JMIR Publications

ABSTRACT

Background:

With thousands of health apps available in the app stores globally, it is crucial to systematically and comprehensively evaluate app quality, as this may impact health-related decisions and health outcomes. The Mobile App Rating Scale (MARS) is the only currently available tool that provides a comprehensive, multidimensional evaluation of app quality. MARS is available in English, Italian, Spanish, and German, and it has been used to evaluate health apps available from US and European app stores in various domains. However, this tool is not available in Arabic.

Objective:

To translate and adapt MARS to Arabic and validate the tool with health apps for the prevention and management of obesity and related conditions.

Methods:

We followed a well-established “universalist” process of cross-cultural adaptation using mixed methods. The process included an initial translation of the tool, followed by an expert content validation through two rounds of independent consultations, culminated in a final version, which was then back-translated into English. Two trained researchers piloted the MARS-Ar with a sample of 10 weight management apps obtained from Google Play and iTunes stores. Inter-rater reliability was established using intra-class correlation coefficients (ICCs). After reliability was ascertained, the two researchers independently evaluated a set of additional 56 apps.

Results:

The MARS-Ar was highly aligned with the original English version. The ICCs for MARS-Ar were good 0.836 (95% CI: 0.817-0.853), as for the MARS English (0.838, 95% CI: 0.819-0.855). The MARS-Ar subscales were highly correlated with the original counterparts (p < 0.001). The lowest was found in the domain of functionality (r = 0.685), followed by aesthetics (r = 0.827), information quality (r = 0.854), engagement (r = 0.894), and total app quality (r = 0.897). Subjective quality was also highly correlated (r = 0.820).

Conclusions:

The MARS-Ar is a valid instrument to assess app quality among trained Arabic-speaking users of health and fitness apps. Researchers and public health professionals in the Arab world can use the overall MARS score and its sub-scales to evaluate app quality of weight management apps reliably. Further studies are needed to test the instrument on health apps focusing on various health topics, such as mindfulness/anxiety prevention, or sexual and reproductive health.