Skip Navigation

Strengthen the Evidence for Maternal and Child Health Programs

Sign up for MCHalert eNewsletter

Evidence Tools
MCHbest. Breastfeeding.

MCHbest Logo

Strategy. Mobile Application-Based Support

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

Return to main MCHbest page >>

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. They often have a growing body of recent, but limited research that documents effects. However, further study is needed to confirm effects, determine which types of health behaviors and conditions these interventions address, and gauge effectiveness across different population groups. (Clarifying Note: The WWFH database calls this "mixed evidence").

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source. (Read more about understanding evidence ratings).

Source. Peer-Reviewed Literature

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 directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies).

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

PROCESS MEASURES:

  • Number of downloads or installations of the breastfeeding support app. (Measures app acquisition)
  • Number of users who created personalized profiles or accounts within the breastfeeding support app. (Assesses user registration)
  • Number of educational articles, videos, or resources accessed by users within the breastfeeding support app. (Evaluates content utilization)

OUTCOME MEASURES:

  • Total number of active users regularly engaging with the breastfeeding support app. (Captures user engagement)
  • Number of users who reported increased breastfeeding knowledge and confidence after using the app. (Measures educational impact)
  • Number of days users continued to breastfeed while using the breastfeeding support app. (Assesses breastfeeding duration)

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

PROCESS MEASURES:

  • Percent of app content that was evidence-based, accurate, and aligned with current breastfeeding guidelines. (Measures content quality)
  • Percent of user interactions or queries within the app that received a timely and appropriate response from a lactation expert. (Evaluates responsiveness)
  • Percent of users who set and tracked personalized breastfeeding goals within the app. (Assesses goal-setting functionality)

OUTCOME MEASURES:

  • Percent of users who reported high satisfaction with the usability, relevance, and helpfulness of the breastfeeding support app. (Measures user experience)
  • Percent of breastfeeding challenges or concerns that were successfully addressed or resolved using the app's resources and support features. (Captures problem resolution)
  • Percent of infants whose growth and development were tracked and found to be within healthy ranges using the app's monitoring tools. (Assesses infant health outcomes)

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

PROCESS MEASURES:

  • Number of user feedback surveys or interviews conducted to gather insights for app improvement and optimization. (Measures user input)
  • Number of app updates or new features released based on user feedback and emerging breastfeeding research. (Assesses continuous improvement)
  • Number of partnerships formed with healthcare providers, lactation consultants, or community organizations to promote and integrate the breastfeeding support app. (Evaluates ecosystem collaboration)

OUTCOME MEASURES:

  • Number of fathers or partners who reported increased involvement and support for breastfeeding after using the app's father-specific content and features. (Captures paternal engagement)
  • Number of referrals made to connect app users with local breastfeeding support services and resources based on their needs and location. (Measures service integration)
  • Number of app users who transitioned to become breastfeeding peer supporters or advocates within their communities. (Assesses ripple effect)

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

PROCESS MEASURES:

  • - Percent of app users from underserved or disadvantaged communities, as identified by demographic data collected during user registration. (Measures equitable access)
  • - Percent of app content and features that were culturally adapted and available in multiple languages to serve diverse user populations. (Evaluates cultural inclusivity)
  • - Percent of app users who granted permission to share their anonymous breastfeeding data for public health research and surveillance purposes. (Assesses data altruism)

OUTCOME MEASURES:

  • - Percent reduction in breastfeeding disparities between app users and non-users, stratified by race, ethnicity, income, or geography. (Measures equity impact)
  • - Percent of users from communities with historically low breastfeeding rates who reported increased breastfeeding initiation, exclusivity, and duration after using the app. (Captures progress in underserved areas)
  • - Percent increase in population-level breastfeeding rates and maternal and child health outcomes in regions with high app adoption and utilization. (Assesses population health impact)

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.