Mobile apps for oral health promotion

Content review and heuristic usability analysis

Brooks Tiffany, Paula Blasi, Sheryl L Catz, Jennifer B. McClure

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: There has been an increase in consumer-facing mobile health (mHealth) apps in recent years. Prior reviews have characterized the availability, usability, or quality of popular mHealth apps targeting a range of health behaviors, but none has examined apps that promote better oral health care. Oral disease affects billions of people worldwide and mobile phone use is on the rise, so the market for well-designed and effective oral health apps is substantial.Objective: We examined the content and usability of popular oral health promotion apps to better understand the current state of these self-help interventions and inform the need and opportunity for future app development.Methods: Between February and March 2018, we identified oral health-focused apps that were designed for Android or iOS, available in English, and targeted adult consumers (as opposed to children or dental health professionals). The sample was limited to the most popular and highly rated apps on each platform. For each app reviewed, we assessed its basic descriptive characteristics (eg, platform, cost), evidence of a theoretical basis or empirical validation, key program functionality, and the extent to which the app addressed diet and tobacco and alcohol use as risk factors for oral disease. We characterized the framing (ie, gain vs loss) of all persuasive messaging and conducted a heuristic analysis to assess each app’s usability as a persuasive health technology.Results: Thirty-three apps were eligible for review based on the selection criteria. Two-thirds (22/33, 67%) were geared toward the general public as opposed to dental clinic patients, insurance plan members, or owners of specific electric toothbrushes. Most (31/33, 94%) were free to download, and a majority (19/33, 58%) were sponsored by software developers as opposed to oral health experts. None offered any theoretical basis for the content or had been empirically validated. Common program features included tools for tracking or reminding one to brush their teeth and assistance scheduling dental appointments. Nineteen apps (58%) included educational or persuasive content intended to influence oral health behavior. Only 32% (6/19) of these included a larger proportion of gain-framed than loss-framed messaging. Most of the apps did not mention diet, alcohol or tobacco—important risk factors for oral disease. Overall, the apps performed poorly on standard usability heuristics recommended for persuasive health technologies.Conclusions: The quality of the reviewed apps was generally poor. Important opportunities exist to develop oral health promotion apps that have theoretically grounded content, are empirically validated, and adhere to good design principles for persuasive health technologies.

Original languageEnglish (US)
Article numbere11432
JournalJMIR mHealth and uHealth
Volume6
Issue number9
DOIs
StatePublished - Sep 1 2018

Fingerprint

Mobile Applications
Oral Health
Health Promotion
Mouth Diseases
Biomedical Technology
Tooth
Telemedicine
Health Behavior
Alcohols
Diet
Dental Clinics
Cell Phones
Tobacco Use
Heuristics
Insurance
Patient Selection
Appointments and Schedules
Software
Delivery of Health Care
Costs and Cost Analysis

Keywords

  • Dental care
  • eHealth
  • Mobile health
  • Oral health
  • Oral hygiene
  • Review

ASJC Scopus subject areas

  • Health Informatics

Cite this

Mobile apps for oral health promotion : Content review and heuristic usability analysis. / Tiffany, Brooks; Blasi, Paula; Catz, Sheryl L; McClure, Jennifer B.

In: JMIR mHealth and uHealth, Vol. 6, No. 9, e11432, 01.09.2018.

Research output: Contribution to journalArticle

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abstract = "Background: There has been an increase in consumer-facing mobile health (mHealth) apps in recent years. Prior reviews have characterized the availability, usability, or quality of popular mHealth apps targeting a range of health behaviors, but none has examined apps that promote better oral health care. Oral disease affects billions of people worldwide and mobile phone use is on the rise, so the market for well-designed and effective oral health apps is substantial.Objective: We examined the content and usability of popular oral health promotion apps to better understand the current state of these self-help interventions and inform the need and opportunity for future app development.Methods: Between February and March 2018, we identified oral health-focused apps that were designed for Android or iOS, available in English, and targeted adult consumers (as opposed to children or dental health professionals). The sample was limited to the most popular and highly rated apps on each platform. For each app reviewed, we assessed its basic descriptive characteristics (eg, platform, cost), evidence of a theoretical basis or empirical validation, key program functionality, and the extent to which the app addressed diet and tobacco and alcohol use as risk factors for oral disease. We characterized the framing (ie, gain vs loss) of all persuasive messaging and conducted a heuristic analysis to assess each app’s usability as a persuasive health technology.Results: Thirty-three apps were eligible for review based on the selection criteria. Two-thirds (22/33, 67{\%}) were geared toward the general public as opposed to dental clinic patients, insurance plan members, or owners of specific electric toothbrushes. Most (31/33, 94{\%}) were free to download, and a majority (19/33, 58{\%}) were sponsored by software developers as opposed to oral health experts. None offered any theoretical basis for the content or had been empirically validated. Common program features included tools for tracking or reminding one to brush their teeth and assistance scheduling dental appointments. Nineteen apps (58{\%}) included educational or persuasive content intended to influence oral health behavior. Only 32{\%} (6/19) of these included a larger proportion of gain-framed than loss-framed messaging. Most of the apps did not mention diet, alcohol or tobacco—important risk factors for oral disease. Overall, the apps performed poorly on standard usability heuristics recommended for persuasive health technologies.Conclusions: The quality of the reviewed apps was generally poor. Important opportunities exist to develop oral health promotion apps that have theoretically grounded content, are empirically validated, and adhere to good design principles for persuasive health technologies.",
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