An independent psychological evaluation of an NHS app designed to improve young people’s health literacy

PURPOSE: 325,000 mobile apps to provide health-related information were registered in 2017 alone. For young people, apps provide the benefit of an anonymous, autonomous and sensitive way to access health information. However, it is not always clear whether these apps deliver high quality information or achieve the changes in behavior intended. In this study, we present the findings of an independent psychological evaluation of a clinically-approved app designed to improve young people’s health literacy. Using a hybrid approach to evaluation we combine two frameworks drawing from Eysenbach et al.’s (2002) to assess the quality of information including completeness, readability and design; and McMillan et al. (2016), based on NICE (2014) guidelines, to assess the impact on health behavior including areas of purpose, initial assessment and tailoring, and behavior change.
DESIGN: The research team agreed the evaluation framework and criteria, setting out a clear protocol prior to conducting the evaluations. 4 reviewers worked on the page evaluations of NHSGo app. Two reviewers were allocated to each of the 11 pages evaluated. Each reviewer recorded their score and provided illustrative comments where relevant and their ratings were combined.
RESULTS: The purpose and the completeness of the information, drawing from a clinically validated information source NHS Choices, were highly rated and was developed with extensive collaboration with young people. However, a number of features faired less favourably: i) limited attention has been paid to special design features (e.g. inappropriate for users with dyslexia), ii) users were not readily able to assess their condition or personalize the information accessed, iii) readability are often too high for the target group, alienating users who struggle with literacy and iv) elements known to encourage behavior change (e.g. interactivity, support groups) were not evident despite the provision of succinct actionable points enabling young people to take control of their health behavior.
LIMITATIONS: The evaluations were conducted by psychologists and further research would benefit from pre-post evaluations to assess behavior change in an objective manner.
IMPLICATIONS: With the increasing use of health-related apps across the globe, there is need to consider whether they achieve their intended aims. Our research presents a framework that can be readily applied to evaluate apps and draws attention to the ways in which apps can be designed to enhance impact.
ORIGINALITY/VALUE: This is the first independent psychological evaluation using a hybrid approach to evaluate the NHS Go app. The approach and learnings from the evaluation can be translated to the design and development of apps designed to stimulate behavior change.