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Browsing by Subject "Maternal and child health"
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Item Evaluating the quality of mobile health apps for maternal and child health (MCH)(2018-08-08) Biviji, Rizwana; Harle, Christopher A.; Vest, Joshua R.; Dixon, Brian E.; Cullen, TheresaIntroduction Mobile health (mHealth) applications (apps) are increasingly accessible and popular. In 2015, over 60% of smartphone users used their phones to look up health related information. mHealth apps related to maternal and child health (MCH) are particularly prevalent and frequently used. As high as 73% pregnant women and new mothers reported the use of MCH apps, with 27% using them daily. Methods A cross-sectional sample of MCH apps was extracted from the Apple App and Google Play stores using a JavaScript Scraper program. A multivariable linear regression, and series of ordinal logistic regression assessed the relationship between MCH app characteristics and two outcomes, end users’ perceived satisfaction (star ratings), and intent to use (downloads). Next, theory-based content analysis reviewed the presence and use of behavior change techniques (BCTs) in popular MCH apps using the mHealth app taxonomy framework. Finally, a qualitative inductive analysis assessed user self-reported experiences, perceived benefits, and general feedback for MCH apps. Results Seven hundred and forty-two apps met the inclusion criteria. A large majority of MCH apps were developed by non-healthcare developers. Google Play store apps had higher user ratings; while, apps within health & fitness genre, with older updates, and no agerestrictions had fewer user ratings. Furthermore, lower priced apps, with high star ratings, in-app purchase options, and in-app advertisement presence had high downloads. And, apps belonging to medical and health & fitness genre had fewer user downloads. Content analysis revealed that popular MCH apps on an average include 7.4 behavior change techniques (BCTs) with a median of 6 BCTs. Apps developed by healthcare developers had higher BCTs present within app content. Qualitative analysis shows that consumers value apps that are low cost, with superior features, smooth technical aspects, high quality content, and easy to use. Conclusions Healthcare providers, app developers, and policymakers may benefit from a better understanding of MCH apps available in two popular app stores and may consider strategies to review and promote apps to consumers based on information accuracy and trustworthiness.Item The Concordance of Electronic Health Record Diagnoses and Substance use Self-Reports Among Reproductive Aged Women Enrolled in a Community-Based Addiction Reduction Program(Sage, 2024) Campbell, Angela G.; Naz, Saman; Gharbi, Sami; Chambers, Joanna; Denne, Scott; Litzelman, Debra K.; Wiehe, Sarah E.; Pediatrics, School of MedicineSubstance use disorders among reproductive aged women are a major public health issue. There is little work investigating the validity and reliability of electronic health record (EHR) data for measuring substance use in this population. This study examined the concordance of self-reported substance use with clinical diagnoses of substance use, substance abuse and substance use disorder in EHR data. Reproductive age women enrolled in the Community-Based Addiction Reduction (CARE) program were interviewed by peer recovery coaches (PRC) at enrollment. That survey data was linked with EHR data (n = 102). Concordance between self-reported substance use and clinical diagnoses in the EHR was examined for opioids, cannabis/THC, and cocaine. Cohen's kappa, sensitivity, and specificity were calculated. The survey captured a higher number of women who use substances compared to the EHR. The concordance of self-report with EHR diagnosis varied by substance and was higher for opioids (17.6%) relative to cannabis/THC (8.8%), and cocaine (3.0%). Additionally, opioids had higher sensitivity (46.2%) and lower specificity (76.2%) relative to cannabis/THC and cocaine. Survey data collected by PRCs captured more substance use than EHRs, suggesting that EHRs underestimate substance use prevalence. The higher sensitivity and lower specificity of opioids was due to a larger number of women who had a diagnosis of opioid use in the EHR who did not self-report opioid use in the self-report survey relative to cannabis/THC and cocaine. Opioid self-report and diagnosis may be influenced by research setting, question wording, or receipt of medication for opioid use disorder.