Health and Rehabilitation Research Institute, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
JMIR Mhealth Uhealth. 2024 Oct 4;12:e49449. doi: 10.2196/49449.
BACKGROUND: Usability has been touted as one determiner of success of mobile health (mHealth) interventions. Multiple systematic reviews of usability assessment approaches for different mHealth solutions for physical rehabilitation are available. However, there is a lack of synthesis in this portion of the literature, which results in clinicians and developers devoting a significant amount of time and effort in analyzing and summarizing a large body of systematic reviews. OBJECTIVE: This study aims to summarize systematic reviews examining usability assessment instruments, or measurements tools, in mHealth interventions including physical rehabilitation. METHODS: An umbrella review was conducted according to a published registered protocol. A topic-based search of PubMed, Cochrane, IEEE Xplore, Epistemonikos, Web of Science, and CINAHL Complete was conducted from January 2015 to April 2023 for systematic reviews investigating usability assessment instruments in mHealth interventions including physical exercise rehabilitation. Eligibility screening included date, language, participant, and article type. Data extraction and assessment of the methodological quality (AMSTAR 2 [A Measurement Tool to Assess Systematic Reviews 2]) was completed and tabulated for synthesis. RESULTS: A total of 12 systematic reviews were included, of which 3 (25%) did not refer to any theoretical usability framework and the remaining (n=9, 75%) most commonly referenced the ISO framework. The sample referenced a total of 32 usability assessment instruments and 66 custom-made, as well as hybrid, instruments. Information on psychometric properties was included for 9 (28%) instruments with satisfactory internal consistency and structural validity. A lack of reliability, responsiveness, and cross-cultural validity data was found. The methodological quality of the systematic reviews was limited, with 8 (67%) studies displaying 2 or more critical weaknesses. CONCLUSIONS: There is significant diversity in the usability assessment of mHealth for rehabilitation, and a link to theoretical models is often lacking. There is widespread use of custom-made instruments, and preexisting instruments often do not display sufficient psychometric strength. As a result, existing mHealth usability evaluations are difficult to compare. It is proposed that multimethod usability assessment is used and that, in the selection of usability assessment instruments, there is a focus on explicit reference to their theoretical underpinning and acceptable psychometric properties. This could be facilitated by a closer collaboration between researchers, developers, and clinicians throughout the phases of mHealth tool development. TRIAL REGISTRATION: PROSPERO CRD42022338785; https://www.crd.york.ac.uk/prospero/#recordDetails.
背景:可用性被吹捧为移动健康(mHealth)干预成功的一个决定因素。针对物理康复的不同 mHealth 解决方案,有多个可用性评估方法的系统评价。然而,在文献的这一部分缺乏综合,这导致临床医生和开发人员花费大量的时间和精力来分析和总结大量的系统评价。
目的:本研究旨在总结评估 mHealth 干预措施(包括物理康复)中可用性评估工具或测量工具的系统评价。
方法:根据已发表的注册方案进行了伞式评价。从 2015 年 1 月至 2023 年 4 月,基于主题在 PubMed、Cochrane、IEEE Xplore、Epistemonikos、Web of Science 和 CINAHL Complete 中进行了系统评价,以调查 mHealth 干预措施中包括物理康复运动的可用性评估工具。纳入标准包括日期、语言、参与者和文章类型。完成并制表以进行综合分析的数据提取和方法学质量评估(AMSTAR 2 [A Measurement Tool to Assess Systematic Reviews 2])。
结果:共纳入 12 项系统评价,其中 3 项(25%)未参考任何理论可用性框架,其余(n=9,75%)最常参考 ISO 框架。样本共参考了 32 种可用性评估工具和 66 种定制的、混合的工具。有 9 项(28%)工具包含关于心理测量学特性的信息,这些工具具有令人满意的内部一致性和结构有效性。缺乏可靠性、反应性和跨文化有效性数据。系统评价的方法学质量有限,有 8 项(67%)研究显示有 2 个或更多关键弱点。
结论:康复用 mHealth 的可用性评估存在显著的多样性,并且通常缺乏与理论模型的联系。广泛使用定制工具,而现有工具通常不具有足够的心理测量强度。因此,现有的 mHealth 可用性评估难以进行比较。建议使用多方法可用性评估,并在选择可用性评估工具时,重点关注其理论基础和可接受的心理测量特性。通过在 mHealth 工具开发的各个阶段加强研究人员、开发人员和临床医生之间的合作,这一点可以得到促进。
试验注册:PROSPERO CRD42022338785;https://www.crd.york.ac.uk/prospero/#recordDetails。
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