Background The United States is currently facing a maternal morbidity and mortality crisis, with the highest rates of any resource-rich nation. In efforts to address this, new guidelines for postpartum care suggest that mobile health (mHealth) apps can help provide complementary clinical support for new mothers during the postpartum period. However, to date no study has evaluated the quality of existing mHealth tools targeted to this time period in terms of sufficiency of maternal health information, inclusivity of people of color, and app usability. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were used to review the peripartum apps from the Apple and Google Play stores in either the Health/Fitness, Medical, or Education categories. Apps were evaluated for extent and quality of maternal health information and inclusivity of people of color using an a priori coding scheme. App usability was evaluated using the Mobile Application Rating Scale (MARS) score. Results Of the 301 apps from the Apple and Google Play stores, 25 met criteria for final evaluation. Of the 30 maternal health topics coded for, the median number addressed by apps was 19.5 (65%). Peripartum behaviors were more frequently addressed than peripartum outpatient care topics and peripartum acute health risks. The coverage of maternal health information and inclusivity of people of color in app imagery both correlated positively with the MARS usability score of the app. Only 8 apps (32%) portrayed greater than 24% images of people of color- the percent of non-white Americans according to 2019 census estimates. There was no correlation between MARS usability score and number of app users, as estimated by number of ratings for the app available on the app store. In addition, apps with evidence-based maternal health information had greater MARS engagement, information, and aesthetics scores. However, presence of evidence-based information did not correlate with greater numbers of app users. Conclusions Current commercially available peripartum apps range widely in quality. Overall current app offerings generally do not provide adequate maternal health information and are not optimally accessible to the target users in terms of inclusivity of women of color or app usability. Apps delivering evidence-based information and more usable design are more likely to meet these standards but are not more likely to be downloaded by users.

Background: The United States is currently facing a maternal morbidity and mortality crisis, with the highest rates of any resource-rich nation. In efforts to address this, new guidelines for postpartum care suggest that mobile health apps can help provide complementary clinical support for new mothers during the postpartum period. However, to date no study has evaluated existing mobile health tools targeted to this time period for sufficiency of maternal health information, inclusivity of people of color, or accessibility to users.Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were used to review the peripartum apps from the Apple and Google Play stores in either the Health/Fitness, Medical, or Education categories. Apps were then evaluated for extent and quality of maternal health information, inclusivity of people of color, and accessibility to app users.Results: Of the 301 apps from the Apple and Google Play stores, 25 met criteria for final evaluation. Of the 30 maternal health topics coded for, the median number addressed by apps was 19.5 (65%). Peripartum behaviors were more frequently addressed than peripartum outpatient care topics and peripartum acute health risks. The amount of maternal health information correlated positively with the Mobile Application Rating Scale (MARS) quality score of the app, and inclusivity of people of color in app imagery also correlated positively with the MARS quality score. Only 8 apps (32%) portrayed greater than 24% images of people of color- the percent of non-white Americans according to 2019 census estimates. There was no correlation between number of users as estimated by number of store ratings and MARS quality. In addition, apps with clinical authority had greater MARS engagement, information, aesthetics, and quality scores, but did not have greater numbers of store ratings.Conclusions: Current commercially available peripartum apps overall do not provide adequate maternal health information, are not inclusive of women of color, and are not optimally accessible to the target users. Apps authored with clinical authority and higher-quality apps, by MARS score, are more likely to meet these standards, but are not more likely to be downloaded and used.

Background: The United States is currently facing a maternal morbidity and mortality crisis, with the highest rates of any resource-rich nation. In efforts to address this, new guidelines for postpartum care suggest that mobile health apps can help provide complementary clinical support for new mothers during the postpartum period. However, to date no study has evaluated existing mobile health tools targeted to this time period for sufficiency of maternal health information, inclusivity of people of color, or accessibility to users.Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were used to review the peripartum apps from the Apple and Google Play stores in either the Health/Fitness, Medical, or Education categories. Apps were then evaluated for extent and quality of maternal health information, inclusivity of people of color, and accessibility to app users.Results: Of the 301 apps from the Apple and Google Play stores, 25 met criteria for final evaluation. Of the 30 maternal health topics coded for, the median number addressed by apps was 19.5 (65%). Peripartum behaviors were more frequently addressed than peripartum outpatient care topics and peripartum acute health risks. The amount of maternal health information correlated positively with the Mobile Application Rating Scale (MARS) quality score of the app, and inclusivity of people of color in app imagery also correlated positively with the MARS quality score. Only 8 apps (32%) portrayed greater than 24% images of people of color- the percent of non-white Americans according to 2019 census estimates. There was no correlation between number of users as estimated by number of store ratings and MARS quality. In addition, apps with clinical authority had greater MARS engagement, information, aesthetics, and quality scores, but did not have greater numbers of store ratings.Conclusions: Current commercially available peripartum apps overall do not provide adequate maternal health information, are not inclusive of women of color, and are not optimally accessible to the target users. Apps authored with clinical authority and higher-quality apps, by MARS score, are more likely to meet these standards, but are not more likely to be downloaded and used.

Background: Current scales to measure motor impairment in adults with spina bifida (SB) are limited by their complexity, variable interpretation (i.e., subjectively defined impairment levels), or inclusion of muscles groups that are not always practical to test in a clinical setting. Objectives: A novel motor impairment tool for adults with SB was evaluated for content validity. The tool uses findings from the manual muscle testing of hip flexion and knee extension to categorize individuals into four motor impairment groups. Methods: Expert feedback was obtained on the tool, and content validity was measured using Lawshe’s content validity ratio (CVR) with critical values recommended by Ayre and Scally. Data from phase 1 and phase 2 were used to revise the survey and calculate the CVR of the tool, respectively (benchmark: CVR ≥ 0.636). Results: Of the 26 experts recruited, 17 received the survey and 15 participated in either phase 1 (n = 6) or 2 (n = 11). The CVR values for each impairment group were as follows: intact strength (0.95), thoracic strength (0.90), hip flexor dominant strength (0.89), and knee extensor dominant strength (0.82). The CVR of the tool overall was 0.89. Qualitative expert feedback revealed common barriers to manual muscle testing and suggestions for improving the tool. However, experts also noted the value in preserving the simplicity of the tool. Conclusion: The high content validity, coupled with expert feedback, suggests the tool may give clinicians and researchers a practical method of classifying an individual’s extent of motor impairment.