Yu Hongli, He Juan, Li Keqiang, Qi Wen, Lin Jiahui, Szumilewicz Anna
Department of Sport, Gdansk University of Physical Education and Sport, Gdańsk, Poland.
Jiuling Primary School, Mianyang, Sichuan, China.
Front Nutr. 2023 Jan 9;9:942331. doi: 10.3389/fnut.2022.942331. eCollection 2022.
Mobile applications (apps) are becoming increasingly prevalent as tools for improving maternal health behaviors. However, the recently updated content and quality of these apps remain unknown. This research investigated the fundamental characteristics, functional modules, and overall quality of maternal apps available in the United States and China to reveal critical nutrition and physical activity gaps.
A systematic search was performed in Android and iOS app stores (China and the United States). Apps were eligible if they targeted pregnant or postpartum women, focused on nutrition or physical activity, and had interfaces in English or Chinese. The basic characteristics, functional modules, and overall quality of the apps were evaluated, and differences between apps available in China or the United States were determined using analysis of variance and chi-square tests. Pearson correlations were utilized to investigate links between objective quality and user rating.
A total of 65 maternity-related nutrition and physical activity apps (34 from China and 31 from the United States) were eligible. Among them, 68% (21/31) of US apps and 56% (19/34) of Chinese apps did not provide supporting evidence for their content. A greater number of Chinese apps provided app-based general education modules, namely food nutrition knowledge ( = 0, 0% in the United States vs. = 30, 88.2% in China). Meanwhile, a greater number of US apps provided exercise modules, namely pregnancy yoga ( = 21, 67.7% in the United States vs. = 2, 5.9% in China). The overall app quality rating in the United States was lower than it was in China (mean: 3.5, SD: 0.6 in China vs. mean: 3.4, SD: 0.7 in the United States). There was no relationship between the overall app quality rating and the user rating in either country (rho = 0.11 in China and rho = -0.13 in the United States).
The characteristics and functional modules of in-store apps for maternal nutrition and physical activity differed between the United States and China. Both countries' apps, especially Chinese apps, lacked evidence-based information, and there was no correlation between app quality and user rating. The results therefore suggest that user ratings cannot be used as an objective indicator of app quality and that it is necessary to improve the empirical basis and credibility of apps in both countries.
移动应用程序（应用）作为改善孕产妇健康行为的工具正变得越来越普遍。然而，这些应用最近更新的内容和质量仍然未知。本研究调查了美国和中国现有的孕产妇应用的基本特征、功能模块和整体质量，以揭示关键的营养和身体活动方面的差距。
在安卓和iOS应用商店（中国和美国）进行了系统搜索。如果应用针对孕妇或产后妇女、专注于营养或身体活动且具有英文或中文界面，则符合入选条件。对应用的基本特征、功能模块和整体质量进行了评估，并使用方差分析和卡方检验确定了中国或美国现有应用之间的差异。利用皮尔逊相关性来研究客观质量与用户评分之间的联系。
共有65款与孕产妇营养和身体活动相关的应用（34款来自中国，31款来自美国）符合入选条件。其中，68%（21/31）的美国应用和56%（19/34）的中国应用没有为其内容提供支持证据。更多的中国应用提供基于应用的一般教育模块，即食物营养知识（美国为0款，占0%；中国为30款，占88.2%）。同时，更多的美国应用提供锻炼模块，即孕期瑜伽（美国为21款，占67.7%；中国为2款，占5.9%）。美国应用的整体质量评分低于中国（均值：中国为3.5，标准差为0.6；美国为3.4，标准差为0.7）。在这两个国家中，应用的整体质量评分与用户评分之间均无关联（中国的相关系数为0.11，美国的相关系数为 -0.13）。
美国和中国用于孕产妇营养和身体活动的应用商店应用的特征和功能模块存在差异。两国的应用，尤其是中国的应用，缺乏循证信息，并且应用质量与用户评分之间没有相关性。因此，结果表明用户评分不能用作应用质量的客观指标，并且有必要提高两国应用的实证基础和可信度。
