Physical and mental health apps quality inequalities in four age groups

Background: There are currently more than 350,000 health apps in the Android and Apple app stores. In order to ensure that they are effective and safe to use, they are assessed for quality, by the Organization for the Review of Care and Health Apps (ORCHA), a United Kingdom based company that specialises in quality assessment of health apps. The ORCHA baseline assessment (OBR) consists of three sections: professional/clinical assurance (PCA), user experience (UX) and data privacy (DP). These three sections result in an overall ORCHA score from 0 to 100 based on how well the app performed on the assessment.
Objective: Discover if there are disparities in quality between physical and mental health apps targeting four different age groups: children, teens, adults, and older people.
Methods: A total of 604 health apps assessed for quality using OBR have been used in this study. The 604 health apps comprise of 254 mental and 350 physical health apps. R language and R studio have been used to analyse the data. Median and interquartile ranges (IQR) have been used to characterize OBR scores for PCA, UX and DP score for each considered age group for physical and mental health apps. Unpaired two sample Wilcoxon test has been used to compare assessments of mental and physical health apps with each other and with each age group. Bonferroni adjusted p-value has been calculated for multiple comparisons tests.
Results: Only physical health apps for children and older people managed to achieve a median ORCHA score above the acceptable threshold of 65. Physical health apps for teens and adults fell below the ORCHA threshold score of 65 and 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, only for older people was the difference statistically significant (p-value =.002). For teens, mental health apps (m=62, IQR=22) outperformed physical health apps (m=58, IQR=21.3). Professional/clinical assurance 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) fell behind other age groups.
Conclusion: Both physical and mental health apps could improve in their professional/clinical assurance. Specifically, mental health apps for older people and physical health apps for teens. The data in this study indicates that for older people, there is more effort given to physical health apps compared to mental health apps regarding their professional/clinical assurance.