Planting Seeds for the Future – A Scoping Review of Child Health Promotion Apps for Parents (Preprint)

BACKGROUND Nearly all adults in middle and upper-income countries use smartphones and use of child health promotion apps are increasingly used by parents. Yet few summaries exist on the topics they address. An evidence gap exists about how these apps are evaluated and what topics they cover. OBJECTIVE The objective of this scoping review is to present an overview of existing child health apps topics for parents and summarize how they are evaluated. METHODS Using the scoping review method, apps or web-based programs aimed at the promotion of child health for use by parents were identified and screened for inclusion through 5 separate interdisciplinary databases. Separate sources were sought through an expert network. Key information of included studies was summarized and analyzed through a systematic and descriptive content analysis: keywords, year of publication, country of origin, aims/purpose, study population/sample size, intervention type, methodology/method(s), broad topic(s), evaluation, outcomes were assessed and summarized. RESULTS Of the initially identified 1040 studies from the five selected databases and 60 apps and programs gathered through the expert network, 39 studies were included in total after screening. Keywords reflected the human, health, and app foci in their description were published between 2016 and 2021, and predominantly from US, Australian, and European-based research. The study aims ranged from giving a topic overview of existing studies or apps, assessing app feasibility, to evaluating the effectiveness of an app or web-based content for child health promotion. Three types of interventions were included: 28 primary studies, 6 app feasibility studies, and 5 app or literature reviews. Eight separate topics were found: parental feeding and nutrition, physical activity, maternal-child health, parent-child health, healthy environment, dental health, mental health, and sleep. Twenty-six studies cited theories for behavior change for their evaluations. Specific to the health topic addressed, self-developed, tailored, and validated questionnaires and evaluation tools were used. User input and qualitative evaluations were often combined with surveys to evaluate apps. Apps were most often rated with the Mobile App Rating Scale (MARS) scale. Most intervention studies reported some positive effects, while several saw no effect at all. Cited difficulties were seen in effectively evaluating changes in behavior through apps, recruiting target groups, and retaining app engagement. CONCLUSIONS New parents provide a key target group for child health apps, whether to increase their knowledge or parental efficacy. Evaluating apps for child health promotion provides a special challenge. They should be tailored to parent needs, adapted to the specific topic, and ideally rooted in a transparent theoretical groundwork. Lessons learned can be garnered from existing research with tailored app content, including intuitive and adaptive features, and embedding well-founded parameters for evaluation to scrutinize the long-term effects of parent apps on child health. CLINICALTRIAL Protocol Registration 26.05.2021: https://osf.io/