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Item Factors Related to User Ratings and User Downloads of Mobile Apps for Maternal and Infant Health: Cross-Sectional Study(JMIR, 2020) Biviji, Rizwana; Vest, Joshua R.; Dixon, Brian E.; Cullen, Theresa; Harle, Christopher A.; Health Policy and Management, School of Public HealthBackground: Mobile health apps related to maternal and infant health (MIH) are prevalent and frequently used. Some of these apps are extremely popular and have been downloaded over 5 million times. However, the understanding of user behavior and user adoption of these apps based on consumer preferences for different app features and categories is limited. Objective: This study aimed to examine the relationship between MIH app characteristics and users’ perceived satisfaction and intent to use. Methods: The associations between app characteristics, ratings, and downloads were assessed in a sample of MIH apps designed to provide health education or decision-making support to pregnant women or parents and caregivers of infants. Multivariable linear regression was used to assess the relationship between app characteristics and user ratings, and ordinal logistic regression was used to assess the relationship between app characteristics and user downloads. Results: The analyses of user ratings and downloads included 421 and 213 apps, respectively. The average user rating was 3.79 out of 5. Compared with the Apple App Store, the Google Play Store was associated with high user ratings (beta=.33; P =.005). Apps with higher standardized user ratings (beta=.80; P <.001), in-app purchases (beta=1.12; P =.002), and in-app advertisements (beta=.64; P =.02) were more frequently downloaded. Having a health care organization developer as part of the development team was neither associated with user ratings (beta=−.20; P =.06) nor downloads (beta=−.14; P =.63). Conclusions: A majority of MIH apps are developed by non–health care organizations, which could raise concern about the accuracy and trustworthiness of in-app information. These findings could benefit app developers in designing better apps and could help inform marketing and development strategies. Further work is needed to evaluate the clinical accuracy of information provided within the apps. [JMIR Mhealth Uhealth 2020;8(1):e15663]Item Ranking of Android Apps based on Security Evidences(2020-12) Maharjan, Ayush; Raje, Rajeev R.; Tuceryan, Mihran; Zou, XukaiWith the large number of Android apps available in app stores such as Google Play, it has become increasingly challenging to choose among the apps. The users generally select the apps based on the ratings and reviews of other users, or the recommendations from the app store. But it is very important to take the security into consideration while choosing an app with the increasing security and privacy concerns with mobile apps. This thesis proposes different ranking schemes for Android apps based on security apps evaluated from the static code analysis tools that are available. It proposes the ranking schemes based on the categories of evidences reported by the tools, based on the frequency of each category, and based on the severity of each evidence. The evidences are gathered, and rankings are generated based on the theory of Subjective Logic. In addition to these ranking schemes, the tools are themselves evaluated against the Ghera benchmark. Finally, this work proposes two additional schemes to combine the evidences from difference tools to provide a combined ranking.Item Untold Stories in User-Centered Design of Mobile Health: Practical Challenges and Strategies Learned From the Design and Evaluation of an App for Older Adults With Heart Failure(JMIR Publications, 2020-07-21) Cornet, Victor Philip; Toscos, Tammy; Bolchini, Davide; Ghahari, Romisa Rohani; Ahmed, Ryan; Daley, Carly; Mirro, Michael J.; Holden, Richard J.; Medicine, School of MedicineBackground User-centered design (UCD) is a powerful framework for creating useful, easy-to-use, and satisfying mobile health (mHealth) apps. However, the literature seldom reports the practical challenges of implementing UCD, particularly in the field of mHealth. Objective This study aims to characterize the practical challenges encountered and propose strategies when implementing UCD for mHealth. Methods Our multidisciplinary team implemented a UCD process to design and evaluate a mobile app for older adults with heart failure. During and after this process, we documented the challenges the team encountered and the strategies they used or considered using to address those challenges. Results We identified 12 challenges, 3 about UCD as a whole and 9 across the UCD stages of formative research, design, and evaluation. Challenges included the timing of stakeholder involvement, overcoming designers’ assumptions, adapting methods to end users, and managing heterogeneity among stakeholders. To address these challenges, practical recommendations are provided to UCD researchers and practitioners. Conclusions UCD is a gold standard approach that is increasingly adopted for mHealth projects. Although UCD methods are well-described and easily accessible, practical challenges and strategies for implementing them are underreported. To improve the implementation of UCD for mHealth, we must tell and learn from these traditionally untold stories.