Comparison of a User-Centered Design, Self-Management App to Existing mHealth Apps for Persons Living with HIV

There is preliminary evidence that mobile health (mHealth) apps are feasible, attractive, and an effective platform for the creation of self-management tools for persons living with HIV (PLWH). As a foundation for the current study, we conducted formative research using focus groups, participatory design sessions, and usability evaluation methods to inform the development of a health management app for PLWH. The formative research resulted in identification of the following functional requirements of a mHealth app for self-management: 

• communication between providers and peers,
• medication reminders, 
• medication log, 
• lab reports, 
• pharmacy information, 
• nutrition and fitness, 
• resources (eg, social services, substance use, video testimonials), 
• settings, and 
• search function.

 The purpose of this study was to conduct an ecological review of the existing apps for PLWH and to compare the functionality of existing apps with the app specifications identified in our formative work.

We searched two mobile app stores (Google Play and iTunes) and found a total of 5606 apps. We reviewed the apps, narrowed our search terms, and found a total of 112 apps. Of these, we excluded 97 (86.6%) apps that were either not in English (10/112, 8.9%), not HIV focused (32/112, 28.9%), or focused only on HIV prevention (2/112, 7.8%); targeted health care providers (26/112, 23.2%); provided information only on conference schedules and events (7/112, 6.3%), fundraisers (7/112, 6.3%), specific clinics (7/112, 6.3%), international or narrow local resources (3/112, 2.7%); or were identified in the first search but were no longer on the market at the next review (4/112, 3.6%). The 15 apps meeting inclusion criteria were then evaluated for inclusion of the nine functionalities identified in our earlier work.

Of the 15 apps that we included in our final review, none had all of the functionalities that were identified in our formative work. The apps that we identified included the following functionalities: 

• communication with providers and/or peers (4/15, 27%), 
• medication reminders (6/15, 40%), 
• medication logs (7/15, 47%), 
• lab reports (5/15, 33%), 
• pharmacy information (4/15, 27%), 
• resources (7/15, 47%), 
• settings (11/15, 73%), 
• and search function (6/15, 40%). 
• No apps included nutrition or fitness information. 

Currently, there are only a small number of apps that have been designed for PLWH to manage their health. Of the apps that are currently available, none have all of the desired functionalities identified by PLWH and experts in our formative research. Findings from this work elucidate the need to develop and evaluate mobile apps that meet PLWH's desired functional specifications.

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By: Schnall R1, Mosley JP, Iribarren SJ, Bakken S, Carballo-Diéguez A, Brown Iii W.
1Columbia University, School of Nursing, New York, NY, United States.