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Self-Monitoring App Preferences for Sun Protection: Discrete Choice Experiment Survey Analysis

BACKGROUND: The availability and use of health apps continues to increase, revolutionizing the way mobile health interventions are delivered. Apps are increasingly used to prevent disease, improve well-being, and promote healthy behavior. On a similar rise is the incidence of skin cancers. Much of t...

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Autores principales: Nittas, Vasileios, Mütsch, Margot, Braun, Julia, Puhan, Milo Alan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732707/
https://www.ncbi.nlm.nih.gov/pubmed/33245282
http://dx.doi.org/10.2196/18889
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author Nittas, Vasileios
Mütsch, Margot
Braun, Julia
Puhan, Milo Alan
author_facet Nittas, Vasileios
Mütsch, Margot
Braun, Julia
Puhan, Milo Alan
author_sort Nittas, Vasileios
collection PubMed
description BACKGROUND: The availability and use of health apps continues to increase, revolutionizing the way mobile health interventions are delivered. Apps are increasingly used to prevent disease, improve well-being, and promote healthy behavior. On a similar rise is the incidence of skin cancers. Much of the underlying risk can be prevented through behavior change and adequate sun protection. Self-monitoring apps have the potential to facilitate prevention by measuring risk (eg, sun intensity) and encouraging protective behavior (eg, seeking shade). OBJECTIVE: Our aim was to assess health care consumer preferences for sun protection with a self-monitoring app that tracks the duration and intensity of sun exposure and provides feedback on when and how to protect the skin. METHODS: We conducted an unlabeled discrete choice experiment with 8 unique choice tasks, in which participants chose among 2 app alternatives, consisting of 5 preidentified 2-level attributes (self-monitoring method, privacy control, data sharing with health care provides, reminder customizability, and costs) that were the result of a multistep and multistakeholder qualitative approach. Participant preferences, and thus, the relative importance of attributes and their levels were estimated using conditional logit modeling. Analyses consisted of 200 usable surveys, yielding 3196 observations. RESULTS: Our respondents strongly preferred automatic over manually operated self-monitoring (odds ratio [OR] 2.37, 95% CI 2.06-2.72) and no cost over a single payment of 3 Swiss francs (OR 1.72, 95% CI 1.49-1.99). They also preferred having over not having the option of sharing their data with a health care provider of their choice (OR 1.66, 95% CI 1.40-1.97), repeated over single user consents, whenever app data are shared with commercial thirds (OR 1.57, 95% CI 1.31-1.88), and customizable over noncustomizable reminders (OR 1.30, 95% CI 1.09-1.54). While most participants favored thorough privacy infrastructures, the attribute of privacy control was a relatively weak driver of app choice. The attribute of self-monitoring method significantly interacted with gender and perceived personal usefulness of health apps, suggesting that female gender and lower perceived usefulness are associated with relatively weaker preferences for automatic self-monitoring. CONCLUSIONS: Based on the preferences of our respondents, we found that the utility of a self-monitoring sun protection app can be increased if the app is simple and adjustable; requires minimal effort, time, or expense; and has an interoperable design and thorough privacy infrastructure. Similar features might be desirable for preventive health apps in other areas, paving the way for future discrete choice experiments. Nonetheless, to fully understand these preference dynamics, further qualitative or mixed method research on mobile self-monitoring-based sun protection and broader preventive mobile self-monitoring is required. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/16087
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spelling pubmed-77327072020-12-22 Self-Monitoring App Preferences for Sun Protection: Discrete Choice Experiment Survey Analysis Nittas, Vasileios Mütsch, Margot Braun, Julia Puhan, Milo Alan J Med Internet Res Original Paper BACKGROUND: The availability and use of health apps continues to increase, revolutionizing the way mobile health interventions are delivered. Apps are increasingly used to prevent disease, improve well-being, and promote healthy behavior. On a similar rise is the incidence of skin cancers. Much of the underlying risk can be prevented through behavior change and adequate sun protection. Self-monitoring apps have the potential to facilitate prevention by measuring risk (eg, sun intensity) and encouraging protective behavior (eg, seeking shade). OBJECTIVE: Our aim was to assess health care consumer preferences for sun protection with a self-monitoring app that tracks the duration and intensity of sun exposure and provides feedback on when and how to protect the skin. METHODS: We conducted an unlabeled discrete choice experiment with 8 unique choice tasks, in which participants chose among 2 app alternatives, consisting of 5 preidentified 2-level attributes (self-monitoring method, privacy control, data sharing with health care provides, reminder customizability, and costs) that were the result of a multistep and multistakeholder qualitative approach. Participant preferences, and thus, the relative importance of attributes and their levels were estimated using conditional logit modeling. Analyses consisted of 200 usable surveys, yielding 3196 observations. RESULTS: Our respondents strongly preferred automatic over manually operated self-monitoring (odds ratio [OR] 2.37, 95% CI 2.06-2.72) and no cost over a single payment of 3 Swiss francs (OR 1.72, 95% CI 1.49-1.99). They also preferred having over not having the option of sharing their data with a health care provider of their choice (OR 1.66, 95% CI 1.40-1.97), repeated over single user consents, whenever app data are shared with commercial thirds (OR 1.57, 95% CI 1.31-1.88), and customizable over noncustomizable reminders (OR 1.30, 95% CI 1.09-1.54). While most participants favored thorough privacy infrastructures, the attribute of privacy control was a relatively weak driver of app choice. The attribute of self-monitoring method significantly interacted with gender and perceived personal usefulness of health apps, suggesting that female gender and lower perceived usefulness are associated with relatively weaker preferences for automatic self-monitoring. CONCLUSIONS: Based on the preferences of our respondents, we found that the utility of a self-monitoring sun protection app can be increased if the app is simple and adjustable; requires minimal effort, time, or expense; and has an interoperable design and thorough privacy infrastructure. Similar features might be desirable for preventive health apps in other areas, paving the way for future discrete choice experiments. Nonetheless, to fully understand these preference dynamics, further qualitative or mixed method research on mobile self-monitoring-based sun protection and broader preventive mobile self-monitoring is required. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/16087 JMIR Publications 2020-11-27 /pmc/articles/PMC7732707/ /pubmed/33245282 http://dx.doi.org/10.2196/18889 Text en ©Vasileios Nittas, Margot Mütsch, Julia Braun, Milo Alan Puhan. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 27.11.2020. https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.
spellingShingle Original Paper
Nittas, Vasileios
Mütsch, Margot
Braun, Julia
Puhan, Milo Alan
Self-Monitoring App Preferences for Sun Protection: Discrete Choice Experiment Survey Analysis
title Self-Monitoring App Preferences for Sun Protection: Discrete Choice Experiment Survey Analysis
title_full Self-Monitoring App Preferences for Sun Protection: Discrete Choice Experiment Survey Analysis
title_fullStr Self-Monitoring App Preferences for Sun Protection: Discrete Choice Experiment Survey Analysis
title_full_unstemmed Self-Monitoring App Preferences for Sun Protection: Discrete Choice Experiment Survey Analysis
title_short Self-Monitoring App Preferences for Sun Protection: Discrete Choice Experiment Survey Analysis
title_sort self-monitoring app preferences for sun protection: discrete choice experiment survey analysis
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732707/
https://www.ncbi.nlm.nih.gov/pubmed/33245282
http://dx.doi.org/10.2196/18889
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