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Assessment of the quality of mobile applications created for arbovirus prevention in Brazil using the Mobile Apps Rating Scale (MARS): review and analysis of content (Preprint)


 BACKGROUND
 In Brazil, the prevalence of diseases caused by arboviruses has increased alarmingly in recent years. Information and communication technologies, especially mobile technologies, has been used to engage the population and to change their practices in order to control the rising of mosquitos.
 
 
 OBJECTIVE
 The objective of this study was to perform a survey of the applications (apps) created for prevention and health promotion in relation to arbovirus diseases transmitted by Aedes Aegypti – such as dengue, zika and chikungunya – as well as classify the quality of these apps based on the Mobile App Rating Scale (MARS). The assessment also investigated whether these apps were elaborated considering the theories of behaviour change.
 
 
 METHODS
 The analysis of the apps for mobile devices was performed using the Android operating system and the Google’s app store. The search terms used were "Chikungunya", "Dengue" and "Zika". The apps were independently analysed by two researchers after a period of training using the MARS scale. Student's T-test was performed to compare the means obtained by the two researchers in order to evaluate if they had a significant difference at the 5% level. The Kappa test was used to evaluate the interobserver agreement for binary categorical variables and for variables using Likert scale. The reliability of the scale was estimated using the Cronbach's alpha coefficient.
 
 
 RESULTS
 Many of the evaluated apps accomplish their goals of transmitting information in an interactive way, but they do not necessarily have the purpose of influencing their users to change behaviours related to the control of disease-vector mosquitoes. Student's T-test did not show significant differences in scores of the different sections of the MARS except for the engagement. Three variables had an almost perfect or strong agreement using Kappa (above 0.61): whether the apps could be classified as informative, had a geolocation feature and were used to entertainment. Cronbach’s Alpha showed good reliability of the MARSs. This study also showed that it is necessary to create and regulate evaluation, dissemination and storage policies for these apps so that, over the years, a deeper analysis of the role of these tools in health promotion can be investigated and better understood.
 
 
 CONCLUSIONS
 In Brazil, the vast majority of apps, created to prevent arboviroses, were developed for informational or entertainment purposes and they were not explicitly based on health behaviour theories.
