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Karim JL, Wan R, Tabet RS, Chiu DS, Talhouk A. Person-Generated Health Data in Women's Health: Scoping Review. J Med Internet Res 2024; 26:e53327. [PMID: 38754098 PMCID: PMC11140278 DOI: 10.2196/53327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 03/15/2024] [Accepted: 03/26/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND The increased pervasiveness of digital health technology is producing large amounts of person-generated health data (PGHD). These data can empower people to monitor their health to promote prevention and management of disease. Women make up one of the largest groups of consumers of digital self-tracking technology. OBJECTIVE In this scoping review, we aimed to (1) identify the different areas of women's health monitored using PGHD from connected health devices, (2) explore personal metrics collected through these technologies, and (3) synthesize facilitators of and barriers to women's adoption and use of connected health devices. METHODS Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for scoping reviews, we searched 5 databases for articles published between January 1, 2015, and February 29, 2020. Papers were included if they targeted women or female individuals and incorporated digital health tools that collected PGHD outside a clinical setting. RESULTS We included a total of 406 papers in this review. Articles on the use of PGHD for women steadily increased from 2015 to 2020. The health areas that the articles focused on spanned several topics, with pregnancy and the postpartum period being the most prevalent followed by cancer. Types of digital health used to collect PGHD included mobile apps, wearables, websites, the Internet of Things or smart devices, 2-way messaging, interactive voice response, and implantable devices. A thematic analysis of 41.4% (168/406) of the papers revealed 6 themes regarding facilitators of and barriers to women's use of digital health technology for collecting PGHD: (1) accessibility and connectivity, (2) design and functionality, (3) accuracy and credibility, (4) audience and adoption, (5) impact on community and health service, and (6) impact on health and behavior. CONCLUSIONS Leading up to the COVID-19 pandemic, the adoption of digital health tools to address women's health concerns was on a steady rise. The prominence of tools related to pregnancy and the postpartum period reflects the strong focus on reproductive health in women's health research and highlights opportunities for digital technology development in other women's health topics. Digital health technology was most acceptable when it was relevant to the target audience, was seen as user-friendly, and considered women's personalization preferences while also ensuring accuracy of measurements and credibility of information. The integration of digital technologies into clinical care will continue to evolve, and factors such as liability and health care provider workload need to be considered. While acknowledging the diversity of individual needs, the use of PGHD can positively impact the self-care management of numerous women's health journeys. The COVID-19 pandemic has ushered in increased adoption and acceptance of digital health technology. This study could serve as a baseline comparison for how this field has evolved as a result. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/26110.
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Affiliation(s)
- Jalisa Lynn Karim
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
| | - Rachel Wan
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
| | - Rhea S Tabet
- Department of Pharmacology and Therapeutics, McGill University, Montréal, QC, Canada
| | - Derek S Chiu
- Department of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada
| | - Aline Talhouk
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
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Augustin M, Wenzel AS, Licata-Dandel M, Breeman LD, Bilgin A, Wolke D, Ziegler M, Mall V, Friedmann A. App-based intervention for parents of children with crying, sleeping, and feeding problems: Usability, usefulness and implications for improvement. Internet Interv 2024; 35:100700. [PMID: 38221943 PMCID: PMC10784306 DOI: 10.1016/j.invent.2023.100700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 11/29/2023] [Accepted: 12/11/2023] [Indexed: 01/16/2024] Open
Abstract
Background There is a lack of evidence-based app guidance for parents of children with crying, sleeping, and feeding problems who are often highly burdened and not likely to seek professional help. A new psychoeducational app for parents providing scientifically sound information via text and videos, a diary function, selfcare strategies, a chat forum and a regional directory of specialized counseling centers may serve as a low-threshold intervention for this target group. Objective We investigated how parents perceived the app in terms of the following: (1) overall impression and usability, (2) feedback on specific app functions regarding usefulness and (3) possible future improvements. Methods Our clinical sample of N = 137 parents of children aged from 0 to 24 months was recruited from a cry baby outpatient clinic in Southern Germany between 2019 and 2022. A convergent parallel mixed methods design was used to collect and analyse cross-sectional data on app evaluation. After app use within the framework of a clinical trial, parents filled in an app evaluation questionnaire. Results Most participants used the app at least once a week (86, 62.8 %) over an average period of 19.06 days (SD = 15.00). Participants rated overall impression and usability as good, and the informational texts, expert videos and regional register of counseling centers as appealing and useful. The diary function and chat forum were found to be helpful in theory, but improvements in implementation were requested, such as a timer function for the diary entry. Regarding future functionality, parents posed several suggestions such as the option to contact counseling centers directly via app, and the inclusion of the profile of their partners. Conclusions Positive ratings of overall impression, usability, and specific app functions are important prerequisites for the app to be effective. App-based guidance for this target group should include easy-to-use information. The app is intended to serve as a secondary preventive low-threshold offer and to complement professional counseling.
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Affiliation(s)
- Michaela Augustin
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Heiglhofstr. 65, 81377 Munich, Germany
| | - Anne Sophie Wenzel
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Heiglhofstr. 65, 81377 Munich, Germany
| | - Maria Licata-Dandel
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Heiglhofstr. 65, 81377 Munich, Germany
- kbo-Kinderzentrum Munich, Heiglhofstr. 65, 81377 Munich, Germany
- Department of Psychology, Charlotte-Fresenius-University, Infanteriestr.11a, 80797 Munich, Germany
| | - Linda D. Breeman
- Health, Medical, and Neuropsychology Unit, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, Netherlands
| | - Ayten Bilgin
- Department of Psychology, University of Essex, Colchester CO4 3SQ, United Kingdom
| | - Dieter Wolke
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, United Kingdom
- Department of Psychology, University of Warwick, Coventry CV4 7HL, United Kingdom
| | - Margret Ziegler
- kbo-Kinderzentrum Munich, Heiglhofstr. 65, 81377 Munich, Germany
| | - Volker Mall
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Heiglhofstr. 65, 81377 Munich, Germany
- kbo-Kinderzentrum Munich, Heiglhofstr. 65, 81377 Munich, Germany
| | - Anna Friedmann
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Heiglhofstr. 65, 81377 Munich, Germany
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Acar Z, Şahin N. Development of a mobile application -based breastfeeding program and evaluation of its effectiveness. J Pediatr Nurs 2024; 74:51-60. [PMID: 37995477 DOI: 10.1016/j.pedn.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/06/2023] [Accepted: 11/06/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Breastfeeding has many benefits for maternal and infant health. Mobile health interventions are increasingly used to increase breastfeeding initiation and support breastfeeding continuation. PURPOSE This study aimed to develop a mobile application-based breastfeeding program (MABBP) and to evaluate effectiveness. DESIGN AND METHODS This randomized controlled trial study was conducted with 73 mothers on the first postpartum day hospitalized in the postpartum service of a university hospital in Turkey. Mothers in the MABBP group (experimental group) were included in the mobile application-based breastfeeding training program on the first postpartum day. The Participant Information Form, the Infant Breastfeeding Assessment Tool (IBFAT), and the Breastfeeding Experience Scale (BES), Breastfeeding Follow-up Form, and Baby Physical Development Follow-up Form were administered. In the second follow-up, the Mobile Application Evaluation Form was used additionally to collect data from the MABBP group. RESULTS There was no significant difference between the postpartum first-day MABBP and control groups in the mean IBFAT scores. In the first and second follow-up, the rate of breastfeeding exclusively was higher and the rate of experiencing breastfeeding problems was lower in the MABBP group compared to the control group. While the mean BES score on the first postpartum day was significantly higher in the MABBP group compared to the control group, it was found to be significantly lower in the second follow-up. CONCLUSION It was determined that the MABBP contributed to the mothers' experiencing fewer breastfeeding problems and feeding the babies exclusively with breast milk at a higher rate. PRACTICE IMPLICATIONS This study suggests that pediatric nurses can support mothers during breastfeeding with the breastfeeding mobile application.
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Affiliation(s)
- Zehra Acar
- University of Health Sciences Hamidiye Faculty of Nursing, Istanbul, Turkey.
| | - Nevin Şahin
- Istanbul University- Cerrahpaşa Florence Nightingale Nursing Faculty, Istanbul, Turkey
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MacMillan Uribe AL, DiFilippo KN, Jarnell K, Patterson JA. Evaluation of Commercially Available Infant-feeding Mobile Applications Using App Quality Evaluation Tool. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:604-611. [PMID: 37389498 DOI: 10.1016/j.jneb.2023.05.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 05/05/2023] [Accepted: 05/21/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVE Assess the quality of free, commercially available infant-feeding mobile applications (apps) and their appropriateness for audiences with low income and of racial and ethnic diversity using the App Quality Evaluation tool. METHODS Researchers selected apps using an iterative process (n = 6). Health professionals (n = 10) who work with mothers with infants and low income who completed the App Quality Evaluation tool for each app, consisting of 7 domains of app quality. Average domain scores were calculated for each app (> 8 indicates high quality). RESULTS Evaluators highly rated app function and purpose for WebMD Baby (8.0 ± 1.8 and 8.2 ± 0.9, respectively) and Baby Center (8.0 ± 2.1 and 8.0 ± 2.6, respectively). For other apps, no domains were highly rated. No apps were rated highly for appropriateness (range 5.7-7.7) nor provided high-quality infant-feeding information for mothers with low income. Few apps were rated highly appropriate for mothers who are Black or Hispanic. CONCLUSIONS AND IMPLICATIONS Commercially available infant-feeding apps are of limited quality, indicating the need to develop high-quality apps for audiences with low income and Black and Hispanic identities.
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Affiliation(s)
- Alexandra L MacMillan Uribe
- Healthy Living Program, Texas A&M AgriLife Institute for Advancing Health through Agriculture, College Station, TX
| | - Kristen N DiFilippo
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL
| | - Kelsey Jarnell
- School of Health Studies, College of Health and Human Sciences, Northern Illinois University, DeKalb, IL
| | - Julie A Patterson
- School of Health Studies, College of Health and Human Sciences, Northern Illinois University, DeKalb, IL.
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Araujo JP, Gallo AM, Parada CMGDL, Marcon SS, Ferrari RAP, Pinto KRTDF, Zani AV. Mobile applications as a strategy to support parents in the care of newborns: a scoping review. Rev Esc Enferm USP 2023; 57:e20220470. [PMID: 37494035 PMCID: PMC10373450 DOI: 10.1590/1980-220x-reeusp-2022-0470en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/29/2023] [Indexed: 07/27/2023] Open
Abstract
OBJECTIVE To map and describe studies available in the literature about mobile applications to support parents in newborn care and data from applications accessible in online stores. METHOD This is a scoping review following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. The searches were carried out in theses and dissertations databases and portals, in September 2021, and articles, theses, and dissertations were included. An independent search was performed in online stores of applications for operating systems Android and iOS, in October and December 2021, and applications with content to support parents of newborns were selected. RESULTS A total of 5,238 studies and 757 applications were found, and of these, 16 and 150, respectively, composed the sample. The topics discussed in the studies were: care, breastfeeding, fever, identification of neonatal diseases, child growth and development. In the applications, the themes found were care, breastfeeding, growth, immunization, development, sleep, tips, and guidelines. CONCLUSION Applications are important support tools for parents, as they are an innovative means and accessible to a large part of the population.
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Augustin M, Licata-Dandel M, Breeman LD, Harrer M, Bilgin A, Wolke D, Mall V, Ziegler M, Ebert DD, Friedmann A. Effects of a Mobile-Based Intervention for Parents of Children With Crying, Sleeping, and Feeding Problems: Randomized Controlled Trial. JMIR Mhealth Uhealth 2023; 11:e41804. [PMID: 36897641 PMCID: PMC10039405 DOI: 10.2196/41804] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/16/2022] [Accepted: 01/13/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Excessive crying, sleeping, and feeding problems in early childhood are major stressors that can result in parents feeling socially isolated and having low self-efficacy. Affected children are a risk group for being maltreated and developing emotional and behavioral problems. Thus, the development of an innovative and interactive psychoeducational app for parents of children with crying, sleeping, and feeding problems may provide low-threshold access to scientifically based information and reduce negative outcomes in parents and children. OBJECTIVE We aimed to investigate whether following the use of a newly developed psychoeducational app, the parents of children with crying, sleeping, or feeding problems experienced less parenting stress; gained more knowledge about crying, sleeping, and feeding problems; and perceived themselves as more self-effective and as better socially supported and whether their children's symptoms decreased more than those of the parents who did not use the app. METHODS Our clinical sample consisted of 136 parents of children (aged 0-24 months) who contacted a cry baby outpatient clinic in Bavaria (Southern Germany) for an initial consultation. Using a randomized controlled design, families were randomly allocated to either an intervention group (IG; 73/136, 53.7%) or a waitlist control group (WCG; 63/136, 46.3%) during the usual waiting time until consultation. The IG was given a psychoeducational app that included evidence-based information via text and videos, a child behavior diary function, a parent chat forum and experience report, tips on relaxation, an emergency plan, and a regional directory of specialized counseling centers. Outcome variables were assessed using validated questionnaires at baseline test and posttest. Both groups were compared at posttest regarding changes in parenting stress (primary outcome) and secondary outcomes, namely knowledge about crying, sleeping, and feeding problems; perceived self-efficacy; perceived social support; and child symptoms. RESULTS The mean individual study duration was 23.41 (SD 10.42) days. The IG reported significantly lower levels of parenting stress (mean 83.18, SD 19.94) after app use compared with the WCG (mean 87.46, SD 16.67; P=.03; Cohen d=0.23). Furthermore, parents in the IG reported a higher level of knowledge about crying, sleeping, and feeding (mean 62.91, SD 4.30) than those in the WCG (mean 61.15, SD 4.46; P<.001; Cohen d=0.38). No differences at posttest were found between groups in terms of parental efficacy (P=.34; Cohen d=0.05), perceived social support (P=.66; Cohen d=0.04), and child symptoms (P=.35; Cohen d=0.10). CONCLUSIONS This study provides initial evidence of the efficacy of a psychoeducational app for parents with child crying, sleeping, and feeding problems. By reducing parental stress and increasing knowledge of children's symptoms, the app has the potential to serve as an effective secondary preventive measure. Additional large-scale studies are needed to investigate long-term benefits. TRIAL REGISTRATION German Clinical Trials Register DRKS00019001; https://drks.de/search/en/trial/DRKS00019001.
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Affiliation(s)
- Michaela Augustin
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Maria Licata-Dandel
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
- kbo-Kinderzentrum Munich, Munich, Germany
| | - Linda D Breeman
- Health, Medical, and Neuropsychology Unit, Leiden University, Leiden, Netherlands
| | - Mathias Harrer
- Psychology & Digital Mental Health Care, Department of Sports and Health Sciences, Technical University of Munich, Munich, Germany
- Clinical Psychology and Psychotherapy, Institute for Psychology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Ayten Bilgin
- School of Psychology, University of Kent, Canterbury, United Kingdom
| | - Dieter Wolke
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Volker Mall
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
- kbo-Kinderzentrum Munich, Munich, Germany
| | | | - David Daniel Ebert
- Psychology & Digital Mental Health Care, Department of Sports and Health Sciences, Technical University of Munich, Munich, Germany
| | - Anna Friedmann
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
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McGowan A, Boundy EO, Nelson JM, Hamner HC. Patterns in Mothers' Recollection of Health Care Providers' Young Child Feeding Recommendations. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:1024-1033. [PMID: 36357041 PMCID: PMC11036331 DOI: 10.1016/j.jneb.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/15/2022] [Accepted: 08/21/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Characterize feeding guidance mothers recall receiving from their child's health care provider (HCP). DESIGN Cross-sectional study of mothers participating in the 2017-2019 National Survey of Family Growth. PARTICIPANTS US mothers reporting (n = 1,302) information about their youngest child (aged 6 months to 5 years). VARIABLES MEASURED Weighted percentage of mothers who recalled their child's HCP discussing 6 different feeding topics by demographic characteristics. ANALYSIS Logistic regression assessing the relationship between recall of feeding guidance and demographics. RESULTS In this sample, 36.9% of mothers (95% confidence interval, 32.3-41.4) recalled HCPs recommending solid food before 6 months old (34.6% at 4-5 months, and 2.3% before 4 months). Mothers who were older or had a higher education level were more likely than their counterparts to recall their HCP discussing several of the feeding topics examined. CONCLUSION AND IMPLICATIONS Mothers reported high recollection of early childhood nutrition guidance from their HCP; however, certain topics (eg, appropriate timing of solid food introduction) could be prioritized, and some subpopulations may need additional focus to improve receipt of messages. A better understanding of variability in recall of feeding guidance could provide information for interventions to address barriers to receiving and retaining guidance.
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Affiliation(s)
- Andrea McGowan
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA; Oak Ridge Institute for Science and Education, Oak Ridge, TN
| | - Ellen O Boundy
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA; US Public Health Service, Rockville, MD
| | - Jennifer M Nelson
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA; US Public Health Service, Rockville, MD
| | - Heather C Hamner
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
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Pérez JC, Aldoney D, García MI, Olhaberry M, Fernández O, Alamo N, Franco P, Pérez F, Fisher J, Rowe H, Coo S. Online intervention to prevent postnatal depression and anxiety in Chilean new mothers: Protocol for a feasibility trial. Health Informatics J 2022; 28:14604582221135440. [DOI: 10.1177/14604582221135440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Symptoms of postpartum depression and anxiety in new mothers are prevalent and negatively impact maternal emotional wellbeing and infant development. Barriers to accessing treatment prevent women from receiving mental health care, a situation that has worsened due to the COVID-19 pandemic. mHealth interventions hold the potential to support women during the transition to parenthood despite these barriers and to promote the use of preventive interventions. This study uses a mixed methods design to assess the feasibility and preliminary effectiveness of a psychoeducational, guided mHealth intervention to prevent postpartum mental health difficulties in women who receive care in primary health centers in Chile. The study will contribute to evidence-based research on the effectiveness of mHealth interventions for new mothers from an understudied cultural background. The findings will also enable the development of a larger randomized controlled trial to assess the effectiveness of the intervention, which, if effective, could significantly contribute to the emotional wellbeing of women and their families.
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Affiliation(s)
- J. Carola Pérez
- Millennium Institute for Research on Depression and Personality (MIDAP), Santiago, Chile; Facultad de Psicología. Universidad del Desarrollo (UDD), Santiago, Chile
| | - Daniela Aldoney
- Facultad de Psicología, Universidad del Desarrollo (UDD), Santiago, Chile
| | - María I García
- Facultad de Psicología, Universidad del Desarrollo (UDD), Santiago, Chile
| | - Marcia Olhaberry
- Millennium Institute for Research on Depression and Personality (MIDAP), Santiago, Chile; School of Psychology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Olga Fernández
- Millennium Institute for Research on Depression and Personality (MIDAP), Santiago, Chile; Universidad de Chile, Santiago, Chile
| | - Nicolle Alamo
- Millennium Institute for Research on Depression and Personality (MIDAP), Santiago, Chile; School of Social Work, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pamela Franco
- Millennium Institute for Research on Depression and Personality (MIDAP), Santiago, Chile; School of Psychology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisca Pérez
- Millennium Institute for Research on Depression and Personality (MIDAP), Santiago, Chile; Universidad Alberto Hurtado, Santiago, Chile
| | - Jane Fisher
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Heather Rowe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Soledad Coo
- Facultad de Psicología, Universidad del Desarrollo (UDD), Santiago, Chile
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Dinour LM. Infant Feeding Tracker Applications: Cross-Sectional Analysis of Use. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:835-843. [PMID: 35643748 DOI: 10.1016/j.jneb.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/09/2022] [Accepted: 03/27/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Examine the extent to which postpartum patients use infant feeding tracker applications (apps), characteristics of app users, and app features most used and desired. DESIGN Cross-sectional survey. SETTING An obstetrics/gynecology practice in Northern New Jersey in 2019. PARTICIPANTS One hundred twenty-six patients aged ≥ 18 years recruited during their 6-week postpartum visit. MAIN OUTCOME MEASURES Self-reported sociodemographics, infant feeding behaviors, and health app use. Respondents were grouped by self-reported use of an infant feeding tracker app. ANALYSIS Frequencies were calculated for descriptive analysis, and comparisons were made between user groups. Fisher's exact tests of independence were used to analyze categorical data. Mann-Whitney U tests were employed for continuous variables (significance at P < 0.002). RESULTS Fifty-seven percent of respondents reported using an app to track infant feeding. Compared with nonusers, users were more likely to have an infant who was ever breastfed (P = 0.001; Cramer's V = 0.30) and exclusively breastfed (P < 0.001; Cramer's V = 0.44). Users also used significantly more health apps than nonusers (P < 0.001). Most respondents used the app to track infant feeding, diapering, and sleep. CONCLUSIONS AND IMPLICATIONS Given their frequency of use-particularly among those who breastfeed-infant feeding tracker apps have the potential to support parents in meeting their infant feeding goals.
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Affiliation(s)
- Lauren M Dinour
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ.
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Till S, Mkhize M, Farao J, Shandu LD, Muthelo L, Coleman TL, Mbombi M, Bopape M, Klingberg S, van Heerden A, Mothiba T, Densmore M, Verdezoto Dias NX. Digital Health Technologies for Maternal and Child Health in African and other LMICs: A Cross-disciplinary Scoping Review with Stakeholder Consultation (Preprint). J Med Internet Res 2022; 25:e42161. [PMID: 37027199 PMCID: PMC10131761 DOI: 10.2196/42161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/16/2022] [Accepted: 01/31/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Maternal and child health (MCH) is a global health concern, especially impacting low- and middle-income countries (LMIC). Digital health technologies are creating opportunities to address the social determinants of MCH by facilitating access to information and providing other forms of support throughout the maternity journey. Previous reviews in different disciplines have synthesized digital health intervention outcomes in LMIC. However, contributions in this space are scattered across publications in different disciplines and lack coherence in what digital MCH means across fields. OBJECTIVE This cross-disciplinary scoping review synthesized the existing published literature in 3 major disciplines on the use of digital health interventions for MCH in LMIC, with a particular focus on sub-Saharan Africa. METHODS We conducted a scoping review using the 6-stage framework by Arksey and O'Malley across 3 disciplines, including public health, social sciences applied to health, and human-computer interaction research in health care. We searched the following databases: Scopus, PubMed, Google Scholar, ACM Digital Library, IEEE Xplore, Web of Science, and PLOS. A stakeholder consultation was undertaken to inform and validate the review. RESULTS During the search, 284 peer-reviewed articles were identified. After removing 41 duplicates, 141 articles met our inclusion criteria: 34 from social sciences applied to health, 58 from public health, and 49 from human-computer interaction research in health care. These articles were then tagged (labeled) by 3 researchers using a custom data extraction framework to obtain the findings. First, the scope of digital MCH was found to target health education (eg, breastfeeding and child nutrition), care and follow-up of health service use (to support community health workers), maternal mental health, and nutritional and health outcomes. These interventions included mobile apps, SMS text messaging, voice messaging, web-based applications, social media, movies and videos, and wearable or sensor-based devices. Second, we highlight key challenges: little attention has been given to understanding the lived experiences of the communities; key role players (eg, fathers, grandparents, and other family members) are often excluded; and many studies are designed considering nuclear families that do not represent the family structures of the local cultures. CONCLUSIONS Digital MCH has shown steady growth in Africa and other LMIC settings. Unfortunately, the role of the community was negligible, as these interventions often do not include communities early and inclusively enough in the design process. We highlight key opportunities and sociotechnical challenges for digital MCH in LMIC, such as more affordable mobile data; better access to smartphones and wearable technologies; and the rise of custom-developed, culturally appropriate apps that are more suited to low-literacy users. We also focus on barriers such as an overreliance on text-based communications and the difficulty of MCH research and design to inform and translate into policy.
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Affiliation(s)
- Sarina Till
- School of Information Technology, Independent Institute of Education, Durban, South Africa
- Department of Computer Science, University of Cape Town, Cape Town, South Africa
| | - Mirriam Mkhize
- Human Sciences Research Council, Centre for Community Based Research, Sweet Waters, South Africa
| | - Jaydon Farao
- Department of Computer Science, University of Cape Town, Cape Town, South Africa
| | - Londiwe Deborah Shandu
- Human Sciences Research Council, Centre for Community Based Research, Sweet Waters, South Africa
| | - Livhuwani Muthelo
- Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | | | - Masenyani Mbombi
- Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Mamara Bopape
- Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Sonja Klingberg
- South African Medical Research Council/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Alastair van Heerden
- Human Sciences Research Council, Centre for Community Based Research, Sweet Waters, South Africa
- South African Medical Research Council/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Tebogo Mothiba
- Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Melissa Densmore
- Department of Computer Science, University of Cape Town, Cape Town, South Africa
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11
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Bunik M, Jimenez-Zambrano A, Solano M, Beaty BL, Juarez-Colunga E, Zhang X, Moore SL, Bull S, Leiferman JA. Mother's Milk Messaging™: trial evaluation of app and texting for breastfeeding support. BMC Pregnancy Childbirth 2022; 22:660. [PMID: 36002798 PMCID: PMC9400217 DOI: 10.1186/s12884-022-04976-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND New mothers experience BF challenges but have limited evidence-based technology-enabled support. OBJECTIVES 1) Determine if using the Mother's Milk Messaging™ app improved aspects of breastfeeding and breastfeeding rates and 2) Describe engagement as well as themes from the qualitative feedback on the app. METHOD Randomized Controlled Trial National sample of primiparous, singleton mothers recruited online and then randomized using stratification by language into three arms: 1) BF text messages plus app; 2) BF text messages, app and physician-moderated private Facebook (FB) group; 3) Attention control group who received injury prevention texts. Exclusive breastfeeding rates as primary outcome and knowledge/attitude, confidence, and social support as secondary outcomes. We determined engagement through analysis of app usage metrics. We conducted and content-coded interviews with participants to learn more about app usage and BF experience. Due to the nature of the intervention participants could not be blinded. RESULTS There were a total of 346 participants in the trial, with 227 in the Intervention (n = 154 group 1 and n = 156 group 2) and 119 in the control group. Because of minimal Facebook activity, the two intervention groups 1 and 2 were combined. There were no differences in breastfeeding exclusivity and duration. (NS). Women in the intervention arm reported significantly higher confidence with breastfeeding and perceived social support to the control group (p < .05). Greater than 80% registered the app and those that engaged with the app had higher scores with time. Mothers appreciated receiving text messages and videos with reliable information. No harm was reported in this study. CONCLUSION MMM increased confidence with breastfeeding and with gathering social supports. Exclusively BF was high in all participants. Mothers perceived it as useful and dependable especially the texting.
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Affiliation(s)
- Maya Bunik
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. .,Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. .,Children's Hospital Colorado, 13123 E. 16th Ave B032, Aurora, CO, 80045, USA.
| | - Andrea Jimenez-Zambrano
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Michael Solano
- Children's Hospital Colorado, 13123 E. 16th Ave B032, Aurora, CO, 80045, USA
| | - Brenda L Beaty
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Elizabeth Juarez-Colunga
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Xuhong Zhang
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Susan L Moore
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sheana Bull
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jenn A Leiferman
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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12
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Uribe ALM, Rudt HG, Leak TM. Stakeholders' Views on Mobile Applications to Deliver Infant and Toddler Feeding Education to Latina Mothers of Low Socioeconomic Status. Nutrients 2021; 13:2569. [PMID: 34444738 PMCID: PMC8398137 DOI: 10.3390/nu13082569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/07/2021] [Accepted: 07/23/2021] [Indexed: 12/02/2022] Open
Abstract
Infant- and toddler-feeding (ITF) practices are critical to long-term health and chronic disease prevention. Using mobile applications (apps) to promote desirable ITF practices shows promise for overcoming challenges of in-person education. However, the viability of ITF apps for Latina mothers of low-socioeconomic status (SES) remains unclear. The objective of this study was to characterize stakeholders' views on Latina mothers' capability, motivation, and barriers to using ITF apps. New York City-based health professionals who frequently engage with Latina mothers of low SES completed in-depth interviews. Directed content analysis was used to identify themes through theoretical and inductive codes. Participants included dietitians, nutrition educators, and physicians (n = 17). The following themes were identified: (1) Most Latina mothers of low-SES are tech-savvy (i.e., high capability and experience using smartphones and apps); (2) Apps are an appealing way to deliver ITF education; (3) There are challenges to using apps that must be carefully considered for ITF education development. Overall, ITF apps are a viable option as skills and use appear high among Latina mothers. Key considerations for app development include targeted app promotion; detailed instructions for obtaining and using app; more visuals, less text for low literacy and multiple dialects; making key features available offline.
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Affiliation(s)
- Alexandra L. MacMillan Uribe
- Division of Nutritional Sciences, Cornell University, 244 Garden Avenue, Ithaca, NY 14853, USA; (H.G.R.); (T.M.L.)
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Mieso B, Neudecker M, Furman L. Mobile Phone Applications to Support Breastfeeding Among African-American Women: a Scoping Review. J Racial Ethn Health Disparities 2020; 9:32-51. [PMID: 33219430 DOI: 10.1007/s40615-020-00927-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Racial disparities persist with respect to breastfeeding. The use of health e-technology is increasing, with promise for a role in improving breastfeeding outcomes. OBJECTIVE We undertook a scoping review of both individual breastfeeding apps and the literature on breastfeeding apps to map the available evidence on app-based breastfeeding support for African-American mothers. DESIGN A systematic search of online databases identified 241 English language papers published on or before June 2020 that included e-technology in support of breastfeeding. We included those that (1) described individual human subjects research studies utilizing any research design, (2) described app-based breastfeeding support, and (3) could be pertinent for African-American mothers, and assessed for inclusion and relevance for this population. We also searched app stores for breastfeeding apps, and evaluated features with a rubric. Our aim was to identify if gaps exist relative to breastfeeding support for African-Americans. RESULTS Of the 15 publications meeting inclusion criteria, 9 focused on app development, 4 examined user experience, and 3 examined breastfeeding outcomes with use of an app (one study overlapped categories). The percentage of African-American participants ranged from 100% (2 studies) to none (7 studies); 3 studies (20%) focused on African-American mothers' breastfeeding experience. Of 77 apps that met inclusion criteria, just one was both breastfeeding-focused by content and targeted for African-Americans by picture predominance. CONCLUSIONS The quality of studies was generally high and many included African-American participants, but research focused on breastfeeding apps specifically for African-American mothers/parents is limited, creating a meaningful gap in the literature.
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Affiliation(s)
- Bethel Mieso
- Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA
| | - Mandy Neudecker
- Department of Pediatrics, Division of General Academic Pediatrics, University Hospitals Rainbow Babies and Children's Hospital, 11000 Euclid Avenue, Cleveland, OH, 44106, USA
| | - Lydia Furman
- Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA. .,Department of Pediatrics, Division of General Academic Pediatrics, University Hospitals Rainbow Babies and Children's Hospital, 11000 Euclid Avenue, Cleveland, OH, 44106, USA.
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