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  • Jwaher A. Almulhem *,† and
  • Raniah N. Aldekhyyel †

Reviewer 1: Manar Alsaid Reviewer 2: Anonymous

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Thank you for submitting this manuscript, which addresses an important and under-researched topic: the current landscape and behavior-change potential of Arabic-language mHealth apps for wellness in the MENA region, with a focused evaluation in Saudi Arabia. The study uses a systematic three-phase approach and the validated ABACUS scale, making it a useful contribution to regional digital health literature. The core findings—the limited number of eligible apps, modest ABACUS scores, and a heavy emphasis on physical activity—are appropriately reported.

However, the manuscript requires major revision before it can be accepted for publication. The primary concerns are methodological transparency, scholarly writing quality, and overgeneralization of conclusions. Below are specific, actionable suggestions to strengthen the paper:

Major Suggestions

1. Enhance Methodological Reproducibility

To ensure scientific soundness, the Methods section (particularly Phases 1–3) must be expanded with sufficient detail for independent replication:

  • Search Parameters: Provide the exact Sensor Tower search parameters used on 18 January 2026, including specific filters, how the “top 0 free app" was extracted from both stores, and the exact process for handling cross-country and cross-platform duplicates.
  • Operational Definitions: Clearly define the four behavior-change screening criteria used in Phase 2, providing examples of what constituted a "yes" for each.
  • Inter-rater Reliability: Report quantitative inter-rater reliability (e.g., percentage agreement or Cohen's) for both the screening process and ABACUS scoring.
  • Protocol Details: Clarify the 15-minute usage protocol in Phase 3, specifying which features were systematically explored.

2. Improve English Language and Scholarly Tone

The current English requires substantial polishing to meet MDPI Healthcare's standards. The manuscript contains repetitive phrasing (e.g., the frequent use of “by u"”), w"rdy or awkward sentence constructions, and inconsistent verb tenses.

  • Professional Editing: A thorough line-by-line edit—ideally through a professional academic editing service—is strongly advised.
  • Active/Passive Voice: Replace repetitive first-person constructions with more concise phrasing to improve flow and academic tone.
  • Concise: Streamline overly long sentences, particularly in the Introduction and Conclusion sections.

3. Refine Interpretation and Conclusions

Because the final evaluation was performed on only three apps, the interpretation of the data must remain cautious:

  • Limit Generalization: Avoid generalizing findings to all “Arab"c mHealth wellness apps in the MENA region.” Cla"ms should be restricted to the Saudi Arabian subset and the specific apps evaluated.
  • Moderate Impact Statements: Tone down assertions regarding broad public-health impact or “sign"ficant advancement,” as "he study does not provide usage or clinical outcome data.
  • Expand Limitations: Explicitly acknowledge the small final sample size, the cross-sectional nature of the study, and reliance on app store rankings as key limitations.

Minor Revisions and Polishing

  • Consistency: Verify numerical reporting for consistency across the Abstract, Results, and Tables (e.g., ensuring app counts at each phase match exactly).
  • Formatting: Standardize Arabic app names and ensure table alignment is visually clear.
  • Context: Briefly expand the Introduction to include more detail on the development and prior validation of the ABACUS tool.
  • Regional Alignment: While linking findings to Saudi Vision 2030 is appropriate, ensure the discussion remains grounded in the results and avoids overstatement.

Summary

These revisions—centered on methodological detail, language polishing, and restrained interpretation—will significantly strengthen the manuscript. The topic is timely, and the use of the ABACUS scale adds necessary rigor. With these improvements, the paper will make a defensible and clear contribution to digital health research in the MENA region.

I look forward to reviewing the revised version.

Comments on the Quality of English Language

The English in the manuscript is generally understandable and successfully conveys the authors' intentions; however, it requires moderate to substantial improvement to achieve the clarity, conciseness, and scholarly tone expected in a reputable peer-reviewed journal like Healthcare. The current writing is characterized by repetitive phrasing, awkward sentence constructions, and occasional grammatical or stylistic issues that diminish readability and professional impact.

Specific Observations

  • Repetitive Phrasing: The phrase "by us" or "we … by us" is used excessively throughout the Methods, Results, and Discussion sections (e.g., "evaluated by us," "reviewed by us," "concurrently evaluated by us"). This creates an informal and repetitive tone. Sentences should be rephrased to vary the structure—for instance, "The apps were evaluated independently by the researchers…" or, where appropriate, in the passive voice.
  • Awkward or Wordy Sentence Constructions: Several sentences are unnecessarily long or convoluted. For example:
    • Page 3: "To begin with, we had to define what wellness apps are by using a standard definition."
    • Page 4: "All eligible behavior change apps identified in Saudi Arabia that did not require an Apple ID sign-in were downloaded on an iPhone and concurrently evaluated by us using the ABACUS scale."
      These should be streamlined for better flow and impact.
  • Minor Grammatical and Stylistic Issues:
    • Tense Consistency: There are instances of inconsistent verb tenses, particularly in the description of study procedures.
    • Nuance in Word Choice: Occasional awkward preposition use and missing articles reduce the polish of the writing.
    • Redundancy: Expressions such as "we noticed that" can often be removed to tighten the prose.
  • Scholarly Tone and Clarity: The manuscript would benefit from more precise academic language. Sections in the Introduction, Discussion, and Conclusion could be edited for conciseness without any loss of content.

Recommendation

A thorough line-by-line language edit (or a professional academic editing service) is strongly advised. While the scientific content is sufficiently clear for evaluation, polishing the English is essential for publication readiness and will significantly enhance the manuscript's scholarly quality.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

The manuscript is interesting, and the authors have tried to address an important and timely topic. However, some concerns must be addressed before the manuscript can be considered for publication.

  1. The manuscript currently reads as a descriptive app review. The authors should more clearly explain what new scientific contribution this study makes beyond prior app evaluation studies. Many studies already assess mHealth apps using rating tools. The key novelty must be presented using clear literature gaps.
  2. Only three Saudi apps were evaluated using ABACUS. This is a very small sample size, making conclusions about Saudi Arabia or the wider MENA region weak. Authors should acknowledge this more explicitly and avoid broad generalizations.
  3. Two reviewers evaluated apps, but no inter-rater agreement statistics are reported. This is essential for scoring-based evaluation.
  4. ABACUS evaluates behavior change potential, but not usability, privacy, engagement quality, readability, security, or clinical validity. Authors should justify why ABACUS alone was chosen.
  5. The discussion repeats results rather than interpreting them scientifically. Authors should connect findings with digital health adoption barriers in the MENA region such as regulation, language localization, cultural tailoring, health literacy, trust, and monetization barriers.
  6. Since wellness apps collect sensitive user data, privacy policies, permissions, data export, consent mechanisms, and compliance with regional regulations should be critically discussed.
  7. Tables are informative but have some issues in visual appearance. Some app names mix Arabic and English. Tables should be reformatted for clarity, aligned properly, and simplified.
  8. Add one section (Practical Implications) about recommendations for policymakers, developers, public health agencies, and researchers to improve Arabic wellness app ecosystems.
  9. Some references appear incomplete, inconsistent, or web-based without stable citation formatting.
  10. Several grammatical issues, awkward phrasing, and inconsistent capitalization are present (e.g., “mhealth” vs “mHealth”, “developing health apps require”). The manuscript requires careful English editing for readability.
Comments on the Quality of English Language

Several grammatical issues, awkward phrasing, and inconsistent capitalization are present (e.g., “mhealth” vs “mHealth”, “developing health apps require”). The manuscript requires careful English editing for readability.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

Thank you for your thorough revisions. The manuscript has improved markedly in both methodological transparency and reproducibility.

The most critical remaining revision is a final, comprehensive academic English language edit. This is still required to eliminate residual wordiness, awkward phrasing, and minor grammatical or stylistic issues, ensuring greater clarity and a consistent scholarly tone.

Once these minor linguistic refinements are addressed, the manuscript will be ready for publication.

Comments on the Quality of English Language

The English in the revised manuscript has improved significantly. Repetitive phrasing has been largely eliminated, and the overall tone is more professional. However, minor issues remain:

  • Syntax: Some long sentences in the Methods and Discussion sections are awkward and should be tightened for readability.

  • Grammar: Occasional errors in article usage, preposition choice, and minor redundancies persist.

  • A final, careful proofreading is recommended to polish the flow and eliminate remaining wordiness.

Author Response

Please see the attachment. 

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

Authors have addressed all the concerns. The article may be accepted. 

Author Response

Please see the attachment. 

Author Response File: Author Response.pdf