JMIR Publications

ABSTRACT

Background:

There is a widely acknowledged global need for more research on reproductive health. However, several factors including high costs and considerable effort impede collection of the necessary data, especially in less accessible and lower income populations. Burgeoning ownership of smartphones and the growing use of menstrual tracking apps may present an opportunity to conduct reproductive health research with fewer impediments than those associated with conventional survey methods.

Objective:

The main objective was to ascertain the potential usefulness and limitations of an app-based survey for reproductive health research.

Methods:

In each of three countries, we evaluated questionnaire responses (1) from current users of a menstrual tracking app (Clue) and (2) from participants recruited by local commercial services that used conventional survey research methods. We compared these responses to published comparable data collected from large nationally representative benchmark samples.

Results:

In each of the countries, neither the app sample nor the conventional method sample emerged as the consistently closer match to the distributions of demographic attributes and patterns of contraceptive use observed in the respective benchmark sample. Despite efforts to obtain representative samples, the conventional method samples sometimes over- and other times under-represented demographic and contraceptive-use subgroups compared to the benchmark samples (for example, underrepresentation of married persons in the US and overrepresentation of rural residents in India). In all three countries the app users were younger, more educated, more likely to be urban residents, and more likely to use non-hormonal rather than hormonal contraceptive methods as compared to the respective national benchmarks. App users, compared to the conventional samples, were more comfortable talking about their menstrual periods with others, suggesting that app users may be more comfortable truthfully responding to reproductive health questions. These demographic and attitudinal consistencies across countries in the app’s user base also lends strength to cross-country comparisons of survey findings of an app’s users.

Conclusions:

Given a sufficiently large user base, menstrual tracking apps such as Clue can provide a quick, scalable and cost-effective method for collecting data across a wide variety of settings and countries. Although there is a gender divide with regards to access to technology, as this gap narrows, more women will benefit from increased digitisation and access to mHealth. Consumer menstrual tracking apps can be a viable modality to strengthen sexual health and reproductive health research.