JMIR Publications

ABSTRACT

Background:

Thousands of apps are available to support people in their quest to quit smoking. Currently, few ways exist to help people easily select an app based on anything other than popularity (rating or number of downloads). It has been hypothesized that selecting an app from the sizable volume without any aid can be overwhelming and difficult. Little is known however about how people choose apps for smoking cessation, and what exactly it is people want to know about an app before choosing to install. Understanding the decision-making process may ultimately be helpful in creating tools to help people meaningfully select apps.

Objective:

The aim of this study is to obtain insights into the process of searching and selecting mobile applications for smoking cessation and to map the range of actions and the accompanying reasons during the search, focusing on the information needs and experiences of those who aim to find an app.

Methods:

Contextual inquiries were conducted with ten Dutch adults wanting to quit smoking by using an app. During the inquiries, we observed people as they chose an app. Additionally, there was a short semi-structured follow up interview over the phone, two weeks later. Through convenience and purposive sampling, we included participants differing in gender, age and educational level. We used thematic analysis to analyze transcribed interviews and leveraged a combination of video and audio recordings in order to understand what is involved in searching and selecting apps for smoking cessation.

Results:

The process of finding smoking cessation apps is comprehensive: participants explored, evaluated and searched for information, imagined using functions, compared apps, assessed trustworthiness of apps and information, made several decisions while navigating the internet and app stores. During the search, participants gained knowledge of apps and developed clearer ideas about wishes and requirements. Confidence and trust in these apps to help quitting, remained quite low or even decreased. Although the process was predominantly a positive experience, the whole process took time, energy, and caused negative emotions such as frustration and disappointment for some participants. In addition, without the participants realizing it, errors in information processing occurred, which affected the choices people made. All participants chose an app with the explicit intention of using it. After two weeks, six participants had used the app, only one of them extensively.

Conclusions:

Finding an app that contains functions and features you expect to help you quit smoking in the current app stores takes considerable time, energy, can be a negative experience, and is prone to errors in information processing that affect decision making. We therefore advise further development of decision aids, such as recommender systems and curated health app portals and make a number of concrete recommendations for the design of such systems.