Reducing Dental Anxiety in Children Using a Mobile Health App: Usability and User Experience Study

Abstract

Background: Dentistry interventions cause common anxiety and fear problems in children (6-11 years), and according to scientific evidence, this causes a decrease in their quality of life. Therapies mediated by IT-based tools have been shown to positively influence children's mood based on distraction as well as relaxing activities, but there is no evidence of their use to reduce dental anxiety in children.

Objective: The aim of this study was to answer the following research question: Does our new children-centered codesign methodology contribute to achieving a usable mobile-based product with a highly scored user experience?

Methods: A mobile health app was developed to reduce dental anxiety in children using rapid application development following the usage-centered design methodology. Structured interviews were conducted to test the usability and user experience of the app prototype among 40 children (n=20, 50%, boys and n=20, 50%, girls; age 6-11 years) using a children-adapted questionnaire and the 7-point Single Ease Question rating scale. The Smiley Faces Program-Revised questionnaire was used to assess the level of dental anxiety in participants.

Results: There were no significant differences between girls and boys. The task completion rate was 95% (n=19) for children aged 6-8 years (group 1) and 100% (n=20) for children aged 9-11 years (group 2). Group 1 found watching the relaxing video (task C) to be the easiest, followed by playing a video minigame (task B) and watching the narrative (task A). Group 2 found task C to be the easiest, followed by task A and then task B. The average time spent on the different types of tasks was similar in both age groups. Most of the children in both age groups were happy with the app and found it funny. All children thought that having the app in the waiting room during a dental visit would be useful.

Conclusions: The findings confirmed that the app is usable and provides an excellent user experience. Our children-adapted methodology contributes to achieving usable mobile-based products for children with a highly scored user experience.

Keywords: app; application development; children; dental anxiety; dentistry; digital health; human-centered design; mHealth; mobile; mobile application; mobile health; usability; user experience.

Figure 1

ARCADE project phases (scheme). This study deals with phase 3: app development and usability and user experience testing (green). ARCADE: App for Reducing Children’s Anxiety in Dentistry Environment; UCD: user-centered design.

Figure 2

ARCADE project usage-centered design user roles map. ARCADE: App for Reducing Children’s Anxiety in Dentistry Environment.

Figure 3

ARCADE project usage-centered design use case map. ARCADE: App for Reducing Children’s Anxiety in Dentistry Environment.

Figure 4

SEQ pictogram. SEQ: Single Ease Question.

Figure 5

The 1-5 face scale ranging from 1 (very easy) to 5 (very difficult).

Figure 6

SEQ results for children aged 6-8 years (group 1). SEQ: Single Ease Question.

Figure 7

SEQ results for children aged 9-11 years (group 2). SEQ: Single Ease Question.

Figure 8

ARCADE general satisfaction results for children aged 6-8 years (group 1). ARCADE: App for Reducing Children’s Anxiety in Dentistry Environment.

Figure 9

ARCADE general satisfaction results for children aged 9-11 years (group 2). ARCADE: App for Reducing Children’s Anxiety in Dentistry Environment.

Figure 10

Smiley Faces Program—Revised (SFP-R) questionnaire results for children aged 6-8 years (group 1).

Figure 11

Smiley Faces Program—Revised (SFP-R) questionnaire results for children aged 9-11 years (group 2).

Figure 12

Smiley Faces Program—Revised (SFP-R) questionnaire quartile results for girls (left) and boys (right) between 6-8 (top) and 9-11 (bottom) years.