Introduction: Mobile health applications (mHealth apps) may support people’s chronic obstructive pulmonary disease (COPD) self-management. Current research has demonstrated the promising effects of mHealth apps for people with COPD but there is still limited information on these apps’ characteristics and qualities, especially those in the public domain. Therefore, there is the need to use a standardized evaluation framework to: 1) describe characteristics and qualities of COPD apps from past studies; 2) characterize the features and qualities of public COPD apps; and 3) determine the appropriateness of public COPD apps from the perspective of clinicians and patients living with COPD. Methods: The mHealth Index and Navigation Database (MIND) framework, an objective evaluation tool was applied across studies. Project 1: A systematic review was conducted, including randomized controlled trials investigating interactive mHealth apps for people living with chronic lung diseases (CLD). Project 2: An evaluation study of the public marketplace (Android and Apple app stores) was conducted. Free mHealth apps created specifically for COPD self-management were included. Project 3: Reviewed COPD apps were presented to stakeholders in an infographic format. A RAND/UCLA Appropriateness Method (RAM) was used to collect feedback from stakeholders on the state of public COPD apps. Results: Many of the COPD apps trialed in past studies have inconsistent reports of their features and qualities, with many publicly unavailable. Most public COPD apps lacked clinical evidence to support their use and have questionable qualities. Stakeholders agreed that public COPD apps were mostly inappropriate but did not dismiss the need to discuss their potential in COPD care plans. Significance: This thesis project advocates for the partnership with multiple heath disciplines and patient-participants for app evaluations to gain stronger understanding of their potential. Future opportunities may include exploring other apps for lung diseases to promote stakeholder engagement throughout the process. / Thesis / Candidate in Philosophy

Mobile health applications (mHealth apps), particularly in the health and fitness category, have experienced an increase in popularity due to their convenience and availability. However, this widespread adoption has raised concerns regarding the security and privacy of user data within these apps. This study investigates the security and privacy risks associated with ten top-ranked Android health and fitness apps, a set which accounts for 237 million downloads. By utilizing tools such as MobSF, Qualys SSL, and CLAUDETTE, we performed a static, dynamic, server-side, and privacy policy analysis in order to gain comprehensive insights into the security and privacy posture of the investigated mobile health and fitness apps. The results from the analysis revealed vulnerabilities in coding practices, hardcoded sensitive information, insecure encryption configurations, misconfiguration, and extensive domain communication. For instance, our analysis revealed that all apps stored their database API key directly in the code, with eight apps additionally exposing the database URL. Furthermore, six apps employed insecure encryption methods, such as CBC mode with PKCS5/PKCS7 padding (five apps) and ECB mode (two apps).In total, the apps interacted with 404 distinct domains. Notably, two apps communicated with more than 230 domains each, while a third app connected with over 100 domains. Despite these findings, developers demonstrated improved awareness and proficiency in addressing privacy and security risks compared to previous studies in the field. The study underscores the importance of continuous research to comprehensively understand the security and privacy landscape of health and fitness apps.