Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Approximately 110 million Farsi speakers worldwide have access to a growing mobile app market. Despite restrictions and international sanctions, Iran’s internal mobile health app market is growing, especially for Android-based apps. However, there is a need for guidelines for developing health apps that meet international quality standards. There are also no tools in Farsi that assess health app quality. Developers and researchers who operate in Farsi could benefit from such quality assessment tools to improve their outputs. Objective: This study aims to translate and culturally adapt the Mobile Application Rating Scale in Farsi (MARS-Fa). This study also evaluates the validity and reliability of the newly developed MARS-Fa tool. Methods: We used a well-established method to translate and back translate the MARS-Fa tool with a group of Iranian and international experts in Health Information Technology and Psychology. The final translated version of the tool was tested on a sample of 92 apps addressing smartphone addiction. Two trained reviewers completed an independent assessment of each app in Farsi and English. We reported reliability and construct validity estimates for the objective scales (engagement, functionality, aesthetics, and information quality). Reliability was based on the evaluation of intraclass correlation coefficients, Cronbach α and Spearman-Brown split-half reliability indicators (for internal consistency), as well as Pearson correlations for test-retest reliability. Construct validity included convergent and discriminant validity (through item-total correlations within the objective scales) and concurrent validity using Pearson correlations between the objective and subjective scores. Results: After completing the translation and cultural adaptation, the MARS-Fa tool was used to assess the selected apps for smartphone addiction. The MARS-Fa total scale showed good interrater reliability (intraclass correlation coefficient=0.83, 95% CI 0.74-0.89) and good internal consistency (Cronbach α=.84); Spearman-Brown split-half reliability for both raters was 0.79 to 0.93. The instrument showed excellent test-retest reliability (r=0.94). The correlations among the MARS-Fa subdomains and the total score were all significant and above r=0.40, suggesting good convergent and discriminant validity. The MARS-Fa was positively and significantly correlated with subjective quality (r=0.90, P<.001), and so were the objective subdomains of engagement (r=0.85, P<.001), information quality (r=0.80, P<.001), aesthetics (r=0.79, P<.001), and functionality (r=0.57, P<.001), indicating concurrent validity. Conclusions: The MARS-Fa is a reliable and valid instrument to assess mobile health apps. This instrument could be adopted by Farsi-speaking researchers and developers who want to evaluate the quality of mobile apps. While we tested the tool with a sample of apps addressing smartphone addiction, the MARS-Fa could assess other domains or issues since the Mobile App Rating Scale has been used to rate apps in different contexts and languages.

Background: Choosing a career in nursing is frequently a complicated decision that is influenced by multiple factors. Purpose: This study was designed to identify and rank the main factors that influence individuals to choose to pursue a career in nursing. Methods: This cross-sectional study was conducted at Mazandaran University of Medical Sciences, Iran. A comprehensive review of the literature was conducted to identify the factors that people consider when making a choice to pursue a career in nursing. The face and content validities of these factors were evaluated. A sample of 250 participants was invited to assess the factors using exploratory factor analysis. Finally, the analytical hierarchy process, in combination with fuzzy logic, was used to rank the criteria and related factors. Results: Twenty factors were identified and extracted from 50 published studies. After confirming the face and content validity of each, these 20 factors were distinguished into four criteria, including (a) external motivation, (b) social dignity, (c) internal motivation, and (d) usefulness of discipline. Each criterion had an eigenvalue greater than 1. External motivation and usefulness of discipline were respectively identified as the most and least important criteria (38.60% vs. 16.11%) in terms of influencing individuals to pursue a nursing career. Conclusions/Implications for Practice: The results of this study show that exposure to positive recommendations from family and friends, receiving positive information about studying nursing, positive perceptions regarding the general usefulness of nursing knowledge, and migration opportunities to other countries are the primary factors that influence individuals in Iran to pursue a career in nursing.