JMIR Publications

ABSTRACT

Background:

There has been a vast amount of mHealth applications for mental health made available in the recent years. While there is reason to be optimistic about their effect on improving health and increasing access to care, there is a call for more knowledge about how the usability of the mHealth applications is being addressed and scientifically measured.

Objective:

The goal for this study is to review the literature on how usability is being addressed and measured in mHealth interventions for mental health problems.

Methods:

We conducted a systematic literature review through a search for peer-reviewed studies published between 2001 and 2018 in the following electronic databases: EMBASE, CINAHL, PsycINFO, PubMED and Web of Science. Two reviewers independently assessed all abstracts against the inclusion and exclusion criteria, following the PRISMA guidelines.

Results:

299 studies were initially identified based on the inclusion keywords. Following a review of the title, abstract and full text, the review resulted in a total of 42 studies. We found that most of the studies evaluated usability with patients (29) and health care providers (11) as opposed to healthy users (8) and were directed at a wide variety of mental health problems (24). Half of the studies set out to evaluate usability (21), secondly feasibility (10) and acceptability (10). Regarding the maturity of the evaluated systems, most were either prototypes or previously tested versions of the technology, and the studies included few accounts of sketching and participatory design processes. The most commonly referred to reason for developing mobile mental health applications was the availability of mobile devices to users, their popularity and how people in general have become accustomed to using them for various purposes.

Conclusions:

This study provides a detailed account of how evidence of usability of mHealth applications are being gathered in the form of usability evaluations from a perspective of computer science and human-computer interaction, including how users feature in the evaluation, which study objectives and outcomes are being stated, which research methods and techniques are being used, and how the notion of mobility features in the mHealth applications. Most studies described their methods as trials, gathered date from a small sample size, and carried out a summative evaluation using a single questionnaire, indicating that usability evaluation was not the main focus. As many described using an adapted version of a standard usability questionnaire, there may be a need for developing a standardized mHealth usability questionnaire.