JMIR Publications

ABSTRACT

Background:

Melanoma is the 4th most commonly diagnosed cancer in Australia. Up to 75% of melanomas are first detected by patients or their family/friends. Many mobile apps for melanoma exist, including apps to encourage skin self-monitoring (SSM) to improve the likelihood of early detection. Previous research in this area has focused on their development, diagnostic accuracy, or validation. Little is known about patients’ views and experiences of using these apps.

Objective:

This study aims to understand patients’ views and experiences of using commercially available melanoma SSM mobile apps for a period of three months.

Methods:

This qualitative study was conducted in two populations: primary care (where the MelatoolsQ tool was used to identify patients who were at increased risk of melanoma) and in secondary care (where patients had a previous diagnosis of melanoma, stages 0-3a). Participants downloaded two of four mobile apps for SSM (SkinVision, UMSkinCheck, Mole Monitor or MySkinPal) and were encouraged to use them for three months. After three months, a semi-structured interview was conducted with participants to discuss their experiences of using the SSM mobile apps.

Results:

Fifty-four participants were recruited into the study with 20 (37%) from primary care and 34 (62%) from secondary care. Interviews were conducted with 34 participants when data saturation was reached. Most participants didn’t use the apps at all (n=12) or tried them once but didn’t continue (n=14). Only eight participants used the apps to assist with SSM for the whole duration of the study. Patients discussed the apps in the context of the importance of early detection and their current SSM behaviours. A range of features of ‘perceived quality’ of each app affected engagement to support SSM. Participants described their SSM routines and potential mismatch with the app reminders. They also described technical and practical difficulties experienced using the apps for SSM. The app’s positioning within existing relationships with healthcare providers was crucial to understand use of the apps.

Conclusions:

This study of patients at increased risk of melanoma highlights several barriers to engagement with apps to support SSM. The results highlight the wide ranging and dynamic influences on engagement with mobile apps, which extend beyond app design and relate to broader contextual factors about SSM routines and relationships with healthcare providers.