Assessing the Content and Quality of Digital Tools for Managing Gestational Weight Gain: Systematic Search and Evaluation

Abstract

Background Digital health resources have the potential to assist women in optimizing gestational weight gain (GWG) during pregnancy to improve maternal health outcomes. Objective In this study, we aimed to evaluate the quality and behavior change potential of publicly available digital tools (websites and apps) that facilitate GWG tracking. Methods Digital tools were identified using key search terms across website search engines and app stores and evaluated using the Mobile App Rating Scale, the App Behavior Change Scale, as well as criteria to evaluate the rigor and safety of GWG information. Results Overall, 1085 tools were screened for inclusion (162 websites and 923 apps), and 19 were deemed eligible. The mean Mobile App Rating Scale quality score was 3.31 (SD 0.53) out of 5, ranging from 2.26 to 4.39, and the mean App Behavior Change Scale score was 6 (SD 3.4) out of 21, ranging from 19 to 0. Of the 19 items used to evaluate rigor of GWG advice, most tools (n=11, 57.9%) contained ≤3 items. Conclusions This review emphasizes the substantial limitations in current digital resources promoting the monitoring and optimization of GWG. Most tools were of low quality, had minimal behavior change potential, and were potentially unsafe, with minimal linkage to evidence-based information or partnership with health care.

OptimalMe Program: A Mixed Method Investigation into the Engagement and Acceptability of a Preconception Digital Health Lifestyle Intervention with Individual Coaching for Women’s Health and Behaviour Change

“…Finally, the desire for a digital platform that delivers push notifications underscores the importance of platform accessibility and timely reminders to sustain user engagement and involvement in behaviour change objectives. The suggested improvements align with features and tools commonly found in popular commercially developed mobile apps for the perinatal period [ 40 ]. High quality commercially developed apps appear to be highly engaging and acceptable to women during their reproductive journey; however, health and lifestyle information or behaviour change tools within them are often of poor quality [ 40 ].…”

“…The suggested improvements align with features and tools commonly found in popular commercially developed mobile apps for the perinatal period [ 40 ]. High quality commercially developed apps appear to be highly engaging and acceptable to women during their reproductive journey; however, health and lifestyle information or behaviour change tools within them are often of poor quality [ 40 ]. Therefore, partnerships among consumers, researchers, designers, developers, policy makers, and the health care sector may present an opportunity to provide women with co-designed intervention resources that balance the valued consumer attributes of apps, alongside evidence-based information and effective behaviour change techniques.…”

Safety considerations for assessing the quality of apps used during pregnancy: A scoping review

“… 45 – 47 Yet increasingly, regulatory and safety concern issues have been raised, 10 , 12 together with several seminal reviews highlighting a lack of evidence-based health information and ability to change health behaviour in apps that have been evaluated across the spectrum of pregnancy and associated conditions. 6 , 13 – 20 In the absence of frameworks that measure safety and little synthesised evidence of app safety concerns, to the best of our knowledge, our review is the first to thematically analyse reviews of pregnancy apps and describe issues raised related to safety. Overall, we found 20 minor themes related to safety which were grouped into five major themes comprising information, transparency, credibility, privacy and security, and app tailoring and responsiveness.…”

“…Previous reviews of commercially available pregnancy apps report their prolific use and popularity, reflected in total downloads as well as generally high consumer ratings on app stores for those that are most widely used. 20 Despite this and women of reproductive age reporting their strong preferences to receive trusted health information from a variety of sources including health technologies, 49 most recent reviews in the field report the content of mHealth apps lack rigour and evidence, 36 , 44 credible expert involvement, and ability to improve behaviour on detailed evaluation, translating to increased potential for communication of harmful information to the consumer. 16 ,17, 20 , 50 This is reflected in results found here, showing low-quality scores across the majority of reviews and limited inclusion of BCTs within apps.…”

“… 10 , 12 This includes several recent reviews highlighting inaccurate content, lack of appropriate screening processes, lack of expert involvement, poor or unclear evidence base of content, and poor validation. 6 , 13 – 20 This may increase the risk of misinformation and subsequent consequences including injury, complications, and/or adverse pregnancy outcomes for both the mother and child. 17 Whilst a variety of tools and frameworks, including the Mobile Application Rating Scale (MARS); 21 Coventry, Aberdeen, and London-Refined (CALO-RE) framework; 22 and APPLICATIONS (app comprehensiveness, price, privacy, literature used, in-app purchases, connectivity, advertisements, text search field, images/videos, other special features, navigation ease, and subjective presentation) scoring system, 23 are available to evaluate mHealth apps, they predominantly assess engagement, functionality, aesthetics, and information quality.…”