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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Breastfeeding.

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Strategy. Mobile Application-Based Support

Approach. Use breastfeeding smartphone applications. (apps) to provide education and support for breastfeeding

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Overview. Pregnancy mobile apps are becoming increasingly popular with parents-to-be seeking information related to their pregnancy and baby through mobile technology. This increase raises the need for prenatal apps with evidence-based content that is personalized and reliable.[1] Interactive apps can contain on-demand breastfeeding educational and video content.[2] Mobile health interventions employing digital technologies also provide a rapidly evolving means of engaging fathers and providing them with the information and support to address breastfeeding and the transition to fatherhood.[3] Research indicates that apps are associated with an increase in certain healthy behaviors and health knowledge and are a preferred method for information seeking and support among parents.

Evidence. Emerging Evidence. Strategies with this rating typically trend positive and have good potential to work...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Health and Health Behaviors/Behavior Change. This strategy improves individuals' physical and mental health and their adoption of healthy behaviors (e.g., healthy eating, physical activity).
  • Environmental Health. This strategy improves the impact of physical, chemical, and biological factors in the environment on health.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Health Teaching (Education and Promotion) (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Population/Systems-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy or aligned components.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of breastfeeding support app features aligned with evidence-based lactation guidelines. (Assesses alignment with best practices) Number of individuals from a variety of backgrounds involved in app design and user testing. (Evaluates authentic engagement)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of app content reviewed by certified lactation consultants for accuracy. (Evaluates adherence to quality standards) Percent of app features designed to be available for users with various abilities. (Assesses involvement of multiple perspectives in app design)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of partnerships formed between app developers and local breastfeeding support organizations. (Shows integration efforts) Number of healthcare systems integrating app usage data into breastfeeding support strategies. (Assesses linkages with broader health goals) Number of breastfeeding-related complications prevented through timely in-app support and guidance. (Measures clinical impact) Number of policy changes implemented to support the development and dissemination of evidence-based breastfeeding support apps. (Assesses system-level improvements)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of app content and features adapted for all user populations. (Evaluates user relevance) Percent of app development resources allocated to ensuring usability for users with limited digital literacy for technology access. (Assesses strategic deployment) Percent reduction in breastfeeding knowledge and practice gaps between app users from different backgrounds. (Measures reach and impact) Percent improvement in community-level breastfeeding rates in areas with high app adoption among populations typically less likely to breastfeed. (Assesses population-level health impacts)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

1 Cawley, C., Buckenmeyer, H., Jellison, T., Rinaldi, J. B., & Vartanian, K. B. (2020). Effect of a Health System–Sponsored Mobile App on Perinatal Health Behaviors: Retrospective Cohort Study. JMIR mHealth and uHealth, 8(7), e17183.

2 Griffin, L. B., López, J. D., Ranney, M. L., Macones, G. A., Cahill, A. G., & Lewkowitz, A. K. (2021). Effect of Novel Breastfeeding Smartphone Applications on Breastfeeding Rates. Breastfeeding Medicine.

3 Scott, J. A., Burns, S. K., Hauck, Y. L., Giglia, R. C., Jorgensen, A. M., White, B. K., ... & Maycock, B. R. (2021). Impact of a Face-To-Face Versus Smartphone App Versus Combined Breastfeeding Intervention Targeting Fathers: Randomized Controlled Trial. JMIR pediatrics and parenting, 4(2), e24579.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.