mHealth technology design and evaluation for early childhood health promotion: A systematic literature review (Preprint)

BACKGROUND Recent increases in smartphone ownership among underserved populations have inspired researchers in medicine, computing, and health informatics to design and evaluate mobile health (mHealth) interventions, specifically for those supporting child development and growth. While these interventions demonstrate possible effectiveness at larger scales, few of these interventions are evaluated to address racial disparities and health equity, which are known factors that affect relevance, uptake, and adherence in target populations. OBJECTIVE In this study, we aimed to identify and document the current design and evaluation practices of mobile health technologies that promote early childhood health, with a specific focus on opportunities for those processes to address health disparities and health equity. METHODS To survey the current design and evaluation methods of current work, identify opportunities to address racial disparities in early- and late-stage processes, and understand the potential efficacy of these interventions, we completed a systematic literature review of studies that design and evaluate mHealth interventions for early childhood health promotion. RESULTS Across literature from medical, computing, and health informatics venues, we identified 15 papers that presented a design or evaluation of a parent-facing health intervention. We found that using mobile-based systems to deliver health interventions was generally well accepted for parents of children under age five. We also found that, when measured, parenting knowledge of early childhood health topics and confidence to engage in health-promoting behaviors improved. Design and evaluation methods held internal consistency within disciplines (e.g., experimental study designs were most prevalent in medical literature, while computing researchers used user-centered design methods in computing venues). However, there was little consistency in design or evaluation methods across venues. CONCLUSIONS To support more interventions undergoing a comprehensive design and evaluation process, we recommend attention to design at the intervention level (e.g., reporting content sources) and at the system level; interdisciplinary collaboration in early childhood health intervention development can lead to large-scale deployment and success among populations.