Usability and accessibility in mHealth stroke apps: An empirical assessment

Abstract

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.