Views on mobile health apps for skin cancer screening in the general population: an in-depth qualitative exploration of perceived barriers and facilitators*

Background: Mobile health (mHealth) applications (apps) incorporating artificial intelligence for skin cancer screening are increasingly reimbursed by health insurers. However, an in-depth exploration of the general public’s views towards these apps is lacking. Objectives: To explore the perceived barriers and facilitators towards mHealth apps for skin cancer screening among the Dutch general population. Methods: A qualitative study consisting of four focus groups with 27 participants was conducted. A two-stage purposive sampling method was used to include information-rich participants from the Dutch general population with varying experience of mHealth. A topic guide was used to structure the sessions. All focus group meetings were transcribed verbatim and analysed in thematic content analysis by two researchers using several coding phases, resulting in an overview of themes and subthemes, categorized as (sub-)barriers and (sub)facilitators. Results: Main barriers to using mHealth apps included a perceived lack of value, perception of untrustworthiness, preference for a doctor, privacy concerns, a complex user interface, and high costs. The main factors facilitating the use of mHealth among the general population were a high perceived value, a transparent and trustworthy identity of app developers, endorsement by healthcare providers and government regulating bodies, and ease and low costs of use. Conclusions: To increase successful adoption in skin cancer screening apps, developers should create a transparent identity and build trustworthy apps. Collaboration between app developers, general practitioners and dermatologists is advocated to improve mHealth integration with skin cancer care. Special attention should be given to the development of low-cost, privacy-friendly, easy-to-use apps