Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Nov 18, 2020)
Date Submitted: Oct 21, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Terms and Conditions apply: Critical issues for readability and jargon in mental health apps
ABSTRACT
Background:
Mental health services are turning to technology to ease the resource burden, but privacy policies are hard to understand potentially compromising consent for people with mental health problems. The FDA recommends a reading grade of 8.
Objective:
To investigate and improve the accessibility and acceptability of mental health app privacy policies.
Methods:
A mixed methods study using quantitative and qualitative data to improve the accessibility of app privacy policies. Service users completed assessments and focus groups to provide information on ways to improve privacy policy accessibility, including identifying and rewording jargon. This was supplemented by comparisons of mental health apps with social media, music and finance apps using readability analyses and examining whether GDPR affected accessibility.
Results:
Service users provided a detailed framework for increasing accessibility that emphasised having critical information for consent. Quantitatively, most app privacy policies were too long and complicated for ensuring informed consent (mental health apps mean reading grade = 13.1 (SD = 2.44). Their reading grades were no different to those for other services. Only 3 mental health apps had a grade 8 or less and 99% contained service user identified jargon. Mental health app privacy policies produced for GDPR weren’t more readable and were longer.
Conclusions:
Apps specifically aimed at people with mental health difficulties are not accessible and even those that fulfilled the FDA’s recommendation for reading grade contained jargon words. Developers and designers can increase accessibility by following a few rules and should, before launching, check whether the privacy policy can be understood. Clinical Trial: N/A
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