Does Personalized Mean Popular? A Content Analysis of Suicide Prevention Smartphone Applications.

Background: Smartphone applications (apps) have wide reach and can help users in real-time; however, it is unclear if suicide prevention apps include content and features that are likely to improve users' experiences, such as personalization and interactivity. It is also unknown if app characteristics that contribute to popularity are also related to user-rated quality. This content analysis evaluated the content, functions, popularity (i.e., downloads), and user-rated quality (i.e., star ratings) of publicly available suicide prevention apps. Methods: Apps were downloaded from May-July 2022 and independently rated by two researchers. Discrepancies were resolved via discussion or a third rater. The Mobile Application Rating Scale assessed app quality. Results: The 74 included apps were collectively downloaded roughly 2,349,710 times. Approximately 22% had dynamic, personalizable, and actionable safety plans (e.g., called supports during crisis). Of variables that were significant in univariate models, larger apps, with secure access, and with risk reduction information were downloaded more frequently. Apps that provided developer's contact information and were rated more favorably by the researchers were given more stars by users. Identifying alcohol as a suicide risk factor was significant in both univariate models, but neither multivariate model. No other variables related to downloads were also related to star ratings. Conclusions: Suicide prevention apps vary in tailoring and dynamic features, but unexpectedly such features are unrelated to user-rated quality and popularity. The features that attract users to download apps, like having secure access and harm reduction, do not also contribute to positive ratings.