Mobile App Rating Scale (User Version) for the assessment of a community health worker medical application

Noncommunicable diseases (NCDs) pose a significant burden in the Philippines, with cardiovascular and cerebrovascular diseases among the leading causes of mortality. The Department of Health implemented the Philippine Package of Essential Non-Communicable Disease Interventions (Phil PEN) to address this issue. However, healthcare professionals faced challenges in implementing the program due to the cumbersome nature of the multiple forms required for patient risk assessment. To address this, a mobile medical app, the PhilPEN Risk Stratification application (App), was developed for community health workers (CHWs) using the extreme prototyping framework. This study aimed to assess the usability of the PhilPEN Risk Stratification App using the (User Version) Mobile App Rating Scale (uMARS)'s 1-5 rating system and to determine the utility of uMARS in app development. The secondary objective was to evaluate whether the app could achieve an acceptable uMARS rating score (>3), highlighting the significance of quality monitoring through validated metrics in improving the adoption and continuous iterative development of medical mobile apps.

The study employed both quantitative and qualitative research methodologies, including key informant interviews, linguistic validation, and cognitive debriefing. The extreme prototyping framework was used for app development, involving iterative refinement through progressively functional prototypes. CHWs from a designated health center participated in the app development and evaluation process, providing feedback and using the app to collect data from patients.

The uMARS scores for the PhilPEN Risk Stratification App were above the targeted acceptable rating, with an objective quality rating of 4.05 and a personal opinion/subjective quality rating of 3.25. The app scored well in functionality (4.19), aesthetics (4.08), and information (4.41), indicating its accuracy, ease of use, and provision of high-quality information. The engagement score (3.53) was lower due to the app's primary focus on healthcare rather than entertainment.

The study demonstrated the effectiveness of the extreme prototyping framework in developing a medical mobile app and the utility of uMARS as a guide for authoring high-quality mobile health apps. The uMARS metrics were beneficial in setting developer expectations, identifying strengths and weaknesses, and guiding the iterative improvement of the app. Further assessment with more CHWs and patients is recommended.