McKechnie Anne Chevalier, Swanson Nellie Munn, Jantraporn Ratchada, Elgersma Kristin M, Iwaszko Wagner Taylor, Park Suhyun, Trebilcock Anna
Child and Family Health, School of Nursing, University of Minnesota, Minneapolis, MN, USA.
Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, USA.
Mhealth. 2025 May 27;11:38. doi: 10.21037/mhealth-24-84. eCollection 2025.
Parents learning about their children with medical complexity often use numerous health-related resources, including mobile health applications (mHealth apps). mHealth apps could provide broad access to key information and support, lower healthcare costs, and improve care. The quality of mHealth apps for this population has been a concern, but is currently unknown. The objective of this systematic review was to identify and evaluate the quality of publicly available mHealth apps designed for parents who are preparing or caring for medically complex infants.
A systematic search strategy was applied to identify mHealth apps in the Apple and Google Play app stores in November 2022 and replicated in August 2024. Apps with no cost, in English, designed for parents of infants with perinatal medical complexity requiring hospitalization were included. Apps for healthy pregnancies, children >1 year, non-parental caregivers or healthcare professionals, primarily for tracking/monitoring, or unrelated activities/products were excluded. Independent raters used the Mobile Application Rating Scale (MARS) subscales of Engagement, Functionality, Aesthetics, and Information to evaluate quality for each app. Mean ratings were calculated by subscale and for overall app quality.
From 1,917 identified apps, 32 apps were downloaded and fully screened. The final sample of 15 unique apps were available on the Apple App Store, with six also available on the Google Play Store. Most apps focused on prematurity (n=6), followed by the neonatal intensive care experience (n=4), congenital heart disease (n=4), and hypoxic-ischemic encephalopathy (n=1). MARS ratings of the overall sample (mean =3.61, median =3.58; range, 2.65-4.68) indicated 20% (3/15) were of good quality and 67% (10/15) were of acceptable quality. Apps showed strengths in Functionality and Information and performed worst in Engagement.
The poorest quality found in Engagement suggests that most of these apps do not effectively target users' interests or needs. Notably, many suffered from a lack of recent updates or became unavailable. This decline appears to parallel the increasing integration of digital health technologies within healthcare systems, which could prompt testing of mHealth apps on health outcomes. High-quality mHealth apps that are valued by parents and offer evidence-based information and support are needed to extend care.
了解自己患有复杂疾病的孩子的家长经常会使用大量与健康相关的资源，包括移动健康应用程序（mHealth应用）。mHealth应用可以广泛提供关键信息和支持，降低医疗成本，并改善护理。针对这一人群的mHealth应用的质量一直是个问题，但目前尚不清楚。本系统评价的目的是识别和评估为准备照顾或正在照顾患有复杂疾病婴儿的家长设计的公开可用mHealth应用的质量。
采用系统检索策略，于2022年11月在苹果应用商店和谷歌Play应用商店中识别mHealth应用，并于2024年8月重复检索。纳入免费、英文、为患有围产期复杂疾病需要住院治疗的婴儿的家长设计的应用。排除用于健康怀孕、1岁以上儿童、非家长照顾者或医疗保健专业人员的应用，主要用于跟踪/监测的应用，或不相关的活动/产品。独立评分者使用移动应用评分量表（MARS）的参与度、功能、美学和信息子量表来评估每个应用的质量。通过子量表和整体应用质量计算平均评分。
从1917个识别出的应用中，下载并全面筛选了32个应用。最终样本为苹果应用商店上的15个独特应用，其中6个也可在谷歌Play应用商店上获得。大多数应用聚焦于早产（n = 6），其次是新生儿重症监护体验（n = 4）、先天性心脏病（n = 4）和缺氧缺血性脑病（n = 1）。总体样本的MARS评分（平均值 = 3.61，中位数 = 3.58；范围，2.65 - 4.68）表明20%（3/15）质量良好，67%（10/15）质量可接受。应用在功能和信息方面表现出优势，在参与度方面表现最差。
在参与度方面发现的最差质量表明，这些应用中的大多数没有有效地针对用户的兴趣或需求。值得注意的是，许多应用存在缺乏近期更新或无法使用的问题。这种下降似乎与数字健康技术在医疗系统中的日益整合并行，这可能促使对mHealth应用在健康结果方面进行测试。需要高质量的、受家长重视并提供循证信息和支持的mHealth应用来扩展护理。
