Objective: To identify smartphone apps that support hand hygiene practice and to assess their content, technical and functional features, and quality. A secondary objective was to make design and research recommendations for future apps.
Materials and Methods: We searched the UK Google Play and Apple App stores for hand hygiene smartphone apps aimed at adults. Information regarding content, technical and functional features was extracted and summarized. Two raters evaluated each app, using the IMS Institute for Healthcare Informatics functionality score and the Mobile App Rating Scale (MARS).
Results: 668 apps were identified, with 90 meeting the inclusion criteria. Most (96%) were free to download. The majority (78%) intended to educate/inform or remind users to hand wash (69%), using behavior change techniques such as personalization and prompting practice. Only 20% and 4% named a best practice guideline or had expert involvement in development, respectively. Innovative means of engagement were used in 42% (e.g. virtual/augmented reality or geolocation-based reminders). Apps included an average of 2.4/10 of the IMS functionality criteria (range 0-8). The mean MARS score was 3.2/5 (SD=0.5), and 68% had a minimum acceptability score of three. Two had been tested/trialed.
Discussion: Although many hand hygiene apps exist, few provide content on best practice. Many did not meet the minimum acceptability criterion for quality or were formally trialed/tested. Research should assess the feasibility and effectiveness of hand hygiene apps (especially within healthcare settings), including when and how they ‘work.’ We recommend that future apps to support hand hygiene practice are developed with infection prevention and control experts and align with best practice. Robust research is needed to determine which innovative methods of engagement create ‘sticky’ apps.