JMIR Publications

ABSTRACT

Background:

Telemedicine and mobile health (mHealth) apps have emerged as powerful tools in healthcare, offering convenient access to services and empowering individuals in managing their health. Among populations with chronic and progressive disease like Multiple Sclerosis (MS), mHealth apps hold promise for enhancing self-management and care. To be employed in clinical practice, validity and usability of mHealth tools should be tested. The most commonly used method for assessing the usability of electronic as well as mHealth technologies are questionnaires.

Objective:

This study aimed to translate and validate the English version of the mHealth App Usability Questionnaire (MAUQ) into Italian (ita-MAUQ) in a sample of people with MS (PwMS).

Methods:

The 18-item MAUQ was forward and back-translated from English into Italian by an expert panel, following scientific guidelines for translation and cross-cultural adaptation. The MAUQ (patient version for standalone apps) comprises three subscales, which are Ease of Use (MAUQ_E), Interface and Satisfaction (MAUQ_I), and Usefulness (MAUQ_U). PwMS fulfilled the ita-MAUQ after interacting with DIGICOG-MS®, a novel mHealth app for cognitive self-assessment in MS. Confirmatory factor analysis, internal consistency, test–retest reliability, and construct validity were assessed. Known-groups validity was examined based on disability levels as indicated by the Expanded Disability Status Scale (EDSS) score and gender.

Results:

One hundred-sixteen PwMS (female= 74; mean age= 47.2 years; mean EDSS= 3.32) were enrolled. The ita-MAUQ demonstrated acceptable model fit, good internal consistency (Cronbach’s α= 0.92), and moderate test–retest reliability (Intraclass Coefficient Correlation= 0.84). Spearman’s coefficients revealed significant correlations between ita-MAUQ total score, MAUQ_E, MAUQ_I, MAUQ_U subscales and the System Usability Scale (all p values < .05). Known-group analysis found no difference between PwMS with mild and moderate EDSS (all p values > .05), suggesting that ambulation ability, mainly detected by the EDSS, did not affect the MAUQ scores. Interestingly, statistical difference between female and male concerning the MAUQ_E from ita-MAUQ was found (p = .024).

Conclusions:

The ita-MAUQ proved to be a reliable and valid tool for assessing the usability of mHealth apps in PwMS. Future research should explore additional factors influencing usability and expand validation to diverse clinical populations.