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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Early Prenatal Care.

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Strategy. Mobile Apps and Technology

Approach. Develop and adopt a mobile prenatal care app to reduce in-person visits for perinatal patients and provide individualized information.

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Overview. The use of mobile prenatal care apps such as Babyscripts [1], SmartMoms [2], and Growing and Glowing [3] were found to be effective in addressing barriers to in-person visits for low-risk birthing persons, without compromising patient or provider satisfaction with prenatal care.[1,2,3] The apps have been found to increase early PNC by providing personalized information and support that is usable.[2] The Growing and Glowing app is specifically designed for birthing persons who identify as Black and has been found to increase the awareness of local resources and information among this population.[3] The utilization of technology platforms, such as Maven, can also supplement routine prenatal care with educational content, and resources, help to reduce emergency room visits, and support care coordination for patients.[4] The mobile app should not replace in-person visits but allow for a modified schedule for low-risk patients. Additional research is needed.[1]

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):

  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Health Outcomes. This strategy helps contribute to reducing avoidable differences among socioeconomic and demographic groups or geographical areas in health status and health outcomes such as disease, disability, or mortality.
  • 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. Direct Care (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Individual/Family-Focused

Examples from the Field. There are currently no ESMs that use this strategy. Search similar intervention components in the ESM database.

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 mobile prenatal care apps developed for perinatal populations. (Measures availability of technology) Number of pregnant women using prenatal care apps. (Assesses reach of technology)

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

  • Percent of app features that are evidence-based and regularly updated. (Measures clinical quality of technology) Percent of app users receiving personalized education based on their unique needs. (Assesses customization of technology)

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

  • Percent of app users reporting high satisfaction and confidence in using the app to help manage their prenatal health. (Measures user experience) Percent of prenatal quality measures identified by Title V showing improvement with sustained app use. (Shows quality impact of technology) Number of health systems integrating prenatal apps into population health strategies. (Measures cross-sector adoption) Number of studies demonstrating cost-effectiveness of prenatal care apps. (Assesses evidence generation)

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

  • Percent of app development process including leadership from individuals with practical experience. (Measures community power in technology creation) Percent of app resources allocated to address needs of all perinatal populations. (Assesses reach in resource distribution) Percent reduction in negative prenatal care outcomes through deployment of mobile technology. (Measures impact of reach) Percent of users from reporting affirming experiences with prenatal care apps. (Assesses user experiences)

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] Shah JS, Revere FL, Toy EC. Improving Rates of Early Entry Prenatal Care in an Underserved Population. Matern Child Health J. 2018 Dec;22(12):1738-1742. https://pubmed.ncbi.nlm.nih.gov/29992373/

[2] Halili, L., Liu, R., Hutchinson, K.A. et al. Development and pilot evaluation of a pregnancy-specific mobile health tool: a qualitative investigation of SmartMoms Canada. BMC Med Inform Decis Mak 18, 95 (2018). https://doi.org/10.1186/s12911-018-0705-8

[3] Bonnevie E, Barth C, May J, Carey T, Knell SB, Wartella E, Smyser J. Growing and Glowing: A Digital Media Campaign to Increase Access to Pregnancy-Related Health Information for Black Women During the COVID-19 Pandemic. Health Promot Pract. 2023 May;24(3):444-454.

[4] Jahnke HR, Rubin-Miller L, Henrich N, Moss C, Shah N, Peahl A. Association Between the Use of a Digital Health Platform During Pregnancy and Helping Users Avoid Emergency and In-Person Care: Retrospective Observational Study. J Med Internet Res. 2023 May 15;25:e43180. doi: 10.2196/43180. PMID: 37184930; PMCID: PMC10227709.

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.