Khan Qaisar, Hickie Ian B, Loblay Victoria, Ekambareshwar Mahalakshmi, Zahed Iqthyer Uddin Md, Naderbagi Aila, Song Yun Jc, LaMonica Haley M
Youth Mental Health and Technology Team, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.
Digit Health. 2025 May 11;11:20552076251335413. doi: 10.1177/20552076251335413. eCollection 2025 Jan-Dec.
The System Usability Scale (SUS) demonstrates good psychometric properties for a range of technologies; however, its reliability and factor structure in the context of a childrearing application (app) and variation across cultures remains largely unexplored. This study investigates the reliability and factor structure of the SUS in the context of a childrearing app that was co-designed for and implemented in diverse low- and middle-income countries (LMICs).
Parents and caregivers of children aged 0-5 years in five LMICs completed the SUS after having access to the app for a minimum of 2 and maximum of 24 weeks. Survey data from participants (668) was analysed using exploratory and confirmatory factor analysis methods.
The bi-factor model shows the best fit to data (comparative fit index = 0.998; Tucker Lewis Index = 0.996; standardised root mean square residual = 0.033). Further analysis suggests that usability and learnability subscales provide additional information not contained in the total SUS score. A two-sample -test shows that younger caregivers, employed full- or part-time, and with fewer children reported significantly better app usability.
The SUS has good psychometric properties, and it is a valid and reliable tool for assessing the usability of mobile apps when used by parents and other caregivers for children's socioemotional and cognitive development. However, it is not essentially unidimensional and appears to have a multidimensional structure that could be specific to our context owing to variations in users' experience, culture, and language. The findings have implications for other mobile health interventions implemented in contexts with cultural and linguistic differences.
系统可用性量表（SUS）在一系列技术中展现出良好的心理测量特性；然而，在育儿应用程序（应用）背景下其可靠性和因子结构以及跨文化差异在很大程度上仍未得到探索。本研究调查了在为不同低收入和中等收入国家（LMIC）共同设计并实施的育儿应用程序背景下SUS的可靠性和因子结构。
五个LMIC国家中0至5岁儿童的父母和照料者在使用该应用程序至少2周且最长24周后完成了SUS。使用探索性和验证性因子分析方法对参与者（668人）的调查数据进行了分析。
双因子模型对数据的拟合度最佳（比较拟合指数 = 0.998；塔克 - 刘易斯指数 = 0.996；标准化根均方残差 = 0.033）。进一步分析表明，可用性和易学性子量表提供了SUS总分中未包含的额外信息。双样本t检验表明，年龄较小、全职或兼职工作且子女较少的照料者报告的应用程序可用性明显更好。
SUS具有良好的心理测量特性，对于父母和其他照料者用于儿童社会情感和认知发展的移动应用程序，它是评估可用性的有效且可靠的工具。然而，它并非本质上是单维的，似乎具有多维结构，由于用户体验、文化和语言的差异，这种结构可能特定于我们的研究背景。这些发现对在存在文化和语言差异的环境中实施的其他移动健康干预措施具有启示意义。
