JMIR Publications

ABSTRACT

Background:

In Thailand, each child born in a government hospital will receive a Maternal and Child Health Handbook (MCHH). But when a new MCHH edition is released, those who have already received a previous edition do not have access to the updated information causing potential conflicting messages and standards of health evaluations. A mobile application is an appealing platform for development of an interactive electronic maternal and child book. We developed “KhunLook”, a mobile application intended to assist parents in child health supervision. As of June 2019, KhunLook has been downloaded by more than 250,000 people.

Objective:

This study describes the 1. Development of KhunLook and 2. Evaluation of the feasibility, acceptability by parents and physicians, and congruence between parents and physician assessments.

Methods:

Phase 1) Describes the development of KhunLook, a qualitative study using individual interviews was carried out, data was used to revise the prototype. Phase 2) Physicians were asked to use KhunLook for 1 week to evaluate their patients. Parents were randomly assigned, by topic to assess their child’s growth, development, nutrition and immunizations by using KhunLook or the MCHH, then a physician assessed their child. Subsequently, all participants answered a questionnaire.

Results:

Phase 1) Four health care providers and 8 parents participated. The majority were female. The mean age for health care providers and parents was 49 and 32 years, respectively. Two themes were identified 1: Mobile Application potentially counters parent’s infrequent use of the MCHH book through accuracy, attractiveness, convenience and simplicity and 2) Health supervision needs to be standard, up to date, and understandable. Phase 2) Seventeen physicians and 56 parents participated. 70% of physicians were female with a mean age of 31.7 years old, and 79% of parents were female with a mean age of 33.8 years old. Physicians rated the mobile application as “Very good - Good” for content accuracy (94.1%) and comprehensibility (82.4 -100%) in all four domains. Physicians and parents rated KhunLook mobile application to be “Very easy - Easy” at higher proportions than the MCHH for all domains with statistical significance, except for the physician’s rating of appropriateness of content, which was equal. KhunLook was given a higher mean score than the MCHH with statistical significance. Most physicians (82.4%) and parents (89.1%) preferred to use KhunLook rather than the MCHH, and all of them will recommend it for others to use. There were no statistically significant differences in the proportions of accurate child health status assessments between physicians and parents who used the mobile application or MCHH, except for head circumference which was more accurate in iOS Users (P= 0.03).

Conclusions:

KhunLook, a Thai mobile application for child health supervision is well accepted for convenience and accuracy by both parents and physicians. Continuous evaluation and refinement of the application along with content update and promotion of wider use is in progress.