Previously submitted to: JMIR Formative Research (no longer under consideration since Jun 16, 2026)
Date Submitted: Dec 18, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A Breastfeeding-Supportive Mobile Health Application for African American and Black Mothers: Design and Development
ABSTRACT
Background:
Breastfeeding exclusively through 6 months, with addition of complementary foods and continued breastfeeding through 2 years is recommended by public health organizations for its many health benefits. However, refractory racial breastfeeding inequities persist, creating an urgent need to identify new ways of engaging and supporting breastfeeding among African American and Black (AA/B) women and families.
Objective:
To overcome this gap, we developed a mobile health application (MHealth app) designed to support breastfeeding for AA/B women and families by addressing root causes of racial inequities.
Methods:
We repurposed the 8-phase ADAPT-ITT framework to describe the stepwise process of MHealth app development using human centered design principles. In phases 1 (needs assessment) and 2 (decision) we identified need, features and content via community partner interviews and designed a high-fidelity wireframe prototype. In phases 3 (adaptation), 4 (production), 5 (topical experts) and 6 (integration), the clickable wireframe app prototype was evaluated and tested by end users including AA/B mothers, fathers/partners, lay and expert lactation providers using multiple modalities including cognitive walk-throughs, focus groups and structured interviews with responsive revision of the app. In phases 7 (training) and 8 (testing), the wireframe app prototype underwent a randomized controlled pilot (NCT06378320) with AA/B mothers.
Results:
A functional clickable prototype app to support breastfeeding for AA/B mothers and families was developed, iteratively revised with end user input and pilot tested.
Conclusions:
In future research a fully functional app, with engagement features including texting, will undergo clinical trial for efficacy with respect to improving breastfeeding outcomes. Clinical Trial: NCT06378320
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.