Experts' Needs Assessment and Evaluation of Mobile Apps for Children of Parents With Mental Illness: Mixed Methods...

Children of parents with mental health illness (COPMI) have the right to receive preventive interventions to avoid developing their own mental health and socioeconomic problems. However, access to interventions varies widely within health care and social services depending on their geographical location in Sweden. In this regard, mobile health (mHealth) interventions for COPMI provide a pathway for more equitable and sustainable preventive support.

This project aims to (1) map and assess the quality of available mHealth apps relevant to COPMI; (2) investigate experts' perceptions of COPMI needs for digital health solutions (particularly mHealth) by consulting and collaborating with an interdisciplinary reference group (scholars, child rights organizations, and IT professionals); and (3) explore the prerequisites for development, implementation, and sustainable access to future digital solutions for COPMI.

We collaborated with a reference group through a series of meetings and workshops, identifying and assessing the quality of 9 free, highly ranked apps (ie, using the well-known Mobile App Rating Scale [MARS]). All the workshop sessions were recorded and transcribed for further qualitative analysis, allowing us to document and derive our main findings.

Three out of 9 apps received high scores across the MARS dimensions of aesthetics, perceived functionality, information, and engagement in the expert heuristic evaluation using recorded demonstrations of the apps, indicating a significant lack of high-quality apps relevant to COPMI. Further findings were derived, such as the experts' preference for more general apps that are not specifically targeted to COPMI, as these could promote self-identification and reduce stigmatization. Regarding the third aim, the results showed that it was important to find an app that protected users' privacy by allowing anonymous access to digital support and that mobile apps should be complemented (or replaced) by web-based applications to improve accessibility for children who may not be allowed to download apps without parental permission.

The sustainability of digital solutions (web applications or mobile apps) for COPMI is the biggest challenge for future developments. Long-term impact requires stable funding, continuous maintenance, and partnering with established organizations that already possess the infrastructure, expertise, and reach necessary to provide ongoing support. To address the limitations in the study design and deployment issues, it is important to actively involve children through participatory and co-creational approaches when designing and developing mHealth solutions. Also, future evaluations should include privacy and data security assessments such as app permissions, privacy-policy presence, and third-party sharing.