title: Assessing the Quality of Mobile Exercise Apps Based on the American College of Sports Medicine Guidelines: A Reliable and Valid Scoring Instrument.
abstract: Regular physical activity can not only help with weight management, but also lower cardiovascular risks, cancer rates, and chronic disease burden. Yet, only approximately 20% of Americans currently meet the physical activity guidelines recommended by the US Department of Health and Human Services. With the rapid development of mobile technologies, mobile apps have the potential to improve participation rates in exercise programs, particularly if they are evidence-based and are of sufficient content quality.
  
  
  
  The goal of this study was to develop and test an instrument, which was designed to score the content quality of exercise program apps with respect to the exercise guidelines set forth by the American College of Sports Medicine (ACSM).
  
  
  
  We conducted two focus groups (N=14) to elicit input for developing a preliminary 27-item scoring instruments based on the ACSM exercise prescription guidelines. Three reviewers who were no sports medicine experts independently scored 28 exercise program apps using the instrument. Inter- and intra-rater reliability was assessed among the 3 reviewers. An expert reviewer, a Fellow of the ACSM, also scored the 28 apps to create criterion scores. Criterion validity was assessed by comparing nonexpert reviewers' scores to the criterion scores.
  
  
  
  Overall, inter- and intra-rater reliability was high with most coefficients being greater than .7. Inter-rater reliability coefficients ranged from .59 to .99, and intra-rater reliability coefficients ranged from .47 to 1.00. All reliability coefficients were statistically significant. Criterion validity was found to be excellent, with the weighted kappa statistics ranging from .67 to .99, indicating a substantial agreement between the scores of expert and nonexpert reviewers. Finally, all apps scored poorly against the ACSM exercise prescription guidelines. None of the apps received a score greater than 35, out of a possible maximal score of 70.
  
  
  
  We have developed and presented valid and reliable scoring instruments for exercise program apps. Our instrument may be useful for consumers and health care providers who are looking for apps that provide safe, progressive general exercise programs for health and fitness.
authors.affiliation: Institute of Natural Resources and Environmental Audits, Nanjing Audit University, Nanjing, China.|Department of Health Outcomes and Policy, University of Florida, Gainesville, FL, United States.
authors.forename: Yi
authors.identifier: 0000-0003-0587-4105
authors.initials: Y
authors.lastname: Guo
authors.affiliation: Department of Health Outcomes and Policy, University of Florida, Gainesville, FL, United States.
authors.forename: Jiang
authors.identifier: 0000-0002-2238-5429
authors.initials: J
authors.lastname: Bian
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, United States.
authors.forename: Trevor
authors.identifier: 0000-0001-9926-1101
authors.initials: T
authors.lastname: Leavitt
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, United States.
authors.forename: Heather K
authors.identifier: 0000-0003-3147-6426
authors.initials: HK
authors.lastname: Vincent
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, United States.
authors.forename: Lindsey
authors.identifier: 0000-0002-4229-2086
authors.initials: L
authors.lastname: Vander Zalm
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, United States.
authors.forename: Tyler L
authors.identifier: 0000-0001-9712-1308
authors.initials: TL
authors.lastname: Teurlings
authors.affiliation: Department of Health Outcomes and Policy, University of Florida, Gainesville, FL, United States.
authors.forename: Megan D
authors.identifier: 0000-0003-2690-0667
authors.initials: MD
authors.lastname: Smith
authors.affiliation: Department of Health Outcomes and Policy, University of Florida, Gainesville, FL, United States.
authors.forename: François
authors.identifier: 0000-0003-4366-0757
authors.initials: F
authors.lastname: Modave
mesh_terms: D003625:Data Collection; D015444:Exercise; D017408:Guidelines as Topic; D006801:Humans; D063731:Mobile Applications / Q000592:standards*; D015203:Reproducibility of Results; D013178:Sports Medicine / Q000592:standards*; D014481:United States
keywords: mHealth; measures; mobile apps; physical activity