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An Evaluation of Publicly Available Smartphone Apps to Support Unpaid Cancer Caregivers

      Abstract

      Context

      With advancements in mobile technology and increased access to smartphones, the use of Mobile Health applications (apps) has surged. These apps provide an innovative avenue for supporting cancer caregivers who face increasing burden and lack formal support; however, the quality of these apps has not been formally evaluated.

      Objectives

      Evaluate the quality, usefulness, therapeutic potential, and security of publicly available apps to support unpaid cancer caregivers in managing their roles and responsibilities.

      Methods

      Cancer caregiving apps were identified through a search of the Apple and Google Play stores in October 2020. Two authors evaluated the apps using 1) the Mobile App Rating Scale (MARS) tool for quality, 2) complementary sections of Enlight for therapeutic persuasiveness and alliance, security and privacy, and 3) an unmet needs checklist to assess usefulness. Analyses were undertaken to identify high-scoring apps.

      Results

      Overall, 24 apps were evaluated by two authors (MB, SW). Across the sample, the mean quality score (MARS) was adequate at 65.7% (3.3/5.0, SD = .5, range: 2.3–4.2). The combined score for therapeutic persuasiveness and alliance (Enlight) was fair at 60.7% (3.0/5.0, SD = .8, range: 1.1–4.5), and the privacy and security checklists yielded means of 79.3% (6.3/8.0, SD = 1.4, range: 50.0%–100.0%) and 41.3% (1.7/4.0, SD = 1.4, range: 0.0–100.0%), respectively. The unmet needs checklist was 43.2% (SD = 5.3, range: 9.4%–69.7%). A hierarchical cluster analysis identified 12 high scoring apps.

      Conclusion

      Superior cluster apps scored acceptably for quality and privacy and low for security and usefulness. Findings will assist clinicians, caregivers, and families identify apps to support cancer caregivers.

      Key Words

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      References

        • Hango D.
        Support received by caregivers in Canada (Insights on Canadian Society).
        Stat Can cat. 2020; (75-006-X): 1-11
      1. CIHI. 1 in 3 unpaid caregivers in Canada are distressed. 2021. Available from: https://www.cihi.ca/en/1-in-3-unpaid-caregivers-in-canada-are-distressed. Accessed November 4, 2021.

        • Denham A.M.
        • Wynne O.
        • Baker A.L.
        • et al.
        An online survey of informal caregivers’ unmet needs and associated factors.
        PLoS One. 2020; 15https://doi.org/10.1371/journal.pone.0243502
        • Kim Y.
        • Schulz R.
        Family caregivers' strains: comparative analysis of cancer caregiving with dementia, diabetes, and frail elderly caregiving.
        J Aging Health. 2008; 20: 483-503https://doi.org/10.1177/0898264308317533
        • Lewandowska A.
        • Rudzki G.
        • Lewandowski T.
        • Rudzki S.
        The problems and needs of patients diagnosed with cancer and their caregivers.
        Int J Environ Res Public Health. 2020; 18: 87https://doi.org/10.3390/ijerph18010087
        • Adashek J.J.
        • Subbiah I.M.
        Caring for the caregiver: a systematic review characterising the experience of caregivers of older adults with advanced cancers.
        ESMO Open. 2020; 5https://doi.org/10.1136/esmoopen-2020-000862
        • van Ryn M.
        • Sanders S.
        • Kahn K.
        • et al.
        Objective burden, resources, and other stressors among informal cancer caregivers: a hidden quality issue?.
        Psycho Oncol. 2010; 20: 44-52https://doi.org/10.1002/pon.1703
        • Mollica M.A.
        • Litzelman K.
        • Rowland J.H.
        • Kent E.E.
        The role of medical/nursing skills training in caregiver confidence and burden: a CanCORS study.
        Cancer. 2017; 123: 4481-4487https://doi.org/10.1002/cncr.30875
        • Sklenarova H.
        • Krumpelmann A.
        • Haun M.W.
        • et al.
        When do we need to care about the caregiver? Supportive care needs, anxiety, and depression among informal caregivers of patients with cancer and cancer survivors.
        Cancer. 2015; 121: 1513-1519https://doi.org/10.1002/cncr.29223
        • Lambert S.
        • Girgis A.
        • Descallar J.
        • Levesque J.V.
        • Jones B.
        Trajectories of mental and physical functioning among spouse caregivers of cancer survivors over the first five years following the diagnosis.
        Patient Educ Couns. 2017; 100: 1213-1221https://doi.org/10.1016/j.pec.2016.12.031
        • Northouse L.
        • Williams A.
        • Given B.
        • McCorkle R.
        Psychosocial care for family caregivers of patients with cancer.
        J Clin Oncol. 2012; 30: 1227-1234https://doi.org/10.1200/jco.2011.39.5798
        • Kim Y.
        • Carver C.S.
        • Ting A.
        • Cannady R.S.
        Passages of cancer caregivers' unmet needs across 8 years.
        Cancer. 2020; 126: 4593-4601https://doi.org/10.1002/cncr.33053
        • Ullrich A.
        • Theochari M.
        • Bergelt C.
        • et al.
        Ethical challenges in family caregivers of patients with advanced cancer – a qualitative study.
        BMC Palliative Care. 2020; 19https://doi.org/10.1186/s12904-020-00573-6
        • Wu V.S.
        • Smith A.B.
        • Girgis A.
        The unmet supportive care needs of Chinese patients and CAREGIVERS affected BY cancer: a systematic review.
        Eur J Cancer Care (Engl). 2020; https://doi.org/10.1111/ecc.13269
        • Park S.S.
        Caregivers’ mental health and somatic symptoms during COVID-19.
        J Gerontol. 2020; 76https://doi.org/10.1093/geronb/gbaa121
        • Sheth K.
        • Lorig K.
        • Stewart A.
        • Parodi J.F.
        • Ritter P.L.
        Effects of COVID-19 on informal caregivers and the development and validation of a scale in English and Spanish to measure the impact of COVID-19 on caregivers.
        J Appl Gerontol. 2020; 40: 235-243https://doi.org/10.1177/0733464820971511
        • Chi N.C.
        • Demiris G.
        A systematic review of telehealth tools and interventions to support family caregivers.
        J Telemed Telecare. 2014; 21: 37-44https://doi.org/10.1177/1357633X14562734
        • Heynsbergh N.
        • Heckel L.
        • Botti M.
        • Livingston P.M.
        Feasibility, useability and acceptability of technology-based interventions for informal cancer carers: a systematic review.
        BMC Cancer. 2018; 18https://doi.org/10.1186/s12885-018-4160-9
        • Kim H.
        • Goldsmith J.V.
        • Sengupta S.
        • et al.
        Mobile health application and e-health literacy: opportunities and concerns for cancer patients and caregivers.
        J Cancer Educ. 2017; 34: 3-8https://doi.org/10.1007/s13187-017-1293-5
        • Fuller-Tyszkiewicz M.
        • Richardson B.
        • Little K.
        • et al.
        Efficacy of a smartphone app intervention for reducing caregiver stress: Randomized controlled trial.
        JMIR Mental Health. 2020; 7https://doi.org/10.2196/17541
        • Sala-González M.
        • Pérez-Jover V.
        • Guilabert M.
        • Mira J.J.
        Mobile apps for helping informal caregivers: a systematic review.
        Int J Environ Res Public Health. 2021; 18: 1702https://doi.org/10.3390/ijerph18041702
        • Lorca-Cabrera J.
        • Martí-Arques R.
        • Albacar-Riobóo N.
        • et al.
        Mobile applications for caregivers of individuals with chronic conditions and/or diseases: quantitative content analysis.
        Int J Med Inf. 2021; 145104310https://doi.org/10.1016/j.ijmedinf.2020.104310
        • Moher D.
        • Shamseer L.
        • Clarke M.
        • et al.
        Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement.
        Syst Rev. 2015; 4https://doi.org/10.1186/2046-4053-4-1
      2. Ward, H. Biggest app stores in the World 2020. Statista Research Department. 2021. Available from: https://www.statista.com/statistics/276623/number-of-apps-available-in-leading-app-stores/. Accessed November 4, 2021.

        • Lim S.L.
        • Bentley P.J.
        • Kanakam N.
        • Ishikawa F.
        • Honiden S.
        Investigating country differences in mobile app user behavior and challenges for software engineering.
        IEEE Trans Softw Eng. 2015; 41: 40-64https://doi.org/10.1109/tse.2014.2360674
        • Brake D.R.
        The invisible hand of the unaccountable algorithm: how Google, Facebook and other tech companies are changing journalism.
        Digital Technol Journalism. 2017; : 25-46https://doi.org/10.1007/978-3-319-55026-8_2
        • Stoyanov S.R.
        • Hides L.
        • Kavanagh D.J.
        • et al.
        Mobile app rating scale: a new tool for assessing the quality of health mobile apps.
        JMIR MHealth UHealth. 2015; 3https://doi.org/10.2196/mhealth.3422
        • Baumel A.
        • Faber K.
        • Mathur N.
        • Kane J.M.
        • Muench F.
        Enlight: a comprehensive quality and therapeutic potential evaluation tool for mobile and web-based ehealth interventions.
        J Med Internet Res. 2017; 19https://doi.org/10.2196/jmir.7270
        • Monton O.
        • Lambert S.
        • Belzile E.
        • Mohr-Elzeki D.
        An evaluation of the suitability, readability, quality, and usefulness of online resources for family caregivers of patients with cancer.
        Patient Educ Couns. 2019; 102: 1892-1897https://doi.org/10.1016/j.pec.2019.05.010
      3. Federal Trade Commission. Mobile Privacy Disclosures: Building Trust Through Transparency: A Federal Trade Commission Staff Report. 2013. Available from:https://www.ftc.gov/reports/mobile-privacy-disclosures-building-trust-through-transparency-federal-trade-commission. Accessed November 4, 2021.

        • O'Loughlin K.
        • Neary M.
        • Adkins E.C.
        • Schueller S.M.
        Reviewing the data security and privacy policies of mobile apps for depression.
        Internet Interv. 2019; 15: 110-115https://doi.org/10.1016/j.invent.2018.12.001
        • Rousseeuw P.J.
        Silhouettes: a graphical aid to the interpretation and validation of cluster analysis.
        J Comput Appl Math. 1987; 20: 53-65https://doi.org/10.1016/0377-0427(87)90125-7
        • Kaufman L.
        • Rousseeuw P.J.
        Finding groups in data: an introduction to cluster analysis. 344. John Wiley & Sons, 2009
        • Terhorst Y.
        • Messner E.
        • Schultchen D.
        • et al.
        Systematic evaluation of content and quality of English and German pain apps in European app stores.
        Internet Interv. 2021; 24100376https://doi.org/10.1016/j.invent.2021.100376
      4. Bosse, E. (2018). Understanding mobile app engagement: an interview study investigating user experiences with health apps (Publication No. 18223) [Master's thesis, University of Twente]. Positive Psychology and Technology.

      5. Eckhardt, T. (2019). Understanding engagement with eHealth-apps: a qualitative interview study (Publication No. 1557378) [Master's thesis, University of Twente]. Positive Psychology and Technology.

        • Singh K.
        • Drouin K.
        • Newmark L.P.
        • et al.
        Many mobile health apps target high-need, high-cost populations, but gaps remain.
        Health Aff. 2016; 35: 2310-2318https://doi.org/10.1377/hlthaff.2016.0578
        • Krebs P.
        • Duncan D.T.
        Health app use among US mobile phone owners: a national survey.
        JMIR MHealth and UHealth. 2015; 3https://doi.org/10.2196/mhealth.4924