JMIR Publications

ABSTRACT

Background:

A healthy start to life is crucial for improving life-long health outcomes. Women are increasingly turning to mobile health platforms to receive health information and support in pregnancy yet their content varies.

Objective:

To identify and assess the ongoing popularity of the top 10 pregnancy apps in Australia using validated tools, over a two year period.

Methods:

A systematic review to identify apps was performed using PRISMA-P guidelines. A Google play search used subject terms ‘pregnancy’, ‘parenting’ and ‘childbirth’. An iTunes search used alternative categories ‘medical’ and ‘health and fitness. The top 250 apps from each store were cross referenced, we then selected the top 100 found in both Google Play and iTunes and screened for eligibility. Apps were included that provided health information or advice for pregnancy. Excluded apps focused on non-health information e.g. baby names. The top 10 pregnancy apps were assessed using the Mobile App Rating Scale (MARS). A comparative analysis was conducted at two time points over two years to assess the ongoing popularity of the apps. The MARS median was compared to the download and star rating data collected from iTunes and Google Play in 2017 and 2019. Health behaviours including breastfeeding, healthy pregnancy weight and awareness of fetal movements were reviewed for perceived impact on the user’s knowledge, attitudes, and behavioural change intentions using the Coventry, Aberdeen and London-Refined taxonomy (CALO-RE).

Results:

A total of 2,052 free apps were screened for eligibility, 1,397 were excluded, 655 were reviewed and scored. The top 10 apps were selected using download numbers and star ratings. All 10 apps were suboptimal in quality, practical and functionality features. It was not possible to identify a primary purpose for all apps and there was overlap in purpose for many. The median overall MARS app quality score across all 10 apps was 3.005 (range 1.97-4.4) in 2017 and 3.40 (range 2.27-4.44) in 2019. A minority of apps scored well for perceived impact on health behaviour or behavioural intention using the CALO-RE 40 item taxonomy. Three apps used Behaviour Change Techniques (BCTs) for breastfeeding, mean 5.4 (range 2-11). Basic diet and exercise information was seen in all apps with a focus primarily on ‘fitness’ rather than weight management, a mean of 4.4 (range 2-12) BCTs were used. Maternal awareness of fetal movement had a mean of 5.3 (range 2-8) but lacked strategies to successfully support behaviour change.

Conclusions:

This review provides valuable information to clinicians and consumers about the quality of apps currently available for pregnancy in Australia. Further consideration is needed in regards to the regulation of information and the potential opportunity to incorporate BCTs to improve maternal and fetal outcomes.