Background Physical activity during pregnancy is associated with several health benefits for the mother and child. However, very few women participate in regular physical activity during pregnancy. eHealth platforms (internet and mobile apps) have become an important information source for pregnant women. Although the use of pregnancy-related apps has significantly increased among pregnant women, very little is known about their theoretical underpinnings, including their utilization of behavior change techniques (BCTs). This is despite research suggesting that inclusion of BCTs in eHealth interventions are important for promoting healthy behaviors, including physical activity. Objective The aim of this study was to conduct a systematic search and content analysis of app quality, features, and the presence of BCTs in apps designed to promote physical activity among pregnant women. Methods A systematic search in the Australian App Store and Google Play store using search terms relating to exercise and pregnancy was performed. App quality and features were assessed using the 19-item Mobile App Rating Scale (MARS), and a taxonomy of BCTs was used to determine the presence of BCTs (26 items). BCTs previously demonstrating efficacy in behavior changes during pregnancy were also identified from a literature review. Spearman correlations were used to investigate the relationships between app quality, app features, and number of BCTs identified. Results Nineteen exercise apps were deemed eligible for this review and they were accessed via Google Play (n=13) or App Store (n=6). The MARS overall quality scores indicated moderate app quality (mean 3.5 [SD 0.52]). Functionality was the highest scoring MARS domain (mean 4.2 [SD 0.5]), followed by aesthetics (mean 3.7 [SD 0.6]) and information quality (mean 3.16 [SD 0.42]). Subjective app quality (mean 2.54 [SD 0.64]) and likelihood for behavioral impact (mean 2.5 [SD 0.6]) were the lowest scoring MARS domains. All 19 apps were found to incorporate at least two BCTs (mean 4.74, SD 2.51; range 2-10). However, only 11 apps included BCTs that previously demonstrated efficacy for behavior change during pregnancy, the most common being provide opportunities for social comparison (n=8) and prompt self-monitoring of behavior (n=7). There was a significant positive correlation between the number of BCTs with engagement and aesthetics scores, but the number of BCTs was not significantly correlated with functionality, information quality, total MARS quality, or subjective quality. Conclusions Our findings showed that apps designed to promote physical activity among pregnant women were functional and aesthetically pleasing, with overall moderate quality. However, the incorporation of BCTs was low, with limited prevalence of BCTs previously demonstrating efficacy in behavior change during pregnancy. Future app development should identify and adopt factors that enhance and encourage user engagement, including the use of BCTs, especially those that have demonstrated efficacy for promoting physical activity behavior change among pregnant women.
Background Guidelines for physical activity and exercise during pregnancy recommend that all women without contraindications engage in regular physical activity to improve both their own health and the health of their baby. Many women are uncertain how to safely engage in physical activity and exercise during this life stage and are increasingly using mobile apps to access health-related information. However, the extent to which apps that provide physical activity and exercise advice align with current evidence-based pregnancy recommendations is unclear. Objective This study aims to conduct a systematic search and content analysis of apps that promote physical activity and exercise in pregnancy to examine the alignment of the content with current evidence-based recommendations; delivery, format, and features of physical activity and exercise instruction; and credentials of the app developers. Methods Systematic searches were conducted in the Australian App Store and Google Play Store in October 2020. Apps were identified using combinations of search terms relevant to pregnancy and exercise or physical activity and screened for inclusion (with a primary focus on physical activity and exercise during pregnancy, free to download or did not require immediate paid subscription, and an average user rating of ≥4 out of 5). Apps were then independently reviewed using an author-designed extraction tool. Results Overall, 27 apps were included in this review (Google Play Store: 16/27, 59%, and App Store: 11/27, 41%). Two-thirds of the apps provided some information relating to the frequency, intensity, time, and type principles of exercise; only 11% (3/27) provided this information in line with current evidence-based guidelines. Approximately one-third of the apps provided information about contraindications to exercise during pregnancy and referenced the supporting evidence. None of the apps actively engaged in screening for potential contraindications. Only 15% (4/27) of the apps collected information about the user’s current exercise behaviors, 11% (3/27) allowed users to personalize features relating to their exercise preferences, and a little more than one-third provided information about developer credentials. Conclusions Few exercise apps designed for pregnancy aligned with current evidence-based physical activity guidelines. None of the apps screened users for contraindications to physical activity and exercise during pregnancy, and most lacked appropriate personalization features to account for an individual’s characteristics. Few involved qualified experts during the development of the app. There is a need to improve the quality of apps that promote exercise in pregnancy to ensure that women are appropriately supported to engage in exercise and the potential risk of injury, complications, and adverse pregnancy outcomes for both mother and child is minimized. This could be done by providing expert guidance that aligns with current recommendations, introducing screening measures and features that enable personalization and tailoring to individual users, or by developing a recognized system for regulating apps.
Background Less than one-third of women gain an appropriate amount of weight during pregnancy, which can influence the long-term health of both the mother and the child. Economically disadvantaged women are the most vulnerable to maternal obesity, excessive weight gain during pregnancy, and poor birth outcomes. Effective and scalable health care strategies to promote healthy weight gain during pregnancy specifically tailored for these women are lacking. Objective This paper presents the design and protocol of a biphasic, community-based eHealth trial, SmartMoms in WIC, to increase the adherence to healthy gestational weight gain (GWG) recommendations in low-income mothers receiving women, infant, and children (WIC) benefits. Methods Phase 1 of the trial included using feedback from WIC mothers and staff and participants from 2 community peer advisory groups to adapt an existing eHealth gestational weight management intervention to meet the needs of women receiving WIC benefits. The health curriculum, the format of delivery, and incentive strategies were adapted to be culturally relevant and at an appropriate level of health literacy. Phase 2 included a pragmatic randomized controlled trial across the 9 health care regions in Louisiana with the goal of enrolling 432 women. The SmartMoms in WIC intervention is an intensive 24-week behavioral intervention, which includes nutrition education and exercise strategies, and provides the technology to assist with weight management, delivered through a professionally produced website application. Results Phase 1 of this trial was completed in July 2019, and recruitment for phase 2 began immediately thereafter. All data are anticipated to be collected by Spring 2023. Conclusions The SmartMoms in WIC curriculum was methodically developed using feedback from community-based peer advisory groups to create a culturally relevant, mobile behavioral intervention for mothers receiving WIC benefits. The randomized clinical trial is underway to test the effectiveness of a sustainable eHealth program on the incidence rates of appropriate GWG. SmartMoms in WIC may be able to offer an innovative, cost-effective, and scalable solution for GWG management in women served by WIC. Trial Registration ClinicalTrials.gov NCT04028843; https://clinicaltrials.gov/ct2/show/NCT04028843 International Registered Report Identifier (IRRID) DERR1-10.2196/18211
BACKGROUND Guidelines on physical activity/exercise during pregnancy recommend all women without contraindications engage in regular physical activity to improve both their own health and the health of their baby. Many women are uncertain how to safely engage in physical activity/exercise during this life-stage and are increasingly using mobile applications (apps) to access health-related information. However, the extent to which apps provide physical activity/exercise advice aligns with current evidence-based pregnancy recommendations is currently unclear. OBJECTIVE The aim of this study was to conduct a systematic search and content analysis of apps that promote physical activity/exercise in pregnancy to examine: (1) alignment of the content with current evidence-based recommendations; (2) delivery, format and features of physical activity/exercise instruction; and (3) credentials of app developers. METHODS Systematic searches were conducted in the Australian AppStore and GooglePlay stores in October 2020. Apps were identified using combinations of search terms relevant to pregnancy and physical activity/exercise and screened for inclusion (primary focus on physical activity/exercise during pregnancy, free to download or did not require immediate paid subscription and an average user rating of 4+ out of 5). Each app was then independently reviewed using an author-designed extraction tool. Data were exported, collated, and reported using descriptive statistics. RESULTS Twenty-seven apps were included in this review (GooglePlay: n=16 and AppStore: n=11). All were exercise-based apps that predominately recommended structured and purposeful activity. Two-thirds (n=17) provided some information relating to each of the FITT principles (frequency, intensity, time, type) of exercise; however, only three provided this information in-line with current evidence-based guidelines. Just over one-third of apps (n=10) provided information about contraindications to exercise during pregnancy and referenced the supporting evidence. No apps actively engaged in screening for potential contraindications. Only four apps collected information about the user’s current exercise behaviours, three apps allowed users to personalise features relating to their exercise preferences, and just over one-third (n=10) provided information about developer credentials. CONCLUSIONS Our findings showed that few exercise apps designed for pregnancy aligned with current evidence-based physical activity guidelines. No apps screened users for contraindications to physical activity/exercise during pregnancy and most lacked appropriate personalisation features to account for individual characteristics. Few involved qualified experts during the development of the app. As such, there is a need to improve the quality of apps that promote exercise in pregnancy, to ensure women are appropriately supported to engage in exercise, and the potential risk of injury, complications and/or adverse pregnancy outcomes for both mother and child is minimised. This could be done by providing expert guidance that aligns with current recommendations, introducing screening measures and features that enable personalisation and tailoring to individual users, or by developing a recognised system for regulating apps. CLINICALTRIAL Not required
BACKGROUND Physical activity during pregnancy is associated with a variety of health benefits for the mother and her child. Despite the many health benefits of physical activity during pregnancy, few women participate in regular physical activity during pregnancy. ehealth platforms, such as the internet and mobile applications (apps), are now altering how women access information about their pregnancy and have become an important information source for pregnant women. Whilst the use of pregnancy-related apps has significantly increased among pregnant women, very little is known about their theoretical underpinnings, including their utilisation of behaviour change techniques. This is despite research suggesting the inclusion of behaviour change techniques in ehealth interventions can play an important role in improving, supporting and maintain healthy behaviours, including physical activity. OBJECTIVE To review physical activity apps designed for pregnant women with a focus on app content, quality and features, and the presence and efficacy of Behaviour Change Techniques (BCTs). METHODS A systematic search in the Australian AppStore and GooglePlay stores using search terms relating to exercise and pregnancy. App features and quality was assessed using the 19-item Mobile Application Rating Scale (MARS) and a taxonomy of BCTs was used to determine presence of BCTs (26 items). BCTs previously demonstrating efficacy in behaviour change during pregnancy were also identified from a review of the literature. RESULTS Nineteen exercise apps were deemed eligible for this review and accessed via GooglePlay (n=13) or AppStore (n=6). MARS Overall Quality scores showed moderate app quality (m=3.5, SD=0.52). Functionality was the highest scoring MARS domain (m=4.2, SD=0.5), followed by Aesthetics (m=3.7, SD=0.6) and Information Quality (m=3.16, SD=0.42). Engagement (m=3.01, SD=0.9), Subjective App Quality (m=2.54, SD=0.64) and Likelihood for Behavioural Impact (m=2.5, SD=0.6) were the lowest scoring MARS domains. All 19 apps were found to incorporate at least two BCTs (m=4.74, SD=2.51, range=2–10), with provide instructions (95%) and provide information on consequences (89%) being the most common BCTs. Eleven apps included BCTs that previously demonstrated efficacy for behaviour change during pregnancy, the most common of these being provide opportunities for social comparison (n=8) and prompt self-monitoring of behaviour (n=7). CONCLUSIONS Apps to improve exercise in pregnant women were functional and aesthetically pleasing, with overall moderate quality. However, the incorporation of BCTs was low, with the prevalence of BCTs previously demonstrating efficacy in promoting and/or supporting physical activity during pregnancy scarce. Thus, it is unlikely that apps reviewed in this study will effectively promote and/or support the exercise behaviours among pregnant women. CLINICALTRIAL Not required.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.