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Usability and accessibility in mHealth stroke apps: An empirical assessment
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Mathematics and Computer Science (from 2013).
Independent Researcher, Karlstad, Sweden.ORCID iD: 0000-0001-8045-1976
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Mathematics and Computer Science (from 2013). (Privacy and Security (PriSec))ORCID iD: 0000-0001-9005-0543
2025 (English)In: Informatics in Medicine Unlocked, ISSN 2352-9148, Vol. 53, p. 1-12, article id 101616Article in journal (Refereed) Published
Abstract [en]

Background: Cerebrovascular accidents or strokes continue to be among the leading causes of death and disability worldwide. This has stressed the need to design digital health solutions that can be effectively used by patients, caregivers, and medical professionals, helping to alleviate the global disease burden. In this context, mobile health (mHealth) apps are shown to be valuable solutions for bridging healthcare gaps. Objective: In this study, we aim to evaluate the quality aspects of usability and accessibility of stroke-related mHealth apps for Android. We seek to identify prevalent issues and discuss recommendations to enhance user experience and app quality. Methods: We selected 16 mHealth stroke apps, accounting for more than 219k downloads. The apps were assessed through different methods, including accessibility testing with the Google Accessibility Scanner, overall quality assessment with the Mobile Application Rating Scale (MARS), and usability testing using heuristic evaluations. Results: Our findings show significant issues with the apps’ touch target sizes and text contrast, which are particularly important for stroke app users with impaired vision and motor skills. MARS evaluations revealed that some apps, such as the Constant Therapy app, excelled in engagement and functionality. In contrast, many apps scored lower due to limited functionality and unclear/confusing interfaces, such as Stroke Recovery Predictor and Conversation Therapy Lite. Heuristic evaluations also highlighted several usability violations, such as a lack of “Visibility of System Status” and “Insufficient Error Messaging.” Conclusion: Overall, most apps presented deficiencies in several aspects of usability and accessibility. As recommendations, developers can increase touch target sizes, improve text contrast, increase functional variety, optimise navigation, and enhance user engagement strategies. Addressing such issues can help improve the stroke apps’ usability and accessibility, aiming for better health outcomes for stroke patients.

Place, publisher, year, edition, pages
Elsevier, 2025. Vol. 53, p. 1-12, article id 101616
Keywords [en]
mHealth, Mobile health, Mobile app, Usability, Accessibility, Stroke, Empirical study
National Category
Computer Sciences Human Computer Interaction
Research subject
Computer Science
Identifiers
URN: urn:nbn:se:kau:diva-103009DOI: 10.1016/j.imu.2025.101616Scopus ID: 2-s2.0-85215861488OAI: oai:DiVA.org:kau-103009DiVA, id: diva2:1934774
Funder
European Regional Development Fund (ERDF), 20365177Region Värmland, RUN/230445Vinnova, 2018-03025Knowledge FoundationAvailable from: 2025-02-05 Created: 2025-02-05 Last updated: 2025-02-24Bibliographically approved

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CiteExportLink to record
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