Assessing the quality of mobile applications targeting postpartum depression in China

Abstract

Postpartum depression is a serious mental illnessdisorder that occurs after delivery and is one of the most common post-partum complications. With the increasing popularity and extensive use of smartphones worldwide and the fact that China has become the country with the largest number of smartphone users, it is necessary to have a deep understanding of the use and influence of smartphones and discuss the role of smartphone applications in postpartum depression. This study evaluated and analysed the contents of all postpartum depression applications available in China, applying the US Preventive Services Task Force Recommendation Statement (Interventions to Prevent Perinatal Depression) and expert consensus on the guidelines for the prevention and treatment of postpartum depression. We used the keywords 'postpartum depression; and 'PPD' to search Android, iOS, and WeChat in the Chinese application market. Two reviewers agreed on the coding guidelines and coded the content and functionality of the application through content analysis to determine its intervention and adherence to the guidelines. In addition, we used the Mobile App Rating Scale (MARS) to evaluate the application for engagement, functionality, aesthetics, and information domains and recorded the features of the postpartum depression application. The current findings suggest that despite the recent expansion of smartphone platforms and increased availability of applications, existing Chinese apps for postpartum depression have low levels of adherence to clinical practice-based guidelines. New apps need to be developed, and existing apps need to be revised following evidence-based principles.

mHealth and Perinatal Depression in Low-and Middle-Income Countries: A Scoping Review of the Literature

“…Of the 12 articles we included in our analysis, 3 (25%) were study protocols [ 41 , 42 , 43 ] and 2 (16.7%) were reviews of available mobile phone applications related to perinatal depression [ 44 , 45 ]. The 7 remaining articles (58.3%) were research studies [ 46 , 47 , 48 , 49 , 50 , 51 , 52 ].…”

“…In terms of the population of focus, 2 of the 12 articles (16.7%) were reviews of mobile phone applications that were intended to be used by women who were pregnant or in the postpartum period [ 44 , 45 ]. Five of the 12 articles (41.7%), 2 of which were study protocols [ 41 , 42 , 46 , 48 , 51 ], focused on pregnant women.…”

“…Of these 5 articles, 2 (40%) included first time mothers [ 49 , 50 ]. Five of the 12 studies (41.7%) took place in China [ 43 , 44 , 46 , 48 , 49 ], followed by 3 studies (25%) in Iran [ 47 , 50 , 52 ]. The primary outcome measure of 8 of the 12 studies (66.7%) was the depressive symptoms of women who were pregnant or in the postpartum period [ 41 , 42 , 43 , 46 , 47 , 48 , 50 , 52 ].…”

“…Two of the 12 articles were reviews of mobile phone applications. One of these review articles evaluated the contents of all postpartum depression applications in China and their alignment with the guidelines for the prevention and treatment of postpartum depression [ 44 ] and the other evaluated mobile phone applications that were available on the Apple iTunes and Google Android play stores [ 45 ]. Of the remaining 10 articles, 9 (90%) were quantitative in nature [ 41 , 42 , 43 , 46 , 47 , 48 , 50 , 51 , 52 ] with 5 articles (55.6%) using randomized control trials as their research method [ 42 , 43 , 46 , 47 , 52 ].…”

“…However, while the flexibility of delivery format was helpful given the busy schedules of new mothers, the authors found it difficult to meet the individual learning needs of new mothers [ 49 ]. One of the 2 review articles (50.0%) identified that postpartum depression mobile phone applications that are used in China do not include content that is known to be effective in terms of interventions or align with Chinese clinical practice guidelines in the management of postpartum depression [ 44 ]. Likewise, the other review article (50%) found that insufficient information is available regarding the authors or creators of the content in the postpartum depression mobile phone applications or where the information was obtained [ 45 ].…”