Health Literacy Goes Mobile: A Case Study of the Healthfinder.Gov Mobile App Challenge

Background: The Patient Protection and Affordable Care Act of 2010 defines health literacy as the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions. With the growing use of new media in searching for and acting on health information, it is important that health literacy principles and plain language are applied to mobile health apps.

Program background: healthfinder.gov is a user-tested federal Web site whose mission is to help the public make informed health decisions by providing accurate, timely, and actionable information. The site was designed based on formative and usability research with 700+ people, including those with limited health literacy. In November 2012, the Office of Disease Prevention and Health Promotion (ODPHP), in coordination with healthcare technology company, Health 2.0, and the Robert Wood Johnson Foundation, challenged developers to work together with health professionals and potential end users to co-design a mobile application that makes healthfinder.gov content customizable and easy to use.  

Evaluation Methods and Results: During the first phase of the challenge (three months), developers worked with end users, via a crowdsourcing platform called Health Tech Hatch, to build a working prototype.  More than 160 individuals registered as testers and provided more than 260 comments. A panel of technical advisors with a range of expertise reviewed the 26 submissions and selected three finalists to move on to the final phase. Submissions to both phases were reviewed based on weighted criteria – health literacy principles, connection to clinical preventive services information, evidence of co-design with end users, usability and design, innovation in design, platform applicability, and healthfinder.gov branding. Developers were provided detailed explanations of the criteria via an informative Webinar and a downloadable guide. The guide included resources for developing and organizing health literate content. Usability measures for mhealth were adapted from a heuristic tool developed by usability experts, including members of the Institute of Medicine’s (IOM) Roundtable on Health Literacy, after identifying criteria that were applicable to mobile apps. The final selection of the grand prize winner was determined by ODPHP and based on quantitative and qualitative feedback from the panel of technical advisors, and live demos of the apps by the finalists.

Conclusions: The winning app, called myfamily, helps individuals manage their families’ health through prevention information personalized for each family member – all in one simple planning tool. App users can access customized prevention information from healthfinder.gov, save relevant tips and tools for each member of the family, create personal health alerts and reminders, and keep track of medical check-ups and vaccinations. App content is written in plain language and adopts health literacy principles.

Implications for research and/or practice: This case study, illustrated in a video co-produced with the IOM, demonstrates how to develop criteria and engage end users in mobile app development. Participants will also gain an understanding of the role of co-design and health literacy in developing engaging mobile apps that will help users make informed decisions about their health.