JMIR Publications

ABSTRACT

Background:

Home assessment is a critical component of successful home modifications, enabling individuals with functional limitations to age in place comfortably. A high-quality home assessment tool should facilitate a valid and reliable assessment involving healthcare and housing professionals, while also engaging and empowering consumers and their caregivers who may be dealing with multiple functional limitations. Unlike traditional paper-pencil assessments, which tend to require extensive training, expert knowledge, and can be alienating to consumers, mobile health (mHealth) apps have the potential to engage all parties involved, empowering and activating consumers to take action. However, little is known about which apps contain all the necessary functionality, their quality appraisals, as well as the accessibility of the apps.

Objective:

The objective of this study was to assess the functionality, overall quality, and accessibility of mHealth home assessment apps.

Methods:

mHealth apps enabling home assessment for aging in place were identified through a comprehensive search of scholarly articles, as well as the Apple (iOS) and Google Play (Android) stores in the United States, and fnd.io. The search was conducted between November 2022 and January 2023, following a method adapted from PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses). Reviewers performed a content analysis of the mobile app features to evaluate their functionality, overall quality, and accessibility. The functionality assessment utilized a home assessment component matrix specifically developed for this study. For the overall quality appraisal, the Mobile Application Rating Scale (MARS) was employed to determine the apps' effectiveness in engaging and activating consumers and their caregivers. The accessibility was assessed using the Web Content Accessibility Guidelines (WCAG 2.1 A and AA), employing a form created for this study. These three assessments were synthesized and visualized to provide a comprehensive evaluation.

Results:

A total of 698 apps were initially identified. After further screening, only six apps remained. Our review revealed that none of the apps used thoroughly tested assessment tools, offered all the functionality required for reliable home assessment, achieved the 'good' quality threshold as measured by the MARS scale, or met the accessibility criteria when evaluated against WCAG 2.1. However, DIYModify received the highest scores in both the overall quality and accessibility assessments. The MapIt apps also showed significant potential due to their ability to measure the 3D environment and the inclusion of a desktop version that extends the app's functionality.

Conclusions:

Our review revealed that there are very few apps available within the United States that possess the necessary functionality, engaging qualities, and accessibility to effectively activate consumers and their caregivers for successful home modification to age in place. Future app development should prioritize the integration of reliable and thoroughly tested assessment tools as the foundation of the development process. Furthermore, efforts should be made to enhance the overall quality and accessibility of these apps to better engage and empower consumers to take necessary actions to age in place.