectrum of existing health apps and extensively explores apps for specific health priorities from a health care and public health perspective. In this context, with its vast and diverse population, India presents a unique context for studying the landscape of mHealth apps.ObjectiveThis study aimed to create a comprehensive dataset of mHealth apps available in India with an initial focus on heart disease (HD)–related apps.MethodsWe collected individual app data from apps in the “medical” and “health and fitness” categories from the Google Play Store and the Apple App Store in December 2022 and July 2023, respectively. Using natural language processing techniques, we selected HD apps, performed statistical analysis, and applied latent Dirichlet allocation for clustering and topic modeling to categorize the resulting HD apps.ResultsWe collected 118,555 health apps from the Apple App Store and 108,945 health apps from the Google Play Store. Within these datasets, we found that approximately 1.7% (1990/118,555) of apps on the Apple App Store and 0.5% (548/108,945) on the Google Play Store included support for Indian languages. Using monograms and bigrams related to HD, we identified 1681 HD apps from the Apple App Store and 588 HD apps from the Google Play Store. HD apps make up only a small fraction of the total number of health apps available in India. About 90% (1496/1681 on Apple App Store and 548/588 on Google Play Store) of the HD apps were free of cost. However, more than 70% (1329/1681, 79.1% on Apple App Store and 423/588, 71.9% on Google Play Store) of HD apps had no reviews and rating-scores, indicating low overall use.ConclusionsOur study proposed a robust method for collecting and analyzing metadata from a wide array of mHealth apps available in India through the Apple App Store and Google Play Store. We revealed the limited representation of India’s linguistic diversity within the health and medical app landscape, evident from the negligible presence of Indian-language apps. We observed a scarcity of mHealth apps dedicated to HD, along with a lower level of user engagement, as indicated by reviews and app ratings. While most HD apps are financially accessible, uptake remains a challenge. Further research should focus on app quality assessment and factors influencing user adoption.

Parents learning about their children with medical complexity often use numerous health-related resources, including mobile health applications (mHealth apps). mHealth apps could provide broad access to key information and support, lower healthcare costs, and improve care. The quality of mHealth apps for this population has been a concern, but is currently unknown. The objective of this systematic review was to identify and evaluate the quality of publicly available mHealth apps designed for parents who are preparing or caring for medically complex infants. A systematic search strategy was applied to identify mHealth apps in the Apple and Google Play app stores in November 2022 and replicated in August 2024. Apps with no cost, in English, designed for parents of infants with perinatal medical complexity requiring hospitalization were included. Apps for healthy pregnancies, children >1 year, non-parental caregivers or healthcare professionals, primarily for tracking/monitoring, or unrelated activities/products were excluded. Independent raters used the Mobile Application Rating Scale (MARS) subscales of Engagement, Functionality, Aesthetics, and Information to evaluate quality for each app. Mean ratings were calculated by subscale and for overall app quality. From 1,917 identified apps, 32 apps were downloaded and fully screened. The final sample of 15 unique apps were available on the Apple App Store, with six also available on the Google Play Store. Most apps focused on prematurity (n=6), followed by the neonatal intensive care experience (n=4), congenital heart disease (n=4), and hypoxic-ischemic encephalopathy (n=1). MARS ratings of the overall sample (mean =3.61, median =3.58; range, 2.65-4.68) indicated 20% (3/15) were of good quality and 67% (10/15) were of acceptable quality. Apps showed strengths in Functionality and Information and performed worst in Engagement. The poorest quality found in Engagement suggests that most of these apps do not effectively target users' interests or needs. Notably, many suffered from a lack of recent updates or became unavailable. This decline appears to parallel the increasing integration of digital health technologies within healthcare systems, which could prompt testing of mHealth apps on health outcomes. High-quality mHealth apps that are valued by parents and offer evidence-based information and support are needed to extend care.

Digital health tools, such as apps, have the potential to promote healthy behaviours, especially self-monitoring, which can facilitate pregnancy management and reduce the risk of associated pregnancy health conditions. While pregnancy apps are popular amongst pregnant women, there is limited information about the overall quality of their content or self-monitoring tools and the number of behaviour change techniques (BCTs) that they include. The aim of this study was thus to assess the quality of pregnancy apps for self-monitoring, and their usage of BCTs. We identified pregnancy apps by web scraping the most popular global apps for self-monitoring in the Apple App Store and Google Play Store available in Australia. The app quality was evaluated using the scorecard approach and the inclusion of BCTs was evaluated using the ABACUS tool. We identified 31 pregnancy apps that met our eligibility criteria. We found that pregnancy apps tended to score the highest in the domains of 'cost and time', 'usability', and 'technical', and lowest on 'clinical' and 'end-user requirements'. Additionally, the majority of apps contained minimal BCTs. Based on our findings, we propose a digital health scorecard visualisation that would break down app quality criteria and present them in a more accessible way to clinicians and pregnant users. We conclude that these findings highlight the shortcomings of available commercial pregnancy apps and the utility of a digital health scorecard visualisation that would empower users to make more informed decisions about which apps are the most appropriate for their needs.

Background The use of mobile apps for health and well-being has grown exponentially in the last decade, as such apps were reported to be ideal platforms for behavioral change and symptoms monitoring and management. Objective This study aimed to systematically review period tracking applications available at Google Play and Apple App Stores and determine the presence, features, and quality of these smartphone apps. In addition, behavioral changes associated with the top 5 rated apps were assessed. Methods This study used the Systematic Search Criteria through Google Play Store and iTunes Apple Store, using terms related to period tracking. Apps were scanned for matching the inclusion criteria and the included apps were assessed by two reviewers using the Mobile Application Rating Scale (MARS), a tool that was developed for classifying and assessing the quality of mHealth apps. Results Forty-nine apps met the inclusion criteria. Most of the apps enabled setting user goals, motivations, and interactivity, tracking multiple symptoms or mood changes, allowed notifications, and used graphs to illustrate the tracking result over a specific period of time. The majority of features and functions within these apps were offered for free, while some apps included limited in-app purchases or needed Internet connection to function. Certain apps were reported by participants to promote behavioral change and increase knowledge and awareness regarding monthly periods. Conclusions Period tracking apps were easy to use and navigate and can hence be readily adopted into routine tracking and management of periods. However, most apps were not based on significant evidence and may need further development to support period-related symptom management.

BackgroundWorldwide, more than 75% of people with acquired brain injury (ABI) experience communication disorders. Communication disorders are impairments in the ability to communicate effectively, that is, sending, receiving, processing, and comprehending verbal and nonverbal concepts and symbols. Such disorders may have enduring impacts on employment, social participation, and quality of life. Technology-enabled interventions such as mobile apps have the potential to increase the reach of speech-language therapy to treat communication disorders. However, ensuring that apps are evidence-based and of high quality is critical for facilitating safe and effective treatment for adults with communication disorders.ObjectiveThe aim of this review is to identify mobile apps that are currently widely available to adults with communication disorders for speech-language therapy and to assess their content and quality using the validated Mobile App Rating Scale (MARS).MethodsGoogle Play Store, Apple App Store, and webpages were searched to identify mobile apps for speech-language therapy. Apps were included in the review if they were designed for the treatment of adult communication disorders after ABI, were in English, and were either free or for purchase. Certified speech-language pathologists used the MARS to assess the quality of the apps.ResultsFrom a total of 2680 apps identified from Google Play Store, Apple App Store, and web searches, 2.61% (70/2680) apps met the eligibility criteria for inclusion. Overall, 61% (43/70) were available for download on the iPhone Operating System (iOS) platform, 20% (14/70) on the Android platform, and 19% (13/70) on both iOS and Android platforms. A content analysis of the apps revealed 43 apps for language, 17 apps for speech, 8 apps for cognitive communication, 6 apps for voice, and 5 apps for oromotor function or numeracy. The overall MARS mean score was 3.7 out of 5, SD 0.6, ranging between 2.1 and 4.5, with functionality being the highest-scored subscale (4.3, SD 0.6), followed by aesthetics (3.8, SD 0.8), information (3.4, SD 0.6), and engagement (3.3, SD 0.6). The top 5 apps were Naming Therapy (4.6/5), Speech Flipbook Standard (4.6/5), Number Therapy (4.5/5), Answering Therapy, and Constant Therapy (4.4/5).ConclusionsTo our knowledge, this is the first study to systematically identify and evaluate a broad range of mobile apps for speech-language therapy for adults with communication disorders after sustaining ABI. We found a lack of interactive and engaging elements in the apps, a critical factor in sustaining self-managed speech-language therapy. More evidence-based apps with a focus on human factors, user experience, and a patient-led design approach are required to enhance effectiveness and long-term use.

Background: Annually, there are 3.7 billion downloads of mobile health apps. There are 275.6 million smartphones in the US. Diabetes affects 34.2 million people and 88 million have prediabetes. Diabetes is a risk factor for COVID-19 and affects longterm health of the survivors. Other risk factors for COVID-19, include race and gender. There are also linguistic barriers to care in Diabetes and COVID-19. Both diabetes and COVID-19 have higher risks associated with race and ethnicity. With the pandemic, the US government, Google and Facebook, in March 2020, provided emergency grants for COVID-19 and dissemination of public education. Did the Diabetes apps meet this moment of public health crisis?. Purpose: Do Diabetes Apps provide information about COVID-19 and its risk factors? Methods: Using the search term “diabetes,” the top ten most downloaded android and iOS apps were assessed in the Google Play Store/Apple App Store, respectively. Inclusion criteria: 1) Android: Downloads > 100,000; iOS: Reviews > 300, star rating >4. Apple App store does not provide download information. 2) Free; 3) Ability to track health data: HbA1C, FBS; 4) Language Accessibility via in-app language settings. Results: In the Google Play Store(DROID), the top ten apps in descending order were: 1) mySugr, 2) Onetouch Reveal, 3) OneDrop Diabetes Management, 4) Diabetes: M, 5) Health2Sync - Diabetes Care, 6) Diabetes, 7) Ontrack Diabetes, 8) Blood Glucose Tracker, 9) Glucose Buddy Diabetes Tracker, and 10) Diabetes Connect. In the Apple App Store(iOS), the top ten apps in descending order were: 1) OneTouch Reveal, 2) Glucose Buddy Diabetes, 3) One Drop for Diabetes, 4) Glucose - Blood Sugar Tracker, 5) Blood Sugar Monitor by Dario, 6) mySugr, 7) Sugarmate, 8) DiabetesPal, 9) Diabetes:M, 10) Center Health - The Diabetes App. Of the 10 DROID apps: 0/10 had COVID symptom information in the app; 3/10 had a COVID statement; In-app language settings: 2/10 had Spanish and 1/10 had Chinese. Gender: 7/10 Droid apps. Race/Ethnicity: 0/10. Of the ten iOS apps: 0/10 had COVID symptom information in the app; 4/10 had a COVID statement (Only mySugr has CDC link for COVID information); In-app language settings: 1/10 had Spanish and 0/10 had Chinese settings. Gender: 9/10 Droid apps; 7/10 iOS apps, Race/Ethnicty:1/10. Conclusion: Of the top 20 diabetes apps, none had information about COVID-19 and its symptoms within the app. Also, the overall language accessibility is limited. Despite popularity of ehealth, physicians can continue to play an important role in public education about Diabetes and COVID-19 during this important time of the pandemic.

Mobile applications (apps) have exploded in popularity, with billions of smartphone users using millions of apps available through markets such as the Google Play Store or the Apple App Store. While these apps have rich and useful functionality that is publicly exposed to end users, they also contain hidden behaviors that are not disclosed, such as backdoors and blacklists designed to block unwanted content. In this paper, we show that the input validation behavior—the way the mobile apps process and respond to data entered by users—can serve as a powerful tool for uncovering such hidden functionality. We therefore have developed a tool, InputScope, that automatically detects both the execution context of user input validation and also the content involved in the validation, to automatically expose the secrets of interest. We have tested InputScope with over 150,000 mobile apps, including popular apps from major app stores and preinstalled apps shipped with the phone, and found 12,706 mobile apps with backdoor secrets and 4,028 mobile apps containing blacklist secrets.

Mobile devices and applications (apps) that act as access tools for health care management aid in the improvement of clinical decision making and patient outcomes. However, the tremendous amount of mobile health (mHealth) apps available in commercial app stores makes it hard for the lay users as well as health care professionals to choose the right one for their individual needs. The contents and features of these apps have not been systematically reviewed and compared. This study aims to assess the contents and features of mHealth apps for caring of older people. A review and comparison of mHealth apps for caring of older people available in Google's Play Store (Android system) and Apple's App Store (iOS system) were performed. Systematic review of previous relevant literature were conducted. The assessment criteria used for comparison were requirement for Internet connection, information of disease, size of app, diagnostics and assessment tools, medical calculator, dosage recommendations and indications, clinical updates, drugs interaction checker, and information on disease management. Twenty-five mHealth apps were assessed. Medscape and Skyscape Medical Library are the most comprehensive mHealth apps for general drug information, medical references, clinical score, and medical calculator. Alzheimer's Disease Pocketcard and Confusion: Delirium & Dementia: A Bedside Guide apps are recommended for clinical assessment, diagnosis, drug information, and management of geriatric patients with Alzheimer disease, delirium, and dementia. More studies about mHealth apps for caring of older people are warranted to ensure the quality and reliability of the mHealth apps.

Loot boxes in video games are a form of in-game transactions with randomized elements. Concerns have been raised about loot boxes' similarities with gambling and their potential harms (e.g. overspending). Recognizing players' and parents' concerns, in mid-2020, the Entertainment Software Rating Board (ESRB) and PEGI (Pan-European Game Information) announced that games containing loot boxes or any forms of in-game transactions with randomized elements will be marked by a new label stating ‘In-Game Purchases (Includes Random Items)’. The same label has also been adopted by the International Age Rating Coalition (IARC) and thereby assigned to games available on digital storefronts, e.g. the Google Play Store. The label is intended to provide more information to consumers and allow them to make more informed purchasing decisions. This measure is not legally binding and has been adopted as industry self-regulation or corporate social responsibility. Previous research has suggested that industry self-regulation might not be effectively complied with due to conflicting commercial interests. Compliance with the ESRB's, PEGI's and IARC's loot box presence warning label was assessed in two studies. The first study found that 60.6% of all games labelled by either the ESRB or PEGI (or 16.1% using a more equitable methodology) were not labelled by the other. The majority of the inconsistencies were caused by the ESRB refusing to apply the measure retroactively. Five instances where one age rating organization culpably failed to accurately identify loot box presence were identified (although only two cases were admitted by the relevant organization). Generally, with newly released games, consumers can rely on the PEGI and ESRB labels. PEGI has retroactively labelled many older games, meaning that consumers can expect the labelling to be accurate. However, due to the ESRB's policies (which it has refused to improve), North American consumers cannot rely on the label for many older games containing loot boxes, unlike their European counterparts. The data suggest that the loot box issue is far more pressing on mobile platforms than console/PC platforms. The second study found that 71.0% of popular games containing loot boxes on the Google Play Store (whose age rating system is regulated through IARC) did not display the label and were therefore non-compliant. The IARC's current policy on the Google Play Store is that only games submitted for rating after February 2022 are required to be labelled. This policy (which the IARC has refused to improve) means that most popular and high-grossing games can be, and presently are, marketed without the label, thus significantly reducing the measure's scope and potential benefit. The Apple App Store still does not allow loot box presence to be disclosed. At present, consumers and parents cannot rely on this self-regulatory measure to provide accurate information as to loot box presence for mobile games. Due to their immense scale, the mobile markets pose regulatory and enforcement challenges that PEGI admits are not yet resolved. The mere existence of this measure cannot be used to justify the non-regulation of loot boxes by governments, given the poor compliance and doubtful efficacy (even if when complied with satisfactorily). Improvements to the existing age rating systems are proposed. Preregistered Stage 1 protocol: https://doi.org/10.17605/OSF.IO/E6QBM (date of in-principle acceptance: 12 January 2023).

Background: In the context of a recovery-oriented approach to mental healthcare, the role of psychotropic medication over extended or indefinite periods is increasingly being called into question. To minimise the risks of withdrawal symptoms and relapse, it is crucial that service users who want to discontinue psychotropic medication are supported throughout the tapering process. However, in the absence of effective interventions and supports, service users are increasingly relying on online resources for guidance and support. To date, the evidence base for mobile phone applications ('apps') and app-based interventions supporting discontinuation of psychotropic use has not been examined. This scoping review aims to examine the content, underpinning evidence base and impact of available mobile phone apps and app-based interventions to support psychotropic tapering. Methods : A scoping review will be conducted using the Joanna Briggs Institute guidance and results will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guideline. Several electronic databases (MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, ACM and IEEE Xplore) will be searched from 2008 onwards. Searches of the major app stores will also be conducted, specifically Apple's App Store (iOS) and Google Play Store (Android). Following screening, key information will be extracted from the included studies and apps. Identified apps will be coded using the Behaviour Change Technique (BCT) Taxonomy. The findings will be described using narrative synthesis. Conclusions : This scoping review will provide a broad overview of available apps to support psychotropic tapering, including a summary of their content using the BCT Taxonomy. The review findings will guide future research relating to the development, implementation and evaluation of app-based interventions to support the tapering of psychotropic medication.

Purpose Explore smartphone apps that may be recommended by clinicians for the self-management of low back pain. Methods Prospectively registered systematic assessment of self-contained apps for self-management of low back pain on the Google Play and Apple App stores (Oceania), including ≥1 NICE low back pain and sciatica clinical guideline-recommended component and functioning without health professional input. Outcomes were quality (Mobile App Rating Scale; MARS), and self-management (Self-Management Support Checklist; SMS-14) and behaviour change potential (App Behaviour Change Scale; ABACUS). Results 25 apps were included. The average quality of included apps was acceptable (Mean MARS score of 3.9 out of a maximum possible 5). The self-management support and behaviour change potential of included apps appeared low (mean SMS-14 score was 3.4/14; mean ABACUS score was 5.4/21). The apps showed no significant correlation between app consumer ratings and MARS scores. App quality was significantly correlated with app price (p = 0.049) but not consumer ratings, however, these findings were based on a small number of studies and the overall model was not significant. Conclusions Smartphone apps for the self-management of low back pain are of average to good quality, with questionable potential for self-management and behaviour change. Clinicians should consider that few apps were designed to specifically incorporate self-management support and behaviour change potential when recommending apps to clients. Further development in these areas of app design would be of benefit. Implications for Rehabilitation Smartphone apps have the potential to improve LBP self-management outcomes, however, apps are not well regulated and the quality of information and advice provided is often low quality. The findings from this systematic assessment indicate that LBP self-management apps have limited self-management support and behaviour change potential features. Recommendation of current smartphone apps for LBP should take into consideration that although apps are of acceptable quality they are not specifically designed with self-management support and behaviour change principles. App quality does not appear to be associated with consumer ratings, however, there may be a positive association between app price and quality which requires further investigation.

All living things including plants need water to survive, and agriculture is the world's biggest user of water [4].Unfortunately, in a worst-case scenario, over-watering and drying up cause both water waste and the plant's death [5].Guided by this problem that is frequently occurring around the world, we designed an app to determine if the plant needs to be watered or not by capturing pictures of a certain plant and training an AI to compare whether the soil in the pot is dry or wet.In this program, we use Raspberry Pi to capture an image of the plant every 10 seconds, in which the Python code using TensorFlow inside the Raspberry Pi will determine the moisture level of the soil [6][7].The result will be posted to Firebase with a timestamp, and lastly, we have a mobile app that can display the result from Firebase to the user.We published our application to Apple's App Store and the Google Play Store, and public installation of the app means that it can have more widespread usage.An experiment was performed to determine whether the application's model can accurately determine soil moisture [8].The results indicate that the model is very accurate for the vast majority of soil samples under various lighting conditions.

As more patients and clinicians are turning to mental health smartphone apps to expand access to services, little is known about the current state of the app marketplaces and what these apps are actually offering in terms of features, privacy, price, and services. To assess the current state of mental health apps, explore the association between app privacy scores and popularity as measured by star ratings and downloads, and to understand opportunities and challenges facing the commercial app landscape. This cross-sectional study had trained raters using the public-facing M-Health Index and Navigation Database (MIND) to assess and review 578 mental health apps. The sample of apps used in this analysis were pulled from MIND and include apps across various conditions including schizophrenia, eating disorders, sleep, and more. Analysis of these apps was conducted in June 2022. There were 578 mental health apps rated across 105 dimensions derived from the American Psychiatric Association's app evaluation framework. App raters assessed each app across 6 categories: (1) app origin and accessibility, (2) privacy and security, (3) clinical foundation, (4) features and engagement, (5) inputs and outputs, and (6) interoperability. Privacy scores were determined by 5 MIND criteria, including (1) having a privacy policy, (2) reporting security measures in place, (3) declaring data use and purpose, (4) allowing for the deletion of data, and (5) allowing users to opt out of data collection. Correlations between privacy scores and popularity metrics (star ratings and number of downloads) were measured. This study included 578 mental health apps that were identified, assessed, and analyzed across 105 MIND dimensions. Psychoeducation, goal setting, and mindfulness were among the top app features. Of the 578 apps analyzed, 443 (77%) had a privacy policy. This analysis of apps with a privacy policy revealed that there was no statistically significant correlation between privacy scores and Apple App Store (r = 0.058, P = .29) or Google Play Store star ratings (r = 0.041; P = .48). The number of app downloads on the Google Play Store, however, was weakly correlated with privacy scores (χ25 = 22.1; P < .001). In this cross-sectional study of mental health apps, findings indicate that the current app marketplaces primarily offered basic features such as psychoeducation, goal tracking, and mindfulness but fewer innovative features such as biofeedback or specialized therapies. Privacy challenges remained common, and app popularity metrics provided little help in identifying apps with more privacy.

BackgroundThe widespread use of mobile phones represents new frontiers for improving access to health care. This includes using mobile apps to deliver general practitioner (GP) services in rural areas. However, the wider adoption of apps for increasing access to rural GP services relies on understanding how they might intersect with the rural health system context.ObjectiveThis research aims to critically review mobile apps for delivering GP services in a rural health service context using the walkthrough method.MethodsThe sample comprised 3 GP service apps under the top 100 list in the medical category in the Apple App Store (also available via the Google Play Store) in Australia as of June 2020. The walkthrough method was applied to extract data and critique the explicit factors, such as the app interface elements, and implicit factors, such as the embedded cultural features related to use for people in rural settings. Data analysis was undertaken between 3 researchers over 6 months applying the walkthrough method and using critical reflection.ResultsThere were 3 main themes: improving rural access, addressing rural health care needs, and providing quality of care. App-based GP services may improve rural GP service availability. However, this may be at a relatively superficial level that does not encompass the scope and intensity of the services needed in rural areas (including relevant chronic and emergency care) at a cost that rural patients can afford. The apps showed signs of limited tailoring to the cultural dimensions of rural health care as a barrier to rural use. Patients generally self-selected to use GP service apps with limited support, potentially leading to inappropriate uptake especially by disadvantaged groups with lower health literacy. Although the apps claimed to avail most GP services (70%-80% in some cases), it emerged after enrollment that emergency, complex, and serious conditions might be excluded, potentially imposing more complex caseloads on in-person rural GPs. Apps provided limited information about continuity and coordination of care and sharing information with rural GPs, potentially leading to fragmented and low-quality care. There was commonly no assurance of rural skills and experience of physicians staffing apps despite the wider scope of skills needed to be effective in rural general practice.ConclusionsGP apps may increase the availability of GP services, but they may require clearer exclusions, appropriate use through decision-making tools, more rural-tailored interfaces, and capacity to align appointment times and costs with patients with complex needs to engage and be useful in a rural context. It is also important to consider how these app-based services could share information with local health care staff for safety and continuity of rural primary care. Finally, information about the physicians’ rural training and experience is critical for quality.