The Quality of Physical and Mental Health Apps Across Four Age Groups

Background: There are currently more than 350,000 health apps in the Android and Apple app stores. The quality of a health app can be assessed by the Organization for the Review of Care and Health Apps (ORCHA), a United Kingdom based company that specialises in the quality assessment of health apps. The ORCHA baseline assessment (OBR) assess three aspects of a health app: 1) professional/clinical assurance (PCA), 2) user experience (UX) and 3) data privacy (DP). These three sections each provide a score but also contribute to an overall ORCHA score from 0 to 100 (where a score of 100 is the highest quality score and a score above 65 is desirable).
Objective: To assess if there are any possible disparities in the quality of physical and mental health apps targeting four different age groups: children, teens, adults, and older people.
Methods: A secondary dataset was used for this study, which included a total of 604 health apps that were previously assessed for quality using OBR. The 604 health apps comprise of 254 mental and 350 physical health apps. R language and R studio were used to analyse this data. Median and interquartile ranges (IQR) were used to assess the spread of app assessment scores achieved for PCA, UX and DP for each of the considered age groups. Unpaired two sample Wilcoxon tests were used to compare the quality assessment scores of mental and physical health apps across each age group. Bonferroni adjusted p-value was calculated for multiple tests.
Results: Only physical health apps for children and older people managed to achieve a median ORCHA score above the acceptable threshold of 65. The median ORCHA score for physical health apps for teens and adults was below 65. The median ORCHA score for mental health apps for all four age groups was below 65. Physical health apps scored better than mental health apps for children, adults, and older people age group; however, this was only statistically significant for older people (p-value =.002). The PCA scores for mental health apps for older people (m=39.7, IQR=33.2) and physical health apps for teens (m=39.4, IQR=42.7) were lower than other age groups.

Conclusion: This study indicates that, for older people, overall quality of physical health apps is higher when compared to mental health apps. Moreover, the professional/clinical assurance of both physical and mental health apps could be improved; specifically, mental health apps for older people and physical health apps for teens. To make adjunctive therapy regarding mental health more suitable for older people, improvements to health app quality should be made. However, with International Organization for Standardization (ISO) - health and wellness apps section, insufficiently addressing user diversity, this issue may persist. A limitation of this analysis is that we are using a secondary dataset to study the quality of apps that were assessed by ORCHA and were included in this dataset. A similar study could be done using a random selection of apps.