iMedicalApps and JMIR Publications have partnered to help disseminate interesting & innovative digital health research being done worldwide. Each article in this series will feature summaries of interesting studies to help you keep up to date on the latest in digital health research. We invite you to share your thoughts on the study in the comments section.
Smartphone apps for the prevention of unintended pregnancy: A systematic review and content analysis
1. What was the motivation behind your study?
Over 50% of pregnancies in the US are unintended, and the unintended pregnancy disproportionately affects lower-income, minority, and adolescent/young adult women. Because of the substantial potential for smartphone apps to reach these populations and the growing field of eHealth, we were interested in exploring what types of pregnancy prevention apps are available and what strategies they employed to prevent unintended pregnancy. We were interested in doing this study to both evaluate currently available pregnancy prevention apps and to develop evaluation criteria.
2. Describe your study.
We systematically reviewed apps by conducting an extensive search of the Apple iTunes and Android Google Play stores for apps that claim to help prevent pregnancy. We included apps that provided information about pregnancy testing and abortion because they present key opportunities to discuss future pregnancy prevention. Eligible apps were downloaded, categorized, and data extraction was performed on <140 attributes. We evaluated multiple content areas (e.g. evidence-based approach, contraceptive information, user interface). Apps were assigned points and ranked.
3. What were the results of the study?
Our search strategy identified 6,805 app descriptions, of which 218 unique apps met inclusion criteria. Apps were grouped into nine categories: fertility trackers, centers and resources, birth control reminders, general sexual and reproductive health (SRH) information, SRH information targeted specifically to young adults (YA), contraceptive information, service or condom locators, pregnancy tests, and games. While a few apps were quite useful, evidence based practices were infrequent. This field would benefit from additional research on the effectiveness of these apps.
4. What is the main point that readers should take away from this study?
We found that most apps for the general public provided one very specific function such as fertility tracking, birth control alarms or referrals to a nearby center. Evidence-based best practices and reliable contraceptive information were notably missing from most apps. Apps
with the highest scores for evidence-based content and overall number of features included young adult and general sexual and reproductive health information apps, but these apps were not the highest rated by users or frequently downloaded.
5. What was the most surprising finding from your study?
Most pregnancy prevention apps in this space only offer one service and miss opportunities to provide users with valuable information, interactive decision-aids, and evidence-based interventions for unintended pregnancy prevention. Further, some apps in this space may increase the likelihood of unintended pregnancy due to the narrow focus of the pregnancy prevention methods offered.
6. What are the next steps? How do you envision this work ultimately translating into clinical practice or affect R&D?
This review identified several useful, evidence-based apps that providers may choose to recommend. The dearth of high-quality apps also invites health care organizations and advocates for family planning to develop more user-friendly apps that engage populations at risk of unintended pregnancy.
This Q&A was contributed by Emily Mangone, MSc and Victoria Lebrun, MSPH from the Department Health Policy and Management at the UNC-Chapel Hill Gillings School of Global Public Health