Chen Elizabeth, Mangone Emily Rose
Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
International Health Division, Abt Associates, Bethesda, MD, United States.
JMIR Mhealth Uhealth. 2016 Nov 10;4(4):e122. doi: 10.2196/mhealth.6611.
Adolescents in the United States and globally represent a high-risk population for unintended pregnancy, which leads to high social, economic, and health costs. Access to smartphone apps is rapidly increasing among youth, but little is known about the strategies that apps employ to prevent pregnancy among adolescents and young adults. Further, there are no guidelines on best practices for adolescent and young adult pregnancy prevention through mobile apps.
This review developed a preliminary evaluation framework for the assessment of mobile apps for adolescent and young adult pregnancy prevention and used this framework to assess available apps in the Apple App Store and Google Play that targeted adolescents and young adults with family planning and pregnancy prevention support.
We developed an assessment rubric called Mobile Criteria for Adolescent Pregnancy Prevention (mCAPP) for data extraction using evidence-based and promising best practices from the literature. mCAPP comprises 4 domains: (1) app characteristics, (2) user interface features, (3) adolescent pregnancy prevention best practices, and (4) general sexual and reproductive health (SRH) features. For inclusion in the review, apps that advertised pregnancy prevention services and explicitly mentioned youth, were in English, and were free were systematically identified in the Apple App Store and Google Play in 2015. Screening, data extraction, and 4 interrater reliability checks were conducted by 2 reviewers. Each app was assessed for 92 facets of the mCAPP checklist.
Our search returned 4043 app descriptions in the Apple App Store (462) and Google Play (3581). After screening for inclusion criteria, 22 unique apps were included in our analysis. Included apps targeted teens in primarily developed countries, and the most common user interface features were clinic and health service locators. While app strengths included provision of SRH education, description of modern contraceptives, and some use of evidence-based adolescent best practices, gaps remain in the implementation of the majority of adolescent best practices and user interface features. Of the 8 best practices for teen pregnancy prevention operationalized through mCAPP, the most commonly implemented best practice was the provision of information on how to use contraceptives to prevent pregnancy (15/22), followed by provision of accurate information on pregnancy risk of sexual behaviors (13/22); information on SRH communication, negotiation, or refusal skills (10/22); and the use of persuasive language around contraceptive use (9/22).
The quality and scope of apps for adolescent pregnancy prevention varies, indicating that developers and researchers may need a supportive framework. mCAPP can help researchers and developers consider mobile-relevant evidence-based best practices for adolescent SRH as they develop teen pregnancy prevention apps. Given the novelty of the mobile approach, further research is needed on the impact of mCAPP criteria via mobile channels on adolescent health knowledge, behaviors, and outcomes.
在美国及全球范围内，青少年都是意外怀孕的高危人群，这会带来高昂的社会、经济和健康成本。青少年使用智能手机应用程序的情况正在迅速增加，但对于这些应用程序预防青少年和年轻成年人怀孕所采用的策略，我们知之甚少。此外，目前还没有关于通过移动应用程序预防青少年和年轻成年人怀孕的最佳实践指南。
本综述为评估预防青少年和年轻成年人怀孕的移动应用程序制定了一个初步评估框架，并使用该框架评估了苹果应用商店和谷歌应用商店中面向青少年和年轻成年人提供计划生育和预防怀孕支持的可用应用程序。
我们开发了一个名为“青少年怀孕预防移动标准”（mCAPP）的评估量表，用于从文献中基于证据和有前景的最佳实践进行数据提取。mCAPP包括4个领域：（1）应用程序特征；（2）用户界面功能；（3）青少年怀孕预防最佳实践；（4）一般性与生殖健康（SRH）功能。为纳入本综述，2015年在苹果应用商店和谷歌应用商店中系统识别出宣传预防怀孕服务且明确提及青少年、为英文且免费的应用程序。由两名评审员进行筛选、数据提取和4次评分者间信度检查。每个应用程序根据mCAPP清单的92个方面进行评估。
我们的搜索在苹果应用商店（462个）和谷歌应用商店（3581个）中返回了4043个应用程序描述。在筛选纳入标准后，我们的分析纳入了22个独特的应用程序。纳入的应用程序主要面向发达国家的青少年，最常见的用户界面功能是诊所和健康服务定位器。虽然应用程序的优点包括提供性与生殖健康教育、现代避孕方法的描述以及一些基于证据的青少年最佳实践的应用，但在大多数青少年最佳实践和用户界面功能的实施方面仍存在差距。通过mCAPP实施的8项青少年怀孕预防最佳实践中，最常实施的最佳实践是提供关于如何使用避孕方法预防怀孕的信息（15/22），其次是提供关于性行为怀孕风险的准确信息（13/22）；性与生殖健康沟通、协商或拒绝技巧的信息（10/22）；以及在避孕使用方面使用有说服力的语言（9/22）。
预防青少年怀孕的应用程序的质量和范围各不相同，这表明开发者和研究人员可能需要一个支持性框架。mCAPP可以帮助研究人员和开发者在开发青少年怀孕预防应用程序时，考虑与移动相关的基于证据的青少年性与生殖健康最佳实践。鉴于移动方法的新颖性，需要进一步研究mCAPP标准通过移动渠道对青少年健康知识、行为和结果的影响。
Zotero 插件