Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Feb 24, 2019
Date Accepted: Mar 31, 2020
(closed for review but you can still tweet)
Limitations of Existing Dialysis Diet Apps in Promoting User Engagement and Patient Self-Management: A Content Analysis of mHealth Apps.
ABSTRACT
Background:
With the unprecedented growth of mobile technology, a plethora of dialysis diet applications (apps) have been developed to promote patient’s self-management. Nevertheless, their utility remains questionable.
Objective:
This study aimed to evaluate the content and features of existing dialysis diet apps for dialysis patients.
Methods:
This is a content analysis of existing dialysis diet apps in Google Play and Apple App stores searched using English ‘dialysis diet; diet for kidney disease’ keywords. Free and paid apps that were available in English which provide nutrition information for adult dialysis patients were included. Apps were excluded if they were not relevant to dialysis care, not meant for patient’s self-management or redundant. Apps were evaluated for option of other language (sub-score=1), credibility (sub-score=1), food database (sub-score=1), valuable features (sub-score=12), health behavior theory constructs (sub-score=60) and technical quality (sub-score=25). Relationships between variables of interest were determined by Pearson correlation. Stepwise multiple linear regression analysis was performed to identify features that predict the technical quality of apps. Statistical significance was defined as P<.05.
Results:
A total of 22 out of 253 apps (9%) were eligible for evaluation. On the basis of 100-point scale, the mean overall score of apps was 31.13 ± 14.08. Only 9% (2/22) of the apps offered language option and 46% (10/22) contained food database. Besides, about 54% (12/22) of the apps were not credible. The mean score for valuable features was 3.27 ± 1.76 (out of 12) in which general education (16/22, 73%), free download (15/22, 68%) and usability (13/22, 59%) were the 3 most popular features. Whereas, the apps scored 13.41 ± 11.56 (out of 60) for health behavior theory constructs. The overall app technical quality was considered poor with the mean score of 2.69 ± 0.41 (out of 5). Scores of valuable features (r=.647, P=.001) and health behaviour theory constructs (r=.545, P=.009) were positively correlated with overall technical quality of the existing dialysis diet apps. Features such as free download (b=0.515, P=.004) and usability (b=0.371, P=.031) could significantly determine the functional quality of the apps. Health behavioural theory construct such as self-monitoring could significantly predict both subjective quality (b=0.518, P=.008) and engagement quality (b=0.853, P=.001) of the apps whereas information quality domain could be determined by plan or order (b=0.722, P=.007) and knowledge (b=0.619, P=.011) theory constructs.
Conclusions:
Although most of the existing dialysis diet apps were available for free and easy to use, they were subjected to theory deficient, limited language option and lacking in food databases, credibility, tailored education and overall technical quality.
Citation
