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Background
Mobile applications (apps) are a promising tool for healthful infant-feeding (IF) promotion among low-income mothers, helping establish healthy dietary patterns in children with high obesity risk. Mothers frequently use health apps, but the quality of existing IF apps is unknown. The App Quality Evaluation Tool (AQEL) is a valid and reliable tool for evaluating nutrition app quality.
Objective
Assess the quality of commercially available IF apps and their appropriateness for a low-income audience using the AQEL.
Study Design, Setting, Participants
Researchers used an iterative process to selected apps for evaluation, only including free apps with breastfeeding and solid foods information. Registered dietitians, lactation consultants, and healthcare providers (n = 10) who work with low-income mothers of infants were recruited to complete the AQEL for each selected app.
Measurable Outcome/Analysis
Five standard AQEL domains (behavior change potential, knowledge support, skill development potential, app functionality, and meeting intended purpose) and two modifiable domains (appropriateness for low-income audience and relevance for those seeking IF information or support). Each domains’ score ranged between 0-10 with score>8 considered high quality. Average scores for each domain were calculated for every app. Interrater reliability was assessed using interclass correlation coefficients (ICC; ICC>0.6 considered good agreement).
Results
Researchers selected six apps for evaluation: WebMD Baby, Baby+, Text4Baby, BabyCenter, What to Expect, and The Bump. All evaluators were white, female, with a bachelor's degree or higher. Evaluators highly rated app function and app purpose for WebMD Baby (8.0+1.8 and 8.2+0.9) and Baby Center (8.0+2.1 and 8.0+2.6). For other apps, no domains were rated highly. For appropriateness for low-income audiences, no apps were rated highly (range: 5.7-7.7). There was good agreement (ICC>0.6) across evaluators for all apps.
Conclusions
Commercially available IF apps are of limited quality and may not be appropriate for low-income audiences. This indicates a need for developing apps that effectively support healthful IF behaviors among low-income mothers.
Funding
Northern Illinois University.
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Copyright
© 2022 Published by Elsevier Inc.
