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Thompson KL, Graf MD. Environmental Scan of Online Government Complementary Feeding Resources in the United States. MCN Am J Matern Child Nurs 2024:00005721-990000000-00053. [PMID: 38864902 DOI: 10.1097/nmc.0000000000001033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
BACKGROUND Parents commonly seek online sources of information on the important complementary feeding period, but the accuracy of these sources varies. The 21st Century Integrated Digital Experience Act (IDEA) states federal government resources should be accurate and user-friendly; however, the quantity, quality, and accuracy of federal resources on complementary feeding is unknown. METHODS An environmental scan of online federal, parent-facing resources about complementary feeding was conducted. The authors reviewed federal resources for concordance of information with the Dietary Guidelines for Americans (DGA). Quality was evaluated using the Patient Education Materials Assessment Tool. RESULTS A total of 112 resources across 2 federal government departments. Overall quality was high as was concordance with recommendations from the DGA for age of complementary food introduction, foods to introduce, and foods to avoid. Allergenic food introduction and textured food progression recommendations were less consistent. Recommendations for improvements to federal resources are made. CLINICAL IMPLICATIONS This environmental scan only included federal resources for CF. Parents may be accessing other, non-federal resources online. However, given the enactment of IDEA, it is expected that these federal resources will be up-to-date and user-friendly, which was not always the case. Nurses should review the DGA guidelines for complementary feeding and provide evidence-based anticipatory guidance to families, focusing especially on allergenic food introduction and textured food progression. Future complementary feeding interventions may benefit from directing families to online exemplars from federal sources.
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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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Blakeslee SB, Vieler K, Horak I, Stritter W, Seifert G. Planting Seeds for the Future: Scoping Review of Child Health Promotion Apps for Parents. JMIR Mhealth Uhealth 2023; 11:e39929. [PMID: 37471125 PMCID: PMC10401193 DOI: 10.2196/39929] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 11/12/2022] [Accepted: 05/02/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Increasingly, parents use child health promotion apps to find health information. An overview of child health promotion apps for parents currently does not exist. The scope of child health topics addressed by parent apps is thus needed, including how they are evaluated. OBJECTIVE This scoping review aims to describe existing reported mobile health (mHealth) parent apps of middle- to high-income countries that promote child health. The focus centers on apps developed in the last 5 years, showing how the reported apps are evaluated, and listing reported outcomes found. METHODS A scoping review was conducted according to PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews) guidelines to identify parent apps or web-based programs on child health promotion published between January 2016 and June 2021 in 5 databases: PubMed, ERIC, IEEE Xplore, Web of Science, and Google Scholar. Separate sources were sought through an expert network. Included studies were summarized and analyzed through a systematic and descriptive content analysis, including keywords, year of publication, country of origin, aims/purpose, study population/sample size, intervention type, methodology/method(s), broad topic(s), evaluation, and study outcomes. RESULTS In total, 39 studies met the inclusion criteria from 1040 database and 60 expert-identified studies. Keywords reflected the health topics and app foci. About 64% (25/39) of included studies were published after 2019 and most stemmed from the United States, Australian, and European-based research. Studies aimed to review or evaluate apps or conducted app-based study interventions. The number of participants ranged from 7 to 1200. Quantitative and qualitative methods were used. Interventions included 28 primary studies, 6 app feasibility studies, and 5 app or literature reviews. Eight separate topics were found: parental feeding and nutrition, physical activity, maternal-child health, parent-child health, healthy environment, dental health, mental health, and sleep. Study intervention evaluations cited behavior change theories in 26 studies and evaluations were carried out with a variety of topic-specific, adapted, self-developed, or validated questionnaires and evaluation tools. To evaluate apps, user input and qualitative evaluations were often combined with surveys and frequently rated with the Mobile App Rating Scale. Outcomes reported some positive effects, while several intervention studies saw no effect at all. Effectively evaluating changes in behavior through apps, recruiting target groups, and retaining app engagement were challenges cited. CONCLUSIONS New parents are a key target group for child health apps, but evaluating child health promotion apps remains a challenge. Whether tailored to parent needs or adapted to the specific topic, apps should be rooted in a transparent theoretical groundwork. Applicable lessons for parent apps from existing research are to tailor app content, include intuitive and adaptive features, and embed well-founded parameters for long-term effect evaluation on child health promotion.
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Affiliation(s)
- Sarah B Blakeslee
- Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Kristin Vieler
- Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ingo Horak
- Digital Health Entrepreneur, Berlin, Germany
| | - Wiebke Stritter
- Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Georg Seifert
- Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Laws RA, Cheng H, Rossiter C, Kuswara K, Markides BR, Size D, Corcoran P, Ong K, Denney‐Wilson E. Perinatal support for breastfeeding using mHealth: A mixed methods feasibility study of the My Baby Now app. MATERNAL & CHILD NUTRITION 2023; 19:e13482. [PMID: 36725007 PMCID: PMC10019053 DOI: 10.1111/mcn.13482] [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: 10/03/2022] [Revised: 12/20/2022] [Accepted: 01/13/2023] [Indexed: 02/03/2023]
Abstract
Despite the well-known benefits of breastfeeding, breastfeeding rates remain suboptimal, particularly for women with lower socioeconomic position. Although popular, breastfeeding apps are often poor quality; their impact on breastfeeding knowledge, attitudes, confidence and intentions is unknown. A mixed method pre-post feasibility study was conducted to: 1) explore the feasibility of the My Baby Now app in providing perinatal breastfeeding support; 2) examine the impact on breastfeeding knowledge, attitudes, confidence and intentions; 3) to examine any differences in acceptability and impact of the app according to maternal education. The My Baby Now app was offered to pregnant women 20-30 weeks gestation. Breastfeeding knowledge and intentions were collected at baseline (T1) and 36-38 weeks gestation (T2); attitudes and confidence were collected at baseline, T2 and T3 (8-12 weeks post-partum). App engagement was measured via app analytics. Qualitative interviews were conducted with a purposeful sample following T3. Of 266 participants recruited, 169 (64%) completed T2 and 157 (59%) completed T3. Mothers without university education rated the app to be higher quality, more useful and impactful than mothers with university education. From T1-T2, breastfeeding knowledge (59.6% vs. 66.5%, p < 0.001) and exclusive breastfeeding intentions (76.6% vs. 80.9%, p < 0.001) increased. Breastfeeding attitudes and confidence scores also increased significantly across T1-T2 and T1-T3. App engagement during pregnancy predicted changes in breastfeeding attitudes from T1-T2 among participants without university education. App engagement did not predict changes in breastfeeding knowledge, confidence or intentions. Future randomised controlled studies should examine the effectiveness of mHealth interventions on breastfeeding outcomes.
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Affiliation(s)
- Rachel A. Laws
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition ScienceDeakin UniversityGeelongAustralia
| | - Heilok Cheng
- Susan Wakil School of Nursing and MidwiferyThe University of SydneyCamperdownAustralia
| | - Chris Rossiter
- Susan Wakil School of Nursing and MidwiferyThe University of SydneyCamperdownAustralia
| | - Konsita Kuswara
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition ScienceDeakin UniversityGeelongAustralia
| | - Brittany R. Markides
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition ScienceDeakin UniversityGeelongAustralia
| | - Donna Size
- Sydney Institute for Women, Children and their Families, Sydney Local Health DistrictSydneyAustralia
| | - Patricia Corcoran
- Sydney Institute for Women, Children and their Families, Sydney Local Health DistrictSydneyAustralia
- Canterbury Hospital Maternity Unit, Sydney Local Health DistrictSydneyAustralia
| | - Kok‐Leong Ong
- Department of Information Systems and Business Analytics, AISSCRMIT UniversityMelbourneAustralia
| | - Elizabeth Denney‐Wilson
- Susan Wakil School of Nursing and MidwiferyThe University of SydneyCamperdownAustralia
- Sydney Institute for Women, Children and their Families, Sydney Local Health DistrictSydneyAustralia
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Mobley AR, Jake-Schoffman DE, Fedele DA, Varela EG, Zeldman J. BabyByte: Qualitative Research to Inform the Development of an App to Improve Responsive Feeding Practices in Parents of Infants and Toddlers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4769. [PMID: 36981679 PMCID: PMC10049234 DOI: 10.3390/ijerph20064769] [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: 01/31/2023] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
Responsive feeding is associated with a reduced risk of childhood obesity. The objective of this qualitative study was to determine parental preferences for mobile health (mHealth) app content and features designed to improve responsive feeding practices. Parents of 0-2-year-old children were interviewed individually. Interview questions were informed by the Technology Acceptance Model, and parents provided feedback on sample app content and features. Interviews were audio-recorded, transcribed verbatim, and coded by two researchers using thematic analysis; responses were compared by parent gender and income. Parents (n = 20 fathers, n = 20 mothers) were, on average, 33 years old, low-income (50%), identified as non-white (52.5%), and had a bachelor's degree or higher (62%). Overall, parents were most interested in feeding tips and recipe content, and app features that allowed tracking child growth and setting feeding goals. Fathers were most interested in content about first foods, choking hazards, and nutrition information, while mothers preferred content on breastfeeding, picky eating, and portion sizes. Parents with lower incomes were interested in nutrition guidelines, breastfeeding, and introducing solids. Non-low-income parents preferred information related to food allergies, portion sizes, and picky eating. The findings of this study provide considerations when developing mHealth apps to improve responsive feeding practices in parents.
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Affiliation(s)
- Amy R. Mobley
- Department of Health Education and Behavior, University of Florida, Gainesville, FL 32611, USA
| | | | - David A. Fedele
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL 32611, USA
| | - Elder Garcia Varela
- Department of Health Education and Behavior, University of Florida, Gainesville, FL 32611, USA
| | - Jamie Zeldman
- Department of Health Education and Behavior, University of Florida, Gainesville, FL 32611, USA
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Duh-Leong C, Yin HS, Salcedo V, Mui A, Perrin EM, Yi SS, Zhao Q, Gross RS. Infant Feeding Practices and Social Support Networks Among Immigrant Chinese American Mothers With Economic Disadvantage in New York City. J Hum Lact 2023; 39:168-177. [PMID: 36082453 PMCID: PMC10165977 DOI: 10.1177/08903344221121571] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Maternal social support promotes healthy infant feeding practices, which influence healthy growth and development. Less is known about how the interplay of social support networks and multicultural health beliefs may influence infant feeding practices, particularly among immigrant Chinese American mothers with economic disadvantage and low breastfeeding rates. RESEARCH AIM To explore the role of social support networks in the development of infant feeding practices in immigrant Chinese American mothers with infants. METHODS This was a prospective, cross-sectional qualitative study where we conducted semi-structured interviews in Mandarin, Cantonese, or English with Chinese American mothers of infants (N = 25) at a federally qualified health center in the Sunset Park neighborhood of Brooklyn, New York. Data were analyzed by a multicultural, multidisciplinary team using qualitative thematic analysis and the constant comparative method to identify and iteratively refine emerging codes. RESULTS Three themes emerged describing how broad transnational communities and close family and friends influence maternal-infant feeding practices: (1) Gathering and processing infant feeding information from broad transnational resources (i.e., from both the mother's country of residence and the mother's country of origin); (2) aligning maternal feeding attitudes with cultural health beliefs of local social networks; and (3) gaining confidence with transactional maternal-infant feeding interactions. CONCLUSIONS Strategies to promote healthy infant feeding should consider how family supports and culturally-relevant coaching can help align multilevel transnational social networks with healthy infant feeding practices.
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Affiliation(s)
- Carol Duh-Leong
- Division of General Pediatrics, Department of Pediatrics, New York University, Grossman School of Medicine, New York, NY, USA
| | - H. Shonna Yin
- Division of General Pediatrics, Department of Pediatrics, New York University, Grossman School of Medicine, New York, NY, USA
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Vanessa Salcedo
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Angel Mui
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Eliana M. Perrin
- Department of Pediatrics, Johns Hopkins School of Medicine and School of Nursing, Baltimore, USA
| | - Stella S. Yi
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Qiuqu Zhao
- Seventh Avenue Family Health Center, New York University Langone Health, Brooklyn, NY, USA
| | - Rachel S. Gross
- Division of General Pediatrics, Department of Pediatrics, New York University, Grossman School of Medicine, New York, NY, USA
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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7
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Doan TTD, Tran TC, Pham NM, Zhao Y, Dinh TPH, Hoai NX, Lee A, Binns C, Bui TTH. Designing and developing a mobile app (BeBo) in a randomized controlled trial study to promote breastfeeding among Vietnamese mothers. Int Breastfeed J 2023; 18:7. [PMID: 36658643 PMCID: PMC9854088 DOI: 10.1186/s13006-023-00543-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 01/07/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Breastfeeding should begin as soon as possible after birth and continue exclusively to 6 months of age. In Vietnam, as in many other countries, breastfeeding is decreasing because of modern lifestyles and the promotion of infant formula. It is important to provide mothers, family members, and the community with the knowledge and strategies to improve breastfeeding rates. Smartphones are almost ubiquitous in Vietnam and of the potential to provide information about breastfeeding. This study aimed to document the process of designing and developing a mobile app to increase breastfeeding rates in Vietnamese women. METHODS We used a four-step mixed methods approach with a literature review, formative research (22 in-depth interviews and 49 self-administered online questionnaires), and testing of prototype apps (3 focus groups discussion and external experts). Formative research and focus group discussion involved 99 participants. Finally, the revisions of the app were tested. All of the formative research was undertaken in Hanoi in 2019-2020. Target behaviors followed by key determinants, to improve breastfeeding self-efficacy were studied and this information was then applied in developing the messages and library content. Barriers and facilitators to breastfeeding were identified from literature reviews and qualitative research. The messages were targeted at not only mothers but also included fathers, mothers-in-law, or families. RESULTS Mothers were mostly concerned about the initiation of breastfeeding, preventing and reducing difficulties encountered during breastfeeding, and nutrition for breastfeeding mothers. Mental health and well-being in the postnatal period are also concerns. Three key features to be included in the app were identified from the formative research: (1) notifications; (2) an information library; and (3) a searching function. The research found that the app should be installed during pregnancy rather than after delivery (81% vs 17%, respectively). Notifications that convey breastfeeding messages should be sent 2-3 times per week. CONCLUSION The development of the app followed a best practice approach, including the involvement of stakeholders and grounding in behavior change theory. The next step is to evaluate the effectiveness of the BeBo mobile app in a well-conducted randomized controlled trial. TRIAL REGISTRATION ACTRN12619000531112.
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Affiliation(s)
- Thi Thuy Duong Doan
- Faculty of Social Sciences, Behaviour and Health Education, Hanoi University of Public Health, 1A Duc Thang Street, Bac Tu Liem District, Hanoi, 10000 Vietnam
- School of Public Health, Curtin University, Bentley, Western Australia 6102 Australia
| | - Trung Chuyen Tran
- Faculty of Information Technology, Department of Hanoi University of Mining and Geology, 18 Vien Street - Bac Tu Liem District, Hanoi, 10000 Vietnam
| | - Ngoc Minh Pham
- School of Public Health, Curtin University, Bentley, Western Australia 6102 Australia
- Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen City, 250000 Vietnam
| | - Yun Zhao
- School of Public Health, Curtin University, Bentley, Western Australia 6102 Australia
| | - Thi Phuong Hoa Dinh
- Faculty of Social Sciences, Behaviour and Health Education, Hanoi University of Public Health, 1A Duc Thang Street, Bac Tu Liem District, Hanoi, 10000 Vietnam
| | - Nguyen Xuan Hoai
- Faculty of Information Technology, HUTECH University, Ho Chi Minh City, 700000 Vietnam
| | - Andy Lee
- School of Public Health, Curtin University, Bentley, Western Australia 6102 Australia
| | - Colin Binns
- School of Public Health, Curtin University, Bentley, Western Australia 6102 Australia
| | - Thi Thu Ha Bui
- Faculty of Social Sciences, Behaviour and Health Education, Hanoi University of Public Health, 1A Duc Thang Street, Bac Tu Liem District, Hanoi, 10000 Vietnam
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Dinour LM, Pole A. Evaluation of Breastfeeding App Features: Content Analysis Study. JMIR Pediatr Parent 2022; 5:e37581. [PMID: 36287596 PMCID: PMC9647452 DOI: 10.2196/37581] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/20/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND While a variety of health apps abound, less than half of adults in the United States report using a health app, despite the ubiquity of smartphones among users aged 18 to 49 years. Several studies have examined the use of breastfeeding apps; however, less is known about the types of features found on these apps and what factors might influence app ratings. OBJECTIVE This paper seeks to characterize breastfeeding apps, assess whether apps with higher user ratings differ from apps with lower user ratings in their tracking and nontracking features, and analyze whether the type and number of features predict user star ratings and whether an app is higher- or lower-rated. METHODS Using a cross-sectional design, a convenience sample of breastfeeding apps was culled from the Apple App Store (iOS) and Google Play Store (Android). Content analysis of the apps (N=82) was conducted using a schema of 87 items, which was then compiled into 9 topical indices for breastfeeding, bottle feeding, solid foods, infant health, infant care, technical characteristics, informatics, informational characteristics, and interactivity. Analysis consisted of descriptive statistics, the Mann-Whitney U test, and Spearman rank correlations. Linear regression and binary logistic regression analyses were conducted to determine which features predicted user star ratings. RESULTS On average, users rated breastfeeding apps 4.4 of 5 stars. Two-thirds of apps (n=54) were higher rated (≥4.5 stars), and one-third (n=28) were lower rated (<4.5 stars). Higher-rated apps offered more tracking features for breastfeeding, bottle feeding, solid foods, infant health, and infant care than lower-rated apps. The breastfeeding, solid-food, and technical indices explained 17% of user star ratings. For each additional breastfeeding and solid-food feature, we can expect to see a 27% and 35% increase, respectively, in user star ratings. Additionally, as the number of solid-food features increased, the odds that the app is higher rated increased 1.58 times. CONCLUSIONS Our findings suggest user ratings are driven in part by tracking features, specifically those related to breastfeeding and solid foods. The proliferation of mobile health apps offers opportunities for parents and caregivers to track behaviors associated with infant feeding and other health metrics in a dynamic, detailed, and comprehensive manner. Hence, breastfeeding apps have the potential to promote and support breastfeeding among users.
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Affiliation(s)
- Lauren M Dinour
- Department of Nutrition and Food Studies, College of Education and Human Services, Montclair State University, Montclair, NJ, United States
| | - Antoinette Pole
- Department of Political Science and Law, College of Humanities and Social Sciences, Montclair State University, Montclair, NJ, United States
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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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Jibb L, Amoako E, Heisey M, Ren L, Grundy Q. Data handling practices and commercial features of apps related to children: a scoping review of content analyses. Arch Dis Child 2022; 107:665-673. [PMID: 35144936 PMCID: PMC9209675 DOI: 10.1136/archdischild-2021-323292] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/21/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Child interaction (including via parent proxy) with mobile apps is common, generating concern about children's privacy and vulnerability to advertising and other commercial interests. Researchers have conducted numerous app content evaluations, but there is less attention to data sharing or commercial practices. OBJECTIVE This scoping review of commercial app evaluation studies describes the nature of such evaluations, including assessments of data privacy, data security and app-based advertising. METHODS We searched Scopus, PubMed, Embase and ACM Digital Library (2005-2020). We included studies that evaluated the properties of apps available through commercial app stores and targeted children, parents of a child (0-18 years) or expectant parents. Data extracted and synthesised were study and app user characteristics, and app privacy, data sharing, security, advertisement and in-app purchase elements. RESULTS We included 34 studies; less than half (n=15; 44.1%) evaluated data privacy and security elements and half (n=17; 50.0%) assessed app commercial features. Common issues included frequent data sharing or lax security measures, including permission requests and third-party data transmissions. In-app purchase options and advertisements were common and involved manipulative delivery methods and content that is potentially harmful to child health. CONCLUSIONS Research related to the data handling and the commercial features of apps that may transmit children's data is preliminary and has not kept pace with the rapid expansion and evolution of mobile app development. Critical examinations of these app aspects are needed to elucidate risks and inform regulations aimed at protecting children's privacy and well-being.
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Affiliation(s)
- Lindsay Jibb
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada .,Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Elsie Amoako
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Melissa Heisey
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Lily Ren
- Lane Medical Library and Knowledge Management Center, Stanford University, Stanford, California, USA
| | - Quinn Grundy
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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Ali S. Almohanna A, Than Win K, Meedya S, Vlahu-Gjorgievska E. Design and content validation of an instrument measuring user perception of the persuasive design principles in a breastfeeding mHealth app: A modified Delphi study. Int J Med Inform 2022; 164:104789. [DOI: 10.1016/j.ijmedinf.2022.104789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/31/2022] [Accepted: 04/28/2022] [Indexed: 11/24/2022]
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12
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Jawad D, Cheng H, Wen LM, Rissel C, Baur L, Mihrshahi S, Taki S. Interactivity, Quality, and Content of Websites Promoting Health Behaviours during Infancy: A six-year update of the Systematic Assessment (Preprint). J Med Internet Res 2022; 24:e38641. [DOI: 10.2196/38641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/03/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
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Brown JM, Franco-Arellano B, Froome H, Siddiqi A, Mahmood A, Arcand J. The Content, Quality, and Behavior Change Techniques in Nutrition-Themed Mobile Apps for Children in Canada: App Review and Evaluation Study. JMIR Mhealth Uhealth 2022; 10:e31537. [PMID: 35171100 PMCID: PMC8892278 DOI: 10.2196/31537] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/04/2021] [Accepted: 12/21/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Children increasingly use mobile apps. Strategies to increase child engagement with apps include the use of gamification and images that incite fun and interaction, such as food. However, the foods and beverages that children are exposed to while using apps are unknown and may vary by app type. OBJECTIVE The aim of this study is to identify the app content (ie, types of foods and beverages) included in nutrition-themed apps intended for children, to assess the use of game-like features, and to examine app characteristics such as overall quality and behavior change techniques (BCTs). METHODS This analysis used a cross-sectional database of nutrition-themed apps intended for children (≤12 years), collected between May 2018 and June 2019 from the Apple App Store and Google Play Store (n=259). Apps were classified into four types: food games or nongames that included didactic nutrition guides, habit trackers, and other. Food and beverages were identified in apps and classified into 16 food categories, as recommended (8/16, 50%) and as not recommended (8/16, 50%) by dietary guidelines, and quantified by app type. Binomial logistic regression assessed whether game apps were associated with foods and beverages not recommended by guidelines. App quality, overall and by subscales, was determined using the Mobile App Rating Scale. The BCT Taxonomy was used to classify the different behavioral techniques that were identified in a subsample of apps (124/259, 47.9%). RESULTS A total of 259 apps displayed a median of 6 (IQR 3) foods and beverages. Moreover, 62.5% (162/259) of apps were classified as food games, 27.4% (71/259) as didactic nutrition guides, 6.6% (17/259) as habit trackers, and 3.5% (9/259) as other. Most apps (198/259, 76.4%) displayed at least one food or beverage that was not recommended by the dietary guidelines. Food game apps were almost 3 times more likely to display food and beverages not recommended by the guidelines compared with nongame apps (β=2.8; P<.001). The overall app quality was moderate, with a median Mobile App Rating Scale score of 3.6 (IQR 0.7). Functionality was the subscale with the highest score (median 4, IQR 0.3). Nutrition guides were more likely to be educational and contain informative content on healthy eating (score 3.7), compared with the other app types, although they also scored significantly lower in engagement (score 2.3). Most apps (105/124, 84.7%) displayed at least one BCT, with the most common BCT being information about health consequences. CONCLUSIONS Findings suggest nutrition-themed apps intended for children displayed food and beverage content not recommended by dietary guidelines, with gaming apps more likely to display not recommended foods than their nongame counterparts. Many apps have a moderate app quality, and the use of consequences (instead of rewards) was the most common BCT.
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Affiliation(s)
| | | | - Hannah Froome
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - Amina Siddiqi
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - Amina Mahmood
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - JoAnne Arcand
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
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Diaz-Skeete YM, McQuaid D, Akinosun AS, Ekerete I, Carragher N, Carragher L. Analysis of Apps With a Medication List Functionality for Older Adults With Heart Failure Using the Mobile App Rating Scale and the IMS Institute for Healthcare Informatics Functionality Score: Evaluation Study. JMIR Mhealth Uhealth 2021; 9:e30674. [PMID: 34726613 PMCID: PMC8596242 DOI: 10.2196/30674] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/08/2021] [Accepted: 07/14/2021] [Indexed: 12/21/2022] Open
Abstract
Background Managing the care of older adults with heart failure (HF) largely centers on medication management. Because of frequent medication or dosing changes, an app that supports these older adults in keeping an up-to-date list of medications could be advantageous. During the COVID-19 pandemic, HF outpatient consultations are taking place virtually or by telephone. An app with the capability to share a patient’s medication list with health care professionals before consultation could support clinical efficiency, for example, by reducing consultation time. However, the influence of apps on maintaining an up-to-date medication history for older adults with HF in Ireland remains largely unexplored. Objective The aims of this review are twofold: to review apps with a medication list functionality and to assess the quality of the apps included in the review using the Mobile App Rating Scale (MARS) and the IMS Institute for Healthcare Informatics functionality scale. Methods A systematic search of apps was conducted in June 2019 using the Google Play Store and iTunes App Store. The MARS was used independently by 4 researchers to assess the quality of the apps using an Android phone and an iPad. Apps were also evaluated using the IMS Institute for Healthcare Informatics functionality score. Results Google Play and iTunes App store searches identified 483 potential apps (292 from Google Play and 191 from iTunes App stores). A total of 6 apps (3 across both stores) met the inclusion criteria. Of the 6 apps, 4 achieved an acceptable MARS score (3/5). The Medisafe app had the highest overall MARS score (4/5), and the Medication List & Medical Records app had the lowest overall score (2.5/5). On average, the apps had 8 functions based on the IMS functionality criteria (range 5-11). A total of 2 apps achieved the maximum score for number of features (11 features) according to the IMS Institute for Healthcare Informatics functionality score, and 2 scored the lowest (5 features). Peer-reviewed publications were identified for 3 of the apps. Conclusions The quality of current apps with medication list functionality varies according to their technical aspects. Most of the apps reviewed have an acceptable MARS objective quality (ie, the overall quality of an app). However, subjective quality (ie, satisfaction with the apps) was poor. Only 3 apps are based on scientific evidence and have been tested previously. A total of 2 apps featured all the IMS Institute for Healthcare Informatics functionalities, and half did not provide clear instructions on how to enter medication data, did not display vital parameter data in an easy-to-understand format, and did not guide users on how or when to take their medication.
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Affiliation(s)
| | | | | | | | - Natacha Carragher
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.,Alcohol, Drugs and Addictive Behaviours, Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Lucia Carragher
- NetwellCASALA Advanced Research Centre, Dundalk Institute of Technology, Dundalk, Ireland
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Woulfe F, Fadahunsi KP, Smith S, Chirambo GB, Larsson E, Henn P, Mawkin M, O' Donoghue J. Identification and Evaluation of Methodologies to Assess the Quality of Mobile Health Apps in High-, Low-, and Middle-Income Countries: Rapid Review. JMIR Mhealth Uhealth 2021; 9:e28384. [PMID: 34636737 PMCID: PMC8548973 DOI: 10.2196/28384] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/22/2021] [Accepted: 07/21/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In recent years, there has been rapid growth in the availability and use of mobile health (mHealth) apps around the world. A consensus regarding an accepted standard to assess the quality of such apps has yet to be reached. A factor that exacerbates the challenge of mHealth app quality assessment is variations in the interpretation of quality and its subdimensions. Consequently, it has become increasingly difficult for health care professionals worldwide to distinguish apps of high quality from those of lower quality. This exposes both patients and health care professionals to unnecessary risks. Despite progress, limited understanding of the contributions of researchers in low- and middle-income countries (LMICs) exists on this topic. Furthermore, the applicability of quality assessment methodologies in LMIC settings remains relatively unexplored. OBJECTIVE This rapid review aims to identify current methodologies in the literature to assess the quality of mHealth apps, understand what aspects of quality these methodologies address, determine what input has been made by authors from LMICs, and examine the applicability of such methodologies in LMICs. METHODS This review was registered with PROSPERO (International Prospective Register of Systematic Reviews). A search of PubMed, EMBASE, Web of Science, and Scopus was performed for papers related to mHealth app quality assessment methodologies, which were published in English between 2005 and 2020. By taking a rapid review approach, a thematic and descriptive analysis of the papers was performed. RESULTS Electronic database searches identified 841 papers. After the screening process, 52 papers remained for inclusion. Of the 52 papers, 5 (10%) proposed novel methodologies that could be used to evaluate mHealth apps of diverse medical areas of interest, 8 (15%) proposed methodologies that could be used to assess apps concerned with a specific medical focus, and 39 (75%) used methodologies developed by other published authors to evaluate the quality of various groups of mHealth apps. The authors in 6% (3/52) of papers were solely affiliated to institutes in LMICs. A further 15% (8/52) of papers had at least one coauthor affiliated to an institute in an LMIC. CONCLUSIONS Quality assessment of mHealth apps is complex in nature and at times subjective. Despite growing research on this topic, to date, an all-encompassing appropriate means for evaluating the quality of mHealth apps does not exist. There has been engagement with authors affiliated to institutes across LMICs; however, limited consideration of current generic methodologies for application in LMIC settings has been identified. TRIAL REGISTRATION PROSPERO CRD42020205149; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=205149.
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Affiliation(s)
- Fionn Woulfe
- School of Medicine, University College Cork, Cork, Ireland
| | - Kayode Philip Fadahunsi
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Simon Smith
- School of Medicine, University College Cork, Cork, Ireland
| | | | - Emma Larsson
- Ashford and St Peter's Hospitals NHS Trust, Chertsey, United Kingdom
| | - Patrick Henn
- Assert Centre, College of Medicine & Health, University College Cork, Cork, Ireland
| | - Mala Mawkin
- School of Medicine, Imperial College London, London, United Kingdom
| | - John O' Donoghue
- Malawi eHealth Research Centre, University College Cork, College Road, Cork, Ireland
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Chen R, Santo K, Wong G, Sohn W, Spallek H, Chow C, Irving M. Mobile Apps for Dental Caries Prevention: Systematic Search and Quality Evaluation. JMIR Mhealth Uhealth 2021; 9:e19958. [PMID: 33439141 PMCID: PMC7840287 DOI: 10.2196/19958] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 08/10/2020] [Accepted: 08/11/2020] [Indexed: 12/23/2022] Open
Abstract
Background Dental caries is the most common multifactorial oral disease; it affects 60% to 90% of the global population. Dental caries is highly preventable through prevention behaviors aimed at improving oral hygiene, adequate fluoride usage, and dietary intake. Mobile apps have the potential to support patients with dental caries; however, little is known about the availability, target audience, quality, and features of these apps. Objective This review aims to systematically examine dental caries prevention apps; to describe their content, availability, target audience, and features; and to assess their quality. Methods We systematically identified and evaluated apps in a process paralleling a systematic review. This included a search strategy using search terms; an eligibility assessment using inclusion and exclusion criteria focused on accessibility and dental caries self-management behaviors, including oral hygiene, dietary intake, and fluoride usage; data extraction on app characteristics, including app store metrics; prevention behavior categorization; feature identification and description; a quality appraisal of all apps using the validated Mobile App Rating Scale (MARS) assessment tool; and data comparison and analysis. Results Using our search strategy, we retrieved 562 apps from the Google Play Store and iTunes available in Australia. Of these, 7.1% (40/562) of the apps fit our eligibility criteria, of which 55% (22/40) targeted adults, 93% (37/40) were free to download, and 65% (26/40) were recently updated. Oral hygiene was the most common dental caries prevention behavior domain, addressed in 93% (37/40) of the apps, while dietary intake was addressed in 45% (18/40) of the apps and fluoride usage was addressed in 42% (17/40) of the apps. Overall, 50% (20/40) of the apps addressed only 1 behavior, and 38% (15/40) of the apps addressed all 3 behaviors. The mean MARS score was 2.9 (SD 0.7; range 1.8-4.4), with 45% (18/40) of the apps categorized as high quality, with a rating above 3.0 out of 5.0. We identified 21 distinctive features across all dental caries prevention behaviors; however, the top 5 most common features focused on oral hygiene. The highest-ranking app was the Brush DJ app, with an overall MARS score of 4.4 and with the highest number of features (n=13). We did not find any apps that adequately addressed dental caries prevention behaviors in very young children. Conclusions Apps addressing dental caries prevention commonly focus on oral hygiene and target young adults; however, many are not of high quality. These apps use a range of features to support consumer engagement, and some of these features may be helpful for specific patient populations. However, it remains unclear how effective these apps are in improving dental caries outcomes, and further evaluation is required before they are widely recommended.
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Affiliation(s)
- Rebecca Chen
- Sydney School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia.,Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia
| | - Karla Santo
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia
| | - Grace Wong
- Northern Sydney LHD, NSW Health, Sydney, Australia
| | - Woosung Sohn
- Sydney School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia
| | - Heiko Spallek
- Sydney School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia
| | - Clara Chow
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia
| | - Michelle Irving
- Sydney School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia
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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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Areemit R, Lumbiganon P, Suphakunpinyo C, Jetsrisuparb A, Sutra S, Sripanidkulchai K. A Mobile App, KhunLook, to Support Thai Parents and Caregivers With Child Health Supervision: Development, Validation, and Acceptability Study. JMIR Mhealth Uhealth 2020; 8:e15116. [PMID: 33124989 PMCID: PMC7665943 DOI: 10.2196/15116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/22/2020] [Accepted: 10/03/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND In Thailand, children born in government hospitals receive a maternal and child health handbook (MCHH). However, when a new MCHH edition is released, those with the previous editions do not have access to the updated information. A mobile app is an appealing platform to fill this gap. We developed a mobile app called "KhunLook" as an interactive electronic MCHH intended to assist parents in child health supervision. OBJECTIVE This study describes the user requirements and development of the KhunLook mobile app, validity of parents' growth assessments, and parents' evaluation of feasibility and acceptability of the app. METHODS Phase 1 was a qualitative study using individual interviews. The interview data were used to revise the prototype. In phase 2, parents were randomly assigned to assess their children's growth with the app or the MCHH. The outcomes were compared to those of the physician's assessment, and congruence was determined. In phase 3, parents evaluated the feasibility and acceptability of the app in comparison to the MCHH through a web-based survey. RESULTS Four health care providers and 8 parents participated in phase 1. Two themes were identified: (1) the mobile app potentially counters parents' infrequent use of the MCHH with accuracy, attractiveness, convenience, and simplicity, and (2) health supervision needs to be standard, up-to-date, and understandable. KhunLook was publicly launched with a family page and 7 key features: growth and nutrition, development, immunizations, oral health, reminders for the next appointment, memories, and health advice. In phase 2, 56 parents participated in the growth parameter assessments; 34 were in the App group and 22 in the MCHH group. The outcomes of the growth parameter assessments between parents and physicians in both the App and MCHH groups were not significantly different. The congruence proportions were higher in the App group for weight and head circumference, but the differences were not statistically significant. In phase 3, 356 parents from all over Thailand participated in a web-based survey. Parents rated the app feasibility as "very easy to easy" to use at higher proportions than the MCHH in all health assessment domains (growth, development, and immunizations) and ease-of-use domains with statistical significance (P<.001). The KhunLook app received a significantly higher mean score (8.59/10) than the MCHH (7.6/10) (P<.001). Most parents (317/356, 89.0%) preferred the app over MCHH. Further, 93.5% (333/356) of the parents stated that they would continue to use the app and 96.9% (345/356) would recommend others to use it. CONCLUSIONS KhunLook, a Thai mobile app for child health supervision, was developed, validated for growth assessments, and was well accepted for ease-of-use by parents. Further studies should be conducted with a large scale of users, and the impact of this app on health behaviors and health outcomes must be evaluated.
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Affiliation(s)
- Rosawan Areemit
- Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Pagakrong Lumbiganon
- Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chanyut Suphakunpinyo
- Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Arunee Jetsrisuparb
- Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sumitr Sutra
- Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kunwadee Sripanidkulchai
- Department of Computer Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
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