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      The Rise of Pregnancy Apps and the Implications for Culturally and Linguistically Diverse Women: Narrative Review

      review-article
      , BA (Hons), DEA, PhD 1 , , , BSC, MBBS, FRANZCOG 2 , , BA, MA, MA (TESOL), PhD 3 , , BA (Hons), DPhil 1 , , MD, MBBS, BMedSc, FANZCA 4
      (Reviewer), (Reviewer), (Reviewer)
      JMIR mHealth and uHealth
      JMIR Publications
      culture, emigrants and immigrants, health communication, information-seeking behavior, literacy, maternal health, mHealth, mobile phone, pregnancy, self-care, vulnerable populations

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          Abstract

          Background

          Pregnancy apps are a booming global industry, with most pregnant women in high-income countries now using them. From the perspective of health care and health information provision, this is both encouraging and unsettling; the demand indicates a clear direction for the development of future resources, but it also underscores the importance of processes ensuring access, reliability, and quality control.

          Objective

          This review provides an overview of current literature on pregnancy apps and aims at describing (1) the ways in which apps are used by women, in general, and by those of a culturally and linguistically diverse (CALD) background; (2) the utility and quality of information provided; and (3) areas where more research, development, and oversight are needed.

          Methods

          We chose a narrative review methodology for the study and performed a structured literature search including studies published between 2012 and 2017. Searches were performed using MEDLINE, EMBASE, and CINAHL databases. Studies were identified for inclusion using two separate search criteria and strategies: (1) studies on pregnancy apps and pregnant women’s use of these apps and (2) studies on CALD pregnant women and their use of technology for accessing information on and services for pregnancy. Overall, we selected 38 studies.

          Results

          We found that pregnancy apps were principally used to access pregnancy health and fetal development information. Data storage capability, Web-based features or personalized tools, and social media features were also popular app features sought by women. Lower rates of the pregnancy app uptake were indicated among lower-income and non-English-speaking women. Preliminary evidence indicates that a combination of technological, health literacy, and language issues may result in lower uptake of pregnancy apps by these groups; however, further investigation is required. A marked limitation of the health app industry is lack of regulation in a commercially dominated field, making it difficult for users to assess the reliability of the information being presented. Health professionals and users alike indicate that given the choice, they would prefer using pregnancy apps that are relevant to their local health care context and come from a trusted source. Evidence indicates a need for greater health professional and institutional engagement in the app development, as well as awareness of and guidance for women’s use of these resources.

          Conclusions

          This is the first review of pregnancy app use, types of information provided, and features preferred by pregnant women in general and by those of a CALD background in particular. It indicates the demand for access to accurate information that is relevant to users, their community, and their associated health services. Given the popularity of pregnancy apps, such apps have enormous potential to be used for the provision of accurate, evidence-based health information.

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          Most cited references57

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          Maternal healthcare in migrants: a systematic review.

          Pregnancy is a period of increased vulnerability for migrant women, and access to healthcare, use and quality of care provided during this period are important aspects to characterize the support provided to this population. A systematic review of the scientific literature contained in the MEDLINE and SCOPUS databases was carried out, searching for population based studies published between 1990 and 2012 and reporting on maternal healthcare in immigrant populations. A total of 854 articles were retrieved and 30 publications met the inclusion criteria, being included in the final evaluation. The majority of studies point to a higher health risk profile in immigrants, with an increased incidence of co-morbidity in some populations, reduced access to health facilities particularly in illegal immigrants, poor communication between women and caregivers, a lower rate of obstetrical interventions, a higher incidence of stillbirth and early neonatal death, an increased risk of maternal death, and a higher incidence of postpartum depression. Incidences vary widely among different population groups. Some migrant populations are at a higher risk of serious complications during pregnancy, for reasons that include reduced access and use of healthcare facilities, as well as less optimal care, resulting in a higher incidence of adverse outcomes. Tackling these problems and achieving equality of care for all is a challenging aim for public healthcare services.
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            The use and value of digital media for information about pregnancy and early motherhood: a focus group study

            Background Many women in countries in the global North access digital media information sources during pregnancy and the early years of motherhood. These include websites, blogs, online discussion forums, apps and social media platforms. Little previous research has sought to investigate in detail how women use the diverse range of digital media now available to them and what types of information they value. A qualitative study using focus groups was conducted to address these issues. Methods Four focus groups were held in Sydney, Australia, including a total of 36 women who were either pregnant or had given birth in the previous three years. The participants were asked to talk about the types of digital media they used for pregnancy and parenting purposes, why they used them and in what ways they found them useful or helpful (or not). Group discussions were transcribed and thematically analysed, identifying the dominant information characteristics identified by women as valuable and useful. Results Nine characteristics emerged from the focus group discussions as most important to women: information that was: 1) immediate; 2) regular; 3) detailed; 4) entertaining; 5) customised; 6) practical; 7) professional; 8) reassuring; and 9) unbiased. These characteristics were valued for different purposes and needs. Digital media provided women with details when they most needed them or at times when they had opportunities to access them. The study showed that women value apps or digital platforms that are multi-functional. The findings revealed the importance of using digital information for establishing and maintaining social connections and intimate relationships with other mothers. However, participants also highly valued expert advice and expressed the desire for greater and more ready access to information and support offered by healthcare professionals. Conclusions Pregnant women and those with young children place a high value on the information and support they receive from and sharing using online sources and apps. They are accustomed to ready and immediate access to information using digital technologies and want better access to that offered by professionals. Recognising and finding ways to meet these needs should be included in planning healthcare provision and support for this group. Further research with women from socioeconomically disadvantaged backgrounds and non-urban locations is required to identify whether they have different information needs and values from the women who were included in the study reported here.
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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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                Author and article information

                Contributors
                Journal
                JMIR Mhealth Uhealth
                JMIR Mhealth Uhealth
                JMU
                JMIR mHealth and uHealth
                JMIR Publications (Toronto, Canada )
                2291-5222
                November 2018
                16 November 2018
                : 6
                : 11
                : e189
                Affiliations
                [1 ] Research Unit for Multilingualism and Cross-Cultural Communication University of Melbourne Parkville Australia
                [2 ] Western Health Sunshine Hospital St Albans Australia
                [3 ] Department of Medical Education University of Melbourne Parkville Australia
                [4 ] Anaesthesia, Perioperative and Pain Medicine Unit Melbourne Medical School University of Melbourne Parkville Australia
                Author notes
                Corresponding Author: Jo-anne Patricia Hughson hughson@ 123456unimelb.edu.au
                Author information
                http://orcid.org/0000-0002-7156-5311
                http://orcid.org/0000-0003-2462-7492
                http://orcid.org/0000-0002-3973-818X
                http://orcid.org/0000-0003-1335-4273
                http://orcid.org/0000-0002-6479-1310
                Article
                v6i11e189
                10.2196/mhealth.9119
                6269626
                30446483
                df1e0ae8-8392-4056-bfc2-5001cb1d8c1a
                ©Jo-anne Patricia Hughson, J Oliver Daly, Robyn Woodward-Kron, John Hajek, David Story. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 16.11.2018.

                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 JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/.as well as this copyright and license information must be included.

                History
                : 5 October 2017
                : 23 November 2017
                : 10 February 2018
                : 18 July 2018
                Categories
                Review
                Review

                culture,emigrants and immigrants,health communication,information-seeking behavior,literacy,maternal health,mhealth,mobile phone,pregnancy,self-care,vulnerable populations

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