Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Oct 15, 2023
Date Accepted: Oct 11, 2024
Self-management support apps for spinal cord injury: Systematic search in app stores and mobile app rating scale evaluation
ABSTRACT
Background:
The use of mobile technology to meet health needs, widely referred to as mobile health (mHeatlh), has played a critical role in providing self-management support (SMS) for chronic health conditions. However, despite its potential benefits, mHealth technologies like SMS apps for spinal cord injury (SCI) have received little research attention and an understanding of their public availability is lacking. Therefore, an overview of these apps is needed to complement findings from the literature for a fuller understanding of mHealth SMS tools for SCI and to support the selection and improvement of existing apps and the development of new ones.
Objective:
The objective of this study was to identify and describe SMS apps for SCI available on major mobile app digital distribution platforms in terms of their quantity, quality, SMS focus, strengths and weaknesses.
Methods:
A systematic search of the Google Play Store and Apple App Store was conducted to identify and summarize SMS apps for SCI updated since 2017. A supplementary systematic literature review was conducted across 11 bibliographic databases to identify publications that described the identified apps in further detail than typically available within app store descriptions. The data synthesis was guided by Corbin and Strauss’ self-management tasks taxonomy, Lorig and Holman’s self-management skills taxonomy and the Practical Reviews in Self-Management Support taxonomy. The PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) extension for searching guided the reporting.
Results:
A total of 13 apps were included in the final synthesis. These apps were launched between 2013 and 2021, mostly originated in the United States, with availability in 72 countries and support for 14 languages. Most of the identified apps used the Android operating system (10/13, 77%), while 31% used iOS (4/13, 31%). The provided SMS apps mainly focused on activities of daily living, physical activity promotion, health literacy, and therapeutic exercise. All 3 self-management tasks (ie, medical, role, and emotional management) and most self-management skills (eg, action planning, resource utilization, and problem-solving) (4/6, 67%) and support activities (eg, training, lifestyle support, and information about resources) (10/14, 71%) were supported by the identified apps. The mean Mobile Apps Rating Scale (MARS) score was 3.86 (SD 0.54), with a maximum of 4.52 and a minimum of 2.72, indicating good overall quality. No publications were found describing these apps.
Conclusions:
Despite their good overall quality, as measured by the MARS assessment, the thirteen identified apps alone or combined, do not appear to offer a comprehensive self-management approach that incorporates theory-based strategies. Besides working to improve comprehensiveness, future research and practice should consider adopting new technologies, such as artificial intelligence, to enhance future SMS apps for SCI. Furthermore, adopting new app development methods, such as low-code development platforms, could help reduce barriers to development, such as time, cost and securing scarce expertise.
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