JMIR Publications

ABSTRACT

Background:

Most health apps lack rigorous scientific evaluation. There is an ongoing debate about what evidence of effectiveness should be expected and how that should vary with the perceived risk associated with different types of health apps. The public should be involved in these discussions, but there is minimal research on their views.

Objective:

To explore public understanding and expectations regarding the evidence needed to demonstrate the effectiveness of health apps, including at varying levels of health risk.

Methods:

Four focus group discussions with UK residents to explore factors influencing public trust in the effectiveness of health apps, ranging from well-being apps to high-risk diagnostic tools. The data was analysed using thematic analysis.

Results:

Participants relied on personal experiences and social endorsements when judging the effectiveness of low-risk digital health interventions while making minimal reference to traditional scientific evidence. However, as the health risks of the apps increase, there is a shift towards expressing a need for greater evidence, which includes authoritative recommendations and professional validations.

Conclusions:

The public have a preference for evidence that resonates on a personal level, but also show a heightened demand for authoritative guidance as the potential risk of digital health interventions increases. These perspectives should guide developers, regulators and policymakers as they balance how to achieve innovation, safety, and public trust in the digital health landscape.