JMIR Publications

ABSTRACT

Background:

Neglected tropical diseases (NTDs) affect over 1.5 billion people worldwide, the majority among impoverished populations in low- and middle-income countries (LMICs). Skin NTDs are a subgroup of NTDs that manifest primarily as skin lesions. The diagnosis and treatment of skin NTDs entail considerable resources, including trained personnel and financial backing. Many interventions are being launched and evaluated, particularly mobile health (mHealth) interventions, such as the SkinNTDs app, a training and decision support tool for Frontline Health Workers (FHWs) created by the World Health Organization (WHO). As most digital health guidelines prioritize the thorough evaluation of mHealth interventions, it is essential to conduct a rigorous and validated assessment of the SkinNTDs app.

Objective:

We aimed to assess the quality of version 3 of the SkinNTDs app, developed for WHO by Universal Doctor and Netherlands Leprosy Relief (NLR) as a training and decision support tool for FHWs.

Methods:

A cross-sectional study was conducted in 2 LMICs: Ghana and Kenya. We used snowball sampling recruitment to select participants from the target population of all FHWs dealing with skin NTDs. The sample group was asked to download and use the SkinNTDs app for at least 5 days before completing an online survey containing demographic variables and the user version of the Mobile Application Rating Scale (uMARS) questionnaire. A smaller group of participants took part in semi-structured interviews and one focus group. Quantitative data were analysed using SPSS with a 95% confidence interval and p≤0.05 for statistical significance. Qualitative data were analysed using ATLAS.ti to identify attributes, cluster themes, and code various dimensions that were explored.

Results:

60 participants were involved in the first part of the study (24 from Kenya and 36 from Ghana). The SkinNTDs app scored highly on the uMARS questionnaire, with an app quality mean score of 4.02/5, a subjective quality score of 3.82/5, and a perceived impact of 4.47/5. There was no significant association between the app quality mean score and any of the categorical variables examined, according to Pearson’s correlation analysis. Findings from the semi-structured interviews and focus group (n=17) supported the results obtained from the uMARS assessment.

Conclusions:

The findings of this study indicate that the SkinNTDs app has a good level of quality as assessed by the uMARS questionnaire (4.02/5) and the semi-structured interviews. These results can be employed to enhance upcoming releases of the SkinNTDs app by examining the perspective of FHWs. Further research is needed to assess its clinical effectiveness and identify a strategy to accomplish worldwide dissemination.