Determinants of mHealth App quality: A case study of CHRONIQ framework to manage chronic disease in South Africa
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Date
2024
Authors
Charlie, Chumani
Journal Title
Journal ISSN
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Publisher
University of Fort Hare
Abstract
The rise of mobile health (mHealth) applications has raised concerns about their quality, especially in managing chronic diseases, where users rely on these apps for vital health-related decisions. Despite their potential, many mHealth apps lack standardised evaluation, compromising their effectiveness, safety, and user trust. This issue is particularly acute in resource-constrained settings like South Africa, where chronic diseases such as diabetes and cardiovascular conditions are prevalent. The core problem this study has addressed is the need for a comprehensive framework to assess the quality of mHealth apps tailored for chronic disease management. Current evaluation tools, such as the MARS, Enlight Suite, and AQUA, still need to fully address these apps' unique requirements. This study aimed to validate and refine the CHRONIQ framework, a tool specifically designed to assess the quality of mHealth apps in chronic disease management, providing an integrated approach that considers information quality (IQ), system quality (SQ), service quality (SEQ), engagement quality (EQ), user satisfaction (US), health outcomes (HO), intention to use (IU), and net benefits (NB). The research objective guiding this study was to identify the determinants of the CHRONIQ framework to create a standardised tool for assessing and improving the responses to mHealth apps for chronic disease management in South Africa. To address this, the study employed a quantitative research methodology, collecting data via an online survey from 250 users of chronic disease management mHealth apps, with a response rate of 80%. The survey instrument was designed based on the constructs of the CHRONIQ framework and was analysed using structural equation modelling (SEM) through SmartPLS 4.0. The results from the study confirmed the validity and reliability of the CHRONIQ framework. The key findings comprise significant relationships between various constructs, such as SQ and EQ (coefficient: 0.276, p < 0.001) and between EQ and US (coefficient: 0.606, p < 0.001). Furthermore, it was found that US significantly influenced IU (coefficient: 0.698, p < 0.001). These study results indicate the importance of app features such as system performance, user satisfaction, and sustained engagement in achieving better health outcomes through mHealth apps. It is worth noting that the IQ construct did not significantly impact EQ; this finding suggests that while important, more than information alone is needed to drive user interaction with robust system performance and service quality. The findings of this study provide significant implications for app developers, healthcare providers, and policymakers. The CHRONIQ framework can serve as a standardised tool to evaluate the effectiveness of mHealth apps in chronic disease management, ensuring that these apps meet user needs for accuracy, reliability, and engagement. For healthcare providers, the framework can aid in recommending the most appropriate apps for chronic disease patients, improving patient self-management and health outcomes. Policymakers can use CHRONIQ to align mHealth app standards with national healthcare objectives, such as South Africa’s National Digital Health Strategy. In conclusion, this study recommends the widespread adoption of the CHRONIQ framework to enhance the quality and effectiveness of mHealth apps for chronic disease management, ensuring that these digital tools contribute meaningfully to public health goals.
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Keywords
Medical informatics, Telecommunication in medicine, chronic disease management