Content, Behavior Change Techniques, and Quality of Pregnancy Apps in Spain: Systematic Search on App Stores

Abstract

Background Women consult information in mobile apps (apps) during pregnancy, and even obstetrics specialists highlight that pregnancy is the ideal moment for the use of apps as consultation sources. However, the high number of apps designed for pregnancy requires a careful assessment to determine their suitability before recommendation. Objective The aim of this study is to identify the apps available in Spanish that can be recommended based on their content, behavior change techniques (BCTs), and quality as a complementary tool during pregnancy. Methods A systematic search on app stores to identify apps was performed in the Apple App Store and Google Play with the subject term “pregnancy.” The apps meeting the following criteria were chosen: pregnancy-related content, free, and available in Spanish. An app was excluded if it was classified as a game or entertainment and thus lacking an educational or health aim and if it did not target the population under study. The selected apps were downloaded, and their quality was assessed using the Mobile Application Rating Scale (MARS), with the BCTs included evaluated using the BCT taxonomy version 1 and its content. Results A total of 457 apps were identified, 25 of which were downloaded for assessment (5.6%). The median for objective and subjective quality was 2.94 (IQR 2.71-3.46) and 1.75 (IQR 1.25-2.25), respectively. Regarding content, the median of topics included in the apps was 23 (IQR 16-23), with weight gain, nutrition, fetal development, and physical activity being the most common. The median number of BCTs was 12 (IQR 0.5-3.5). The most frequently identified BCTs in the apps were “Self-Monitoring of Outcomes,” followed by “Goal Behavior” and “Instructions.” Statistically significant correlations were observed between objective quality and content (ρ=0.624; P=.001), subjective quality and content (ρ=0.638; P=.001), objective quality and BCTs (ρ=0.672; P<.001), subjective quality and BCTs (ρ=0.623; P<.001), and BCTs and content (ρ=0.580; P=.002). Conclusions The results of this study suggest that only a small percentage of free pregnancy apps available in Spanish should be recommended. The apps with the best MARS scores were those that addressed a higher number of topics and included a higher number of BCTs. Those with the best content and quality, and a higher number of BCTs included could be recommended by health professionals.

Quality evaluation of pregnancy-related mobile applications in South Korea: a descriptive study

“…The apps included in this study had an objective quality score of 3.86 points, suggesting a higher quality of pregnancy and childbirth-related apps in Korea compared to the 2.94 points scored in a similar Spanish study [ 11 ]. This discrepancy in quality assessment scores may be attributed to the nature of the app content.…”

“…Most pregnancy and childbirth-related apps fall under the categories of health/fitness, medical care, or education. Their functions typically include information provision, education, tips or advice, pregnancy tracking and monitoring, meditation, and goal achievement [ 11 ]. Pregnancy-related mobile health apps can motivate individuals to adopt lifestyle changes that promote optimal health during pregnancy.…”

“…Recent studies assessing apps have highlighted that many health apps are rarely reviewed or approved by healthcare providers, nor do they have peer review systems in place to ensure the content and quality of information [ 18 , 19 ]. Moreover, while the benefits of apps that support decision-making during pregnancy are emphasized, it has been noted that there is a lack of rigorous assessments of content quality [ 11 ]. An evaluation of 10 pregnancy and childbirth-related apps in Australia found them to be highly useful in providing health information and education, monitoring various health-related behaviors, and offering advice, tips, and strategies.…”

“…Previous research examining the features of pregnancy and childbirth apps available in app stores, as well as their quality, has been conducted in the United States, Spain, and Australia [ 1 , 10 - 12 ]. The most frequently addressed topics were “weight gain,” “nutrition,” “fetal development,” “physical activity,” and “changes during pregnancy,” with the primary usage being self-monitoring or goal setting [ 1 , 11 ]. Past studies have shown that app usage can effectively enhance health behaviors such as improving knowledge, promoting physical activity, and encouraging a healthy diet among pregnant women.…”

Pregnancy in the digital health era: exploring digital health usage amidst the COVID-19 pandemic

“…The usage of pregnancy apps either persisted or increased during the COVID-19 pandemic, partly due to the decreased access to in-person healthcare services [9]. However, several recent scoping reviews and cross-sectional studies have highlighted the need for better quality apps with greater content credibility [8, [10][11][12][13][14]. Most pregnancy apps are primarily focused on providing educational information, and do not include self-monitoring features, which can assist with behaviour changes that lead to improved healthcare outcomes [12,15].…”