JMIR Publications

ABSTRACT

Background:

Parents of preterm infants increasingly use their smartphone to search for health information. In a recent review, websites targeted towards parents with infants in the Neonatal Intensive Care Unit (NICU) were found to have poor to moderate quality educational material; however, there is a dearth of literature regarding mobile applications (apps) for NICU parents.

Objective:

To identify and evaluate apps targeting parents of infants in the NICU for quality of information, usability, and credibility.

Methods:

We systematically searched Apple App Store and Google Play using 49 key terms (e.g. “preterm infant”) on July 26-August 18, 2017. English apps targeting NICU parents that cost less than $20 were included. Apps for healthcare professionals, e-books/magazines, or non-relevant results were excluded. Three tools were used for evaluation: Mobile Application Rating Scale (MARS) to measure quality; Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-AV) to measure the app’s content usability; and Trust it or Trash It to measure credibility.

Results:

Initial search yielded 6579 apps, with 49 apps eligible after title and description screening. A total of 27 apps met the eligibility criteria with 9 apps available in both app stores; of those, the app with the most recent update date was chosen to be included in the analysis. Thus, 18 unique apps were included for final analysis. Using MARS, seven apps (38.8%) received a good score on overall quality (i.e. 4.0 out of 5.0), with none receiving an excellent score. Eight apps (44.4%) received a PEMAT-AV score between 51-75% on the understandability subscale and eight apps (44.4%) received 76%-100% on the actionability subscale. Trust It or Trash It deemed 13 apps (72.2%) as ‘trash’ for reasons including no identification of sources or lack of current information, with only 5 (27.7%) deemed trustworthy. Reviewer’s expert evaluation found 16 apps contained content that matched information provided by multiple sources however, most apps did not meet other objective measurement items to support credibility. When comparing the MARS overall quality and subjective quality scores with trustworthiness of apps, there was no statistically significant difference. A statistically significant difference was found between the two MARS quality scores, indicating that on average apps were ranked significantly lower on subjective quality compared to overall quality measures.

Conclusions:

This evaluation revealed that of the available apps targeting NICU parents, less than half should be considered as acceptable educational material. Over two-thirds of the apps were found to have issues regarding credibility and just over a quarter were considered good quality. The apps currently available for NICU parents remain lacking and of concern in terms of quality and credibility. Clinical Trial: Richardson B, Dol J, Rutledge K, et al. Evaluation of smart-device applications targeted to parents of infants in the neonatal intensive care unit: a systematic review. PROSPERO. http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017072548. Published 2017. Accessed June 5, 2018.