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      Gaps and Future Challenges of Italian Apps for Pregnancy and Postnatal Care: Systematic Search on App Stores

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          Abstract

          Background

          Despite the availability of thousands of health apps worldwide, when considering those addressing children’s first 1000 days of life, most apps fail to consider the continuity between the prenatal and postnatal stages, and their joint impact on maternal and child health. The reliability, quality, and effectiveness of these apps are largely unknown, and the provided content seems questionable in terms of completeness, updating, and trustworthiness.

          Objective

          This study evaluates available Italian pregnancy and postnatal care apps to highlight the main gaps to be overcome and the resulting future challenges to be met in this mobile health–related field.

          Methods

          A systematic search was conducted on the Apple App Store and Google Play Store, and basic information was collected for all identified apps. After deduplication and further selection based on the exclusion criteria, an in-depth analysis of each app was performed by two researchers independently. A 71-item six-domain questionnaire about the desirable features of apps was used to assess information, functionalities, and technical features, while the Mobile Application Rating Scale (MARS) was employed for app quality evaluation.

          Results

          From an initial sample of 684 apps, 22 were deeply analyzed. Most apps did not fulfill the expectations, as just one achieved 50% of all desirable aspects. Postnatal care and counselling for both the mother and child was the least accomplished domain. Moreover, the quality of app information was generally rated more negatively than the quality of their functionality and esthetic features. The lacking aspects were information about methods for postpartum family planning and birth spacing (1/22, 5%) and immunization (2/22, 9%).

          Conclusions

          The identified gaps could serve as a basis for designing and implementing increasingly high-quality, targeted, and effective apps for pregnancy and postnatal health care, which provide comprehensive, reliable, and evidence-based information, as well as appropriate esthetic and functional characteristics, with relevant implications in terms of maternal and newborn health prevention and promotion.

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          Most cited references19

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          Mobile App Rating Scale: A New Tool for Assessing the Quality of Health Mobile Apps

          Background The use of mobile apps for health and well being promotion has grown exponentially in recent years. Yet, there is currently no app-quality assessment tool beyond “star”-ratings. Objective The objective of this study was to develop a reliable, multidimensional measure for trialling, classifying, and rating the quality of mobile health apps. Methods A literature search was conducted to identify articles containing explicit Web or app quality rating criteria published between January 2000 and January 2013. Existing criteria for the assessment of app quality were categorized by an expert panel to develop the new Mobile App Rating Scale (MARS) subscales, items, descriptors, and anchors. There were sixty well being apps that were randomly selected using an iTunes search for MARS rating. There were ten that were used to pilot the rating procedure, and the remaining 50 provided data on interrater reliability. Results There were 372 explicit criteria for assessing Web or app quality that were extracted from 25 published papers, conference proceedings, and Internet resources. There were five broad categories of criteria that were identified including four objective quality scales: engagement, functionality, aesthetics, and information quality; and one subjective quality scale; which were refined into the 23-item MARS. The MARS demonstrated excellent internal consistency (alpha = .90) and interrater reliability intraclass correlation coefficient (ICC = .79). Conclusions The MARS is a simple, objective, and reliable tool for classifying and assessing the quality of mobile health apps. It can also be used to provide a checklist for the design and development of new high quality health apps.
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            An Australian survey of women's use of pregnancy and parenting apps.

            There are now many pregnancy and parenting apps available on the market for both pregnancy and parenting.
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              Effects of Social Media and Mobile Health Apps on Pregnancy Care: Meta-Analysis

              Background The use of social media and mobile health (mHealth) apps has been increasing in pregnancy care. However, the effectiveness of these interventions is still unclear. Objectives We conducted a meta-analysis to examine the effectiveness of these interventions with regard to different health outcomes in pregnant and postpartum women and investigate the characteristics and components of interventions that may affect program effectiveness. Method We performed a comprehensive literature search of major electronic databases and reference sections of related reviews and eligible studies. A random effects model was used to calculate the effect size. Results Fifteen randomized controlled trial studies published in and before June 2018 that met the inclusion criteria were included in the meta-analysis. The interventions were effective in promoting maternal physical health including weight management, gestational diabetes mellitus control, and asthma control with a moderate to large effect size (d=0.72). Large effect sizes were also found for improving maternal mental health (d=0.84) and knowledge about pregnancy (d=0.80). Weight control interventions using wearable devices were more effective. Conclusion Social media and mHealth apps have the potential to be widely used in improving maternal well-being. More large-scale clinical trials focusing on different health outcomes are suggested for future studies.
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J Med Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                August 2021
                10 August 2021
                : 23
                : 8
                : e29151
                Affiliations
                [1 ] Department of Medical, Surgical and Health Sciences University of Trieste Trieste Italy
                [2 ] Quality and Accreditation Unit Friuli Centrale Healthcare University Trust Udine Italy
                [3 ] Innovation and Complex Systems Department Area Science Park Trieste Italy
                [4 ] Clinical Engineering, ICT and Procurement Institute for Maternal and Child Health, IRCCS Burlo Garofolo Trieste Italy
                [5 ] Clinical Management Staff Institute for Maternal and Child Health, IRCCS Burlo Garofolo Trieste Italy
                [6 ] Unit of Fetal Medicine and Prenatal Diagnosis Institute for Maternal and Child Health, IRCCS Burlo Garofolo Trieste Italy
                Author notes
                Corresponding Author: Laura Brunelli laura.brunelli@ 123456phd.units.it
                Author information
                https://orcid.org/0000-0002-5475-0021
                https://orcid.org/0000-0002-8486-4062
                https://orcid.org/0000-0003-1171-9312
                https://orcid.org/0000-0002-7172-6744
                https://orcid.org/0000-0002-4261-4858
                https://orcid.org/0000-0001-8890-1791
                https://orcid.org/0000-0001-6409-573X
                https://orcid.org/0000-0003-4740-2915
                https://orcid.org/0000-0002-7521-3380
                https://orcid.org/0000-0003-1965-3477
                https://orcid.org/0000-0002-9080-3848
                Article
                v23i8e29151
                10.2196/29151
                8386367
                34383668
                cf285981-2d96-4979-93e4-84cc20bc634c
                ©Laura Brunelli, Chiara De Vita, Fabrizio Cenedese, Michela Cinello, Marta Paris, Francesca Samogizio, Anja Starec, Michele Bava, Margherita Dal Cin, Sara Zanchiello, Tamara Stampalija. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 10.08.2021.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 1 April 2021
                : 23 April 2021
                : 10 May 2021
                : 24 May 2021
                Categories
                Original Paper
                Original Paper

                Medicine
                pregnancy,postnatal care,app,mhealth,mobile health,newborn
                Medicine
                pregnancy, postnatal care, app, mhealth, mobile health, newborn

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