Published on in Vol 11 (2023)

This is a member publication of Charite - Universitaetsmedizin Berlin, Medizinische Bibliothek, Germany

Preprints (earlier versions) of this paper are available at https://preprints.jmir.org/preprint/39929, first published .
Planting Seeds for the Future: Scoping Review of Child Health Promotion Apps for Parents

Planting Seeds for the Future: Scoping Review of Child Health Promotion Apps for Parents

Planting Seeds for the Future: Scoping Review of Child Health Promotion Apps for Parents

Review

1Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany

2Digital Health Entrepreneur, Berlin, Germany

Corresponding Author:

Sarah B Blakeslee, Dr rer med

Department of Pediatrics

Division of Oncology and Hematology

Charité - Universitätsmedizin Berlin

Augustenburger Platz 1

Berlin, 13353

Germany

Phone: 49 30 450 566058

Email: sarah.blakeslee@charite.de


Background: Increasingly, parents use child health promotion apps to find health information. An overview of child health promotion apps for parents currently does not exist. The scope of child health topics addressed by parent apps is thus needed, including how they are evaluated.

Objective: This scoping review aims to describe existing reported mobile health (mHealth) parent apps of middle- to high-income countries that promote child health. The focus centers on apps developed in the last 5 years, showing how the reported apps are evaluated, and listing reported outcomes found.

Methods: A scoping review was conducted according to PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews) guidelines to identify parent apps or web-based programs on child health promotion published between January 2016 and June 2021 in 5 databases: PubMed, ERIC, IEEE Xplore, Web of Science, and Google Scholar. Separate sources were sought through an expert network. Included studies were summarized and analyzed through a systematic and descriptive content analysis, including keywords, year of publication, country of origin, aims/purpose, study population/sample size, intervention type, methodology/method(s), broad topic(s), evaluation, and study outcomes.

Results: In total, 39 studies met the inclusion criteria from 1040 database and 60 expert-identified studies. Keywords reflected the health topics and app foci. About 64% (25/39) of included studies were published after 2019 and most stemmed from the United States, Australian, and European-based research. Studies aimed to review or evaluate apps or conducted app-based study interventions. The number of participants ranged from 7 to 1200. Quantitative and qualitative methods were used. Interventions included 28 primary studies, 6 app feasibility studies, and 5 app or literature reviews. Eight separate topics were found: parental feeding and nutrition, physical activity, maternal-child health, parent-child health, healthy environment, dental health, mental health, and sleep. Study intervention evaluations cited behavior change theories in 26 studies and evaluations were carried out with a variety of topic-specific, adapted, self-developed, or validated questionnaires and evaluation tools. To evaluate apps, user input and qualitative evaluations were often combined with surveys and frequently rated with the Mobile App Rating Scale. Outcomes reported some positive effects, while several intervention studies saw no effect at all. Effectively evaluating changes in behavior through apps, recruiting target groups, and retaining app engagement were challenges cited.

Conclusions: New parents are a key target group for child health apps, but evaluating child health promotion apps remains a challenge. Whether tailored to parent needs or adapted to the specific topic, apps should be rooted in a transparent theoretical groundwork. Applicable lessons for parent apps from existing research are to tailor app content, include intuitive and adaptive features, and embed well-founded parameters for long-term effect evaluation on child health promotion.

JMIR Mhealth Uhealth 2023;11:e39929

doi:10.2196/39929

Keywords



Digital health is a growing field and apps are used regularly to target health prevention. eHealth measures have steadily gained popularity and are increasingly available in the app form. For the promotion and maintenance of health, digital interventions have been examined for their ability to work as a preventive measure [Cushing CC, Steele RG. A meta-analytic review of eHealth interventions for pediatric health promoting and maintaining behaviors. J Pediatr Psychol. Oct 2010;35(9):937-949. [CrossRef] [Medline]1]. An increasing number of apps target parents and children for child health promotion and well-being, yet little is known about their impact. Research is conclusive that health promotion activities for child health have a long-term impact on health, whether it be mental health, physical activity, nutrition, or risk behavior prevention [Mead E, Brown T, Rees K, Azevedo LB, Whittaker V, Jones D, et al. Diet, physical activity and behavioural interventions for the treatment of overweight or obese children from the age of 6 to 11 years. Cochrane Database Syst Rev. Jun 22, 2017;6(6):CD012651. [FREE Full text] [CrossRef] [Medline]2-Weissberg RP, Kumpfer KL, Seligman MEP. Prevention that works for children and youth: An introduction. American Psychologist. Jun 2003;58(6-7):425-432. [CrossRef]6]. Smartphones are estimated to be owned by over 50% of the world’s population (~4.3 billion people by 2023) [O'Dea S. Telecommunications Smartphone users worldwide 2016-2023. Statista. 2020. URL: https://www.statista.com/statistics/330695/number-of-smartphone-users-worldwide/ [accessed 2023-06-22] 7], with smartphone ownership averaging over 75% in countries with high-level economies such as the United States and the European Union [Silver L. Smartphone Ownership Is Growing Rapidly Around the World, but Not Always Equally. Pew Research Center. Feb 5, 2019. URL: https:/​/www.​pewresearch.org/​global/​2019/​02/​05/​smartphone-ownership-is-growing-rapidly-around-the-world-but-not-always-equally/​ [accessed 2021-05-08] 8]. Nearly all adults (96%) aged 18-29 own a smartphone in the United States [Mobile Fact Sheet: Mobile phone ownership over time. Pew Research Center. Apr 7, 2021. URL: https://www.pewresearch.org/internet/fact-sheet/mobile/ [accessed 2023-06-22] 9] and in Europe on average 75% of people in this age bracket use the internet every day [Being young in Europe today - digital world. Statistics Explained. 2020. URL: https://tinyurl.com/5n8dfzrf [accessed 2023-06-22] 10]. Current parents and the next generation of parents are seeking health information from digital sources and increasingly from apps, demonstrating the opportunity for health promotion through app use [Kubb C, Foran HM. Online Health Information Seeking by Parents for Their Children: Systematic Review and Agenda for Further Research. J Med Internet Res. Aug 25, 2020;22(8):e19985. [FREE Full text] [CrossRef] [Medline]11].

Stemming from different theoretical approaches from health psychology and fields studying social behavior [Schwarzer R. Modeling Health Behavior Change: How to Predict and Modify the Adoption and Maintenance of Health Behaviors. Applied Psychology. Jan 2008;57(1):1-29. [CrossRef]12-Cane J, O'Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci. Apr 24, 2012;7:37. [FREE Full text] [CrossRef] [Medline]16], a need to evaluate the ability of illness prevention and health promotion interventions to change behaviors led to the development of behavior change techniques (BCTs) [Hayman M, Alfrey K, Cannon S, Alley S, Rebar AL, Williams S, et al. Quality, Features, and Presence of Behavior Change Techniques in Mobile Apps Designed to Improve Physical Activity in Pregnant Women: Systematic Search and Content Analysis. JMIR Mhealth Uhealth. Apr 07, 2021;9(4):e23649. [FREE Full text] [CrossRef] [Medline]17]. These are categories of evaluable information, termed taxonomies, that track and measure how effective health promotion interventions can be [Michie S, Wood C, Johnston M, Abraham C, Francis J, Hardeman W. Behaviour change techniques: the development and evaluation of a taxonomic method for reporting and describing behaviour change interventions (a suite of five studies involving consensus methods, randomised controlled trials and analysis of qualitative data). Health Technol Assess. Nov 2015;19(99):1-188. [FREE Full text] [CrossRef] [Medline]18]. The application of such evaluative measures in digital interventions has become a well-established method to evaluate changes in behavior over the last decade [Wang Y, Fadhil A, Lange J, Reiterer H. Integrating Taxonomies Into Theory-Based Digital Health Interventions for Behavior Change: A Holistic Framework. JMIR Res Protoc. Jan 15, 2019;8(1):e8055. [FREE Full text] [CrossRef] [Medline]19,Yardley L, Spring B, Riper H, Morrison L, Crane D, Curtis K, et al. Understanding and Promoting Effective Engagement With Digital Behavior Change Interventions. Am J Prev Med. Nov 2016;51(5):833-842. [FREE Full text] [CrossRef] [Medline]20]. For instance, there has been some evidence demonstrating moderate effects of health apps on physical activity and diet in pregnant women [Hayman M, Alfrey K, Cannon S, Alley S, Rebar AL, Williams S, et al. Quality, Features, and Presence of Behavior Change Techniques in Mobile Apps Designed to Improve Physical Activity in Pregnant Women: Systematic Search and Content Analysis. JMIR Mhealth Uhealth. Apr 07, 2021;9(4):e23649. [FREE Full text] [CrossRef] [Medline]17,Brown HM, Bucher T, Collins CE, Rollo ME. A review of pregnancy iPhone apps assessing their quality, inclusion of behaviour change techniques, and nutrition information. Matern Child Nutr. Jul 06, 2019;15(3):e12768. [FREE Full text] [CrossRef] [Medline]21], adults [Direito A, Carraça E, Rawstorn J, Whittaker R, Maddison R. mHealth Technologies to Influence Physical Activity and Sedentary Behaviors: Behavior Change Techniques, Systematic Review and Meta-Analysis of Randomized Controlled Trials. Ann Behav Med. Apr 18, 2017;51(2):226-239. [CrossRef] [Medline]22], or children [Schoeppe S, Alley S, Rebar AL, Hayman M, Bray NA, Van Lippevelde W, et al. Apps to improve diet, physical activity and sedentary behaviour in children and adolescents: a review of quality, features and behaviour change techniques. Int J Behav Nutr Phys Act. Jun 24, 2017;14(1):83. [FREE Full text] [CrossRef] [Medline]23]. A recent meta-analysis of apps directed at health promotion and illness management described the need for stronger evidence to underscore their effects [Iribarren SJ, Akande TO, Kamp KJ, Barry D, Kader YG, Suelzer E. Effectiveness of Mobile Apps to Promote Health and Manage Disease: Systematic Review and Meta-analysis of Randomized Controlled Trials. JMIR Mhealth Uhealth. Jan 11, 2021;9(1):e21563. [FREE Full text] [CrossRef] [Medline]24]. At the same time, when it comes to the promotion of health, not enough is known about how or if the use of apps has an effect on behavior change, nor to what extent the evaluation of such apps is undertaken [Edwards EA, Lumsden J, Rivas C, Steed L, Edwards LA, Thiyagarajan A, et al. Gamification for health promotion: systematic review of behaviour change techniques in smartphone apps. BMJ Open. Oct 04, 2016;6(10):e012447. [FREE Full text] [CrossRef] [Medline]25], nor how this relates to the actual use of such health apps [Mano R. Mobile Health Apps and Health Management Behaviors: Cost-Benefit Modeling Analysis. JMIR Hum Factors. Apr 22, 2021;8(2):e21251. [FREE Full text] [CrossRef] [Medline]26]. Despite the potential and opportunity for combining prevention activities into digital health apps, evaluation of behaviors to measure the effectiveness of mobile interventions is imperative to demonstrate any impact on well-being.

New parents bestow both the genetic makeup and the preliminary foundation for health to their children—from pregnancy to independent adulthood. Despite being an essential cornerstone and stakeholder of child health promotion and well-being, parents often feel unprepared for parenthood [Entsieh AA, Hallström IK. First-time parents' prenatal needs for early parenthood preparation-A systematic review and meta-synthesis of qualitative literature. Midwifery. Aug 2016;39:1-11. [FREE Full text] [CrossRef] [Medline]27] and ill-informed about their child’s development [Cashin M, Wroe J, Campbell LE. What parents want to know in the first postnatal year: A Delphi consensus study. Child Care Health Dev. Jan 21, 2021;47(1):47-56. [CrossRef] [Medline]28]. There has been no review to our knowledge that assesses if and how child health promotion broadly targeted in parent-based interventions is being evaluated. In an ever-changing digital landscape with continually developed new apps, establishing what apps exist to target parenting and childhood health promotion as well as how they are evaluated is an area of interest.

A preliminary search of literature confirmed that reviews have systematically looked at the impact of apps on behavior [McKay FH, Cheng C, Wright A, Shill J, Stephens H, Uccellini M. Evaluating mobile phone applications for health behaviour change: A systematic review. J Telemed Telecare. Jan 2018;24(1):22-30. [CrossRef] [Medline]29], and also specific areas of health promotion have been systematically addressed for adults and children, such as nutrition or physical activity [Hayman M, Alfrey K, Cannon S, Alley S, Rebar AL, Williams S, et al. Quality, Features, and Presence of Behavior Change Techniques in Mobile Apps Designed to Improve Physical Activity in Pregnant Women: Systematic Search and Content Analysis. JMIR Mhealth Uhealth. Apr 07, 2021;9(4):e23649. [FREE Full text] [CrossRef] [Medline]17,DiFilippo KN, Huang W, Andrade JE, Chapman-Novakofski KM. The use of mobile apps to improve nutrition outcomes: A systematic literature review. J Telemed Telecare. Feb 12, 2015;21(5):243-253. [CrossRef]30-Villinger K, Wahl DR, Boeing H, Schupp HT, Renner B. The effectiveness of app-based mobile interventions on nutrition behaviours and nutrition-related health outcomes: A systematic review and meta-analysis. Obes Rev. Oct 2019;20(10):1465-1484. [FREE Full text] [CrossRef] [Medline]32], literacy [Lin Y, Lou M. Effects of mHealth-based interventions on health literacy and related factors: A systematic review. J Nurs Manag. Apr 2021;29(3):385-394. [CrossRef] [Medline]33], pregnancy [Villinger K, Wahl DR, Boeing H, Schupp HT, Renner B. The effectiveness of app-based mobile interventions on nutrition behaviours and nutrition-related health outcomes: A systematic review and meta-analysis. Obes Rev. Oct 2019;20(10):1465-1484. [FREE Full text] [CrossRef] [Medline]32], and even general well-being [McKay FH, Cheng C, Wright A, Shill J, Stephens H, Uccellini M. Evaluating mobile phone applications for health behaviour change: A systematic review. J Telemed Telecare. Jan 2018;24(1):22-30. [CrossRef] [Medline]29]. However, a comprehensive compendium of apps that apply to parents for the health promotion activities in children does not exist nor are the evaluative effects of such apps clear. The need to better understand the scope of what apps exist and how they are currently evaluated provides the rationale for this review. The aim of this scoping review is therefore to address this gap by reviewing the existing studies on mobile health (mHealth) prevention apps that target parents for promoting the health of their children. The primary objective of this review is to describe existing reported mHealth parent apps of middle- to high-income countries that promote child health, with a focus on the parent apps developed in the last 5 years. To achieve the objective, this paper intends to give an overview and details on the topic areas of health promotion that parent apps cover and presents the scope of apps that are reported on (keywords, year of publication, country of origin, aims/purpose, study population and sample size, intervention type, and methods). The secondary objective of this review is to compile a list of how the reported apps are evaluated by listing and describing health measures found. The research questions that guided this review were as follows: What current parent mHealth apps exist in middle- to upper-income countries for promoting child health and how, when, and where are they reported on? What topics do they cover? How are child promotion apps for parents evaluated and what outcomes are described in terms of their effectiveness and efficacy? This scoping review aims to shed light on and give a comprehensively reported overview of existing parent apps to promote children’s health.


Design and Overview

A scoping review method was chosen as the appropriate review type to give a broad overview of the existing apps on child health available for parents because this field has not yet been comprehensively mapped and ever-emerging evidence rapidly changes. A planned 3-step search strategy study protocol was registered with the Open Science Forum [Blakeslee S, Stritter W, Horak I, Seifert G. Protocol Registration: Planting Seeds for the Future -- A Scoping Review of Digital Prevention Apps for Parents. osf. Open Science Forum. May 19, 2021. URL: https://osf.io/pn36g/ [accessed 2023-06-22] 34] and used with an established scoping framework [Peters MDJ, Godfrey CM, Khalil H, McInerney P, Parker D, Soares CB. Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc. Sep 2015;13(3):141-146. [CrossRef] [Medline]35-Levac D, Colquhoun H, O'Brien KK. Scoping studies: advancing the methodology. Implement Sci. Sep 20, 2010;5:69. [FREE Full text] [CrossRef] [Medline]37] to search for apps geared toward parents for health promotion in children. The scoping review reporting was supported throughout by the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews) checklist [Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. Oct 02, 2018;169(7):467-473. [FREE Full text] [CrossRef] [Medline]38].

Parental Mobile App Study Search Strategy

In a first step, from May 26, 2021 to May 28, 2021, 4 available databases were searched in 2 rounds to include the fields of health, education, and technology: PubMed, ERIC, IEEE Xplore, and Web of Science. After the first-round search with Google Scholar (Google Inc.), too many undifferentiated resources outside the inclusion were found for the search terms, and thus we decided to strategically limit the search to 2021 to find the most recent publications that may be found in the first months after publication, but before these are added to other databases. Search terms combined the keywords “health promotion,” “parent*,” “child*,” and “app,” “eHealth” and “mHealth,” “mobile health prevention,” and “digital health” (

Multimedia Appendix 1

Search strategy details.

DOCX File , 24 KBMultimedia Appendix 1). Inclusion and exclusion were described and then tailored after the initial search with the study team (SBB, WS, IH, and GS).

In a parallel organizational step to include health expert input from May to August.20, 2021, the third author (IH), gathered stakeholder inputs with authors and health experts located in Germany and Europe to identify parenting studies or apps that may not have been included. This was conducted first through a LinkedIn (Microsoft Corporation) post from a well-established networking account asking for expert input(s) on apps or research projects aimed at young parents to promote the health of their children from birth and how these have been assessed or evaluated. From the expert responses, this information was followed up on to elicit more detailed information on known apps.

Eligibility and Exclusion Criteria

Apps or projects that met the inclusion criteria (Table 1) were assessed further. Study inclusion and exclusion were documented at each step (Figure 1). We aimed to include studies, evaluations, and assessments of digital apps developed toward parents for child health promotion. Studies of all types, reports, and assessments were included if they were (1) digital apps (2) used primarily by parents or expectant parents for (3) health promotion of children without a diagnosis or risk.

We included both primary studies and reviews of studies and apps. Gray literature was included as long as there was an evaluative component to the work. The apps could be web or mobile-based programs. Based on content, we allowed for a broad range of study interest as it applied to both programs and the people these programs were applied to, including app feasibility or design, evaluation of the apps themselves, evaluation of the potential or actual effect on behaviors, or discussed evaluation strategies. For the expert input, we included studies collected from German or European digital health experts, child health experts, educational experts, or study authors. Only studies based in a middle- or high-income country and published in or after 2016 were included because we were particularly interested in the most recent apps and contexts most resembling the German context of our own research.

All studies that aimed to manage illness or high risk of illness were excluded. Exclusion was applied to any apps or programs aimed solely toward professions or children or where parents were simply gatekeepers. Additionally, studies on apps that were only used as health monitoring, tracking, product-based devices, or as information communication tools such as for text messaging/SMS transmission, videoconferencing, or telehealth were removed from review.

Table 1. Inclusion and exclusion criteria overview.
Selection categoryInclusion criteriaExclusion criteria
Study populationExpectant parents, parents, parents and children togetherProfessionals use in work setting, primary use by children with parents only as an app gatekeeper
Health areaAll areas of illness prevention/health promotionApps for active management of diagnosis, illness, secondary disease prevention, sexual health, those that are institution based, or those recruiting high-risk patients
App typeSmartphone/tablet/desktopTelehealth, text messaging/SMS-based health support, videoconferencing, health product–based, app only for tracking device facilitation, virtual reality
Publication typeEmpirical studies, reports, reviews, study synthesis, meta-analysis, theses, study protocolsGuidelines, handbooks, instructional manuals, user-based information, technical or specialist publications, commentary, product description
Content of interestApp design, reports on app functionality, evaluations of apps and study reviews, behavior change techniques reporting or evaluation, evaluation strategies, structured digital applicationReview of app functionality, usability survey results
Countries of interestAll upper-middle or high-income country context [The World Bank. World Bank Country and Lending Groups. The World Bank. Washington, D.C. The World Bank Group; 2021. URL: https:/​/datahelpdesk.​worldbank.org/​knowledgebase/​articles/​906519-world-bank-country-and-lending-groups [accessed 2021-05-20] 39]≤Lower- to middle-income country contexts
Stakeholder inputDigital health experts, child health experts, educational experts, study authors (focus on Germany and Europe)No restrictions applicable
Timeframe≥2016 (Google Scholar >2021)<2015
Figure 1. PRISMA-ScR flowchart. PRISMA-ScR: Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews.

Study Selection

The search took place following an initial identification of studies through the databases. Then, we performed a screening of the title, abstract, and keywords for applicability according to the inclusion and exclusion criteria and studies were imported into EndNote X9 (Clarivate) [EndNote X9 [software]. Philadelphia, PA. Clarivate; 2013. URL: https://endnote.com/downloads [accessed 2023-06-22] 40].

In the next screening step, the first author (SBB) applied the inclusion and exclusion criteria according to study abstracts, eliminated duplicates, and added full-text PDFs of all studies fitting the inclusion criteria. All expert contributions were controlled for documentary evaluation or assessment of the apps or projects, ensuring they fit within the inclusion/exclusion criteria and removing duplication. The resulting full-text studies and corresponding research information system (RIS) files that compiled bibliographic data information were imported into the analysis management software MAXQDA (version 20; VERBI GmbH) [MAXQDA 2020 [software]. In: MAXQDA/VERBI. Berlin, Germany. VERBI Software; 2019.41].

All studies that passed the original screening were reviewed in full text, coded deductively with the bibliographic RIS content, and systematically evaluated according to the paper sections. After full-text scrutiny, studies not meeting the inclusion criteria were excluded and adjustments were discussed, justified, and made within the whole team when necessary, based on the refinement of the inclusion criteria. Additionally, scrutiny of the included bibliographies, especially topically relevant reviews, was culled for additional studies.

Summarizing the Data

The included studies summarized the key information as suggested by Peters et al [Peters MDJ, Godfrey CM, Khalil H, McInerney P, Parker D, Soares CB. Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc. Sep 2015;13(3):141-146. [CrossRef] [Medline]35] and this key information was analyzed through a systematic and descriptive content analysis based on Mayring and Fenzl [Mayring P, Fenzl T. Qualitative inhaltsanalyse. In: Handbuch Methoden der empirischen Sozialforschung. Berlin, Germany. Springer; 2014;543-556.42] using a combined deductive and inductive approach. Deductive coding and descriptive analysis were conducted on all the included studies to compile and describe the following information: (1) keywords, (2) year of publication, (3) country of origin, (4) aims/purpose, (5) study population and sample size, (6) intervention type, (7) methodology/method(s), (8) broad topic(s), (9) evaluation, and (10) outcomes and details. Following this, key findings that related to the scoping review questions were coded inductively within the deductive descriptive categories: broad paper topics and evaluation. To verify the reliability of the coding of the study types and topics, the second author (KV) reviewed all studies based on inductively developed definitions. Discrepancies were discussed within the team and code definitions were adjusted accordingly. A descriptive summary of how apps and behaviors were evaluated are summarized in Table 2.

Table 2. List of evaluation tools found in included studies.
Broad paper topics and evaluation tool categoryEvaluation tool type or name [reference]
Physical activity
  • Assessment of subcategories: changes in physical activity, adult physical activity, family and social group physical activity, children’s physical activity evaluation, and tracking physical activity and real-time measurements


Moderators of physical activity
  • Ecological Momentary Assessment (EMA); Behavioral Regulation in Exercise Questionnaire; Self-Efficacy Scale; intention to participate in physical activity and to eat healthy foods [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43]
  • Barriers to Being Active Quiz; Self-Efficacy for Physical Activity Scale; Physical Activity Stages of Change [Choi J, Lee JH, Vittinghoff E, Fukuoka Y. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women. Matern Child Health J. May 2016;20(5):1091-1101. [FREE Full text] [CrossRef] [Medline]44]


Adult physical activity
  • Short Questionnaire to Assess Health-Enhancing Physical Activity (SQUASH) [Dodd JM, Louise J, Cramp C, Grivell RM, Moran LJ, Deussen AR. Evaluation of a smartphone nutrition and physical activity application to provide lifestyle advice to pregnant women: The SNAPP randomised trial. Matern Child Nutr. Jan 2018;14(1):e12502. [FREE Full text] [CrossRef] [Medline]45]
  • International Physical Activity Questionnaire [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43]
  • Stanford Brief Physical Activity Survey [Choi J, Lee JH, Vittinghoff E, Fukuoka Y. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women. Matern Child Health J. May 2016;20(5):1091-1101. [FREE Full text] [CrossRef] [Medline]44]
  • WHOa physical activity criteria [Meixner C, Baumann H, Fenger A, Wollesen B. Gamification in health apps to increase physical activity within families. New York, NY. IEEE; Presented at: 2019 International Conference on Wireless and Mobile Computing, Networking and Communications (WiMob); October 21-23, 2019, 2019;21-23; Barcelona, Spain. [CrossRef]46]


Family and social group physical activity
  • Modified National Board of Health and Welfare’s survey [Henriksson H, Alexandrou C, Henriksson P, Henström M, Bendtsen M, Thomas K, et al. MINISTOP 2.0: a smartphone app integrated in primary child health care to promote healthy diet and physical activity behaviours and prevent obesity in preschool-aged children: protocol for a hybrid design effectiveness-implementation study. BMC Public Health. Nov 23, 2020;20(1):1756. [FREE Full text] [CrossRef] [Medline]47]
  • Parental Support for Physical Activity Scale [De Lepeleere S, De Bourdeaudhuij I, Cardon G, Verloigne M. The effect of an online video intervention 'Movie Models' on specific parenting practices and parental self-efficacy related to children's physical activity, screen-time and healthy diet: a quasi experimental study. BMC Public Health. Apr 27, 2017;17(1):366. [FREE Full text] [CrossRef] [Medline]48]
  • The Social Support and Exercise Survey [Choi J, Lee JH, Vittinghoff E, Fukuoka Y. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women. Matern Child Health J. May 2016;20(5):1091-1101. [FREE Full text] [CrossRef] [Medline]44]
  • Family Health Climate Scale [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43]
  • Family physical activity goal setting [Henriksson H, Alexandrou C, Henriksson P, Henström M, Bendtsen M, Thomas K, et al. MINISTOP 2.0: a smartphone app integrated in primary child health care to promote healthy diet and physical activity behaviours and prevent obesity in preschool-aged children: protocol for a hybrid design effectiveness-implementation study. BMC Public Health. Nov 23, 2020;20(1):1756. [FREE Full text] [CrossRef] [Medline]47]


Children’s physical activity evaluation
  • Test of Gross Motor Development 2nd Edition (TGMD-2); The Burdette Outdoor Playtime Checklist [Trost SG, Brookes DSK. Effectiveness of a novel digital application to promote fundamental movement skills in 3- to 6-year-old children: A randomized controlled trial. J Sports Sci. Feb 27, 2021;39(4):453-459. [CrossRef] [Medline]49]


Tracking physical activity
  • Average minutes per day physical activity [Henriksson H, Alexandrou C, Henriksson P, Henström M, Bendtsen M, Thomas K, et al. MINISTOP 2.0: a smartphone app integrated in primary child health care to promote healthy diet and physical activity behaviours and prevent obesity in preschool-aged children: protocol for a hybrid design effectiveness-implementation study. BMC Public Health. Nov 23, 2020;20(1):1756. [FREE Full text] [CrossRef] [Medline]47]
  • Accelerometers or pedometers [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43,Choi J, Lee JH, Vittinghoff E, Fukuoka Y. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women. Matern Child Health J. May 2016;20(5):1091-1101. [FREE Full text] [CrossRef] [Medline]44,Sun A, Cheng J, Bui Q, Liang Y, Ng T, Chen J. Home-Based and Technology-Centered Childhood Obesity Prevention for Chinese Mothers With Preschool-Aged Children. J Transcult Nurs. Nov 2017;28(6):616-624. [CrossRef] [Medline]50]
  • Physical Activity Diary [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43]


Body measurements for physical activity
  • BMI or height and weight [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43-Dodd JM, Louise J, Cramp C, Grivell RM, Moran LJ, Deussen AR. Evaluation of a smartphone nutrition and physical activity application to provide lifestyle advice to pregnant women: The SNAPP randomised trial. Matern Child Nutr. Jan 2018;14(1):e12502. [FREE Full text] [CrossRef] [Medline]45,Henriksson H, Alexandrou C, Henriksson P, Henström M, Bendtsen M, Thomas K, et al. MINISTOP 2.0: a smartphone app integrated in primary child health care to promote healthy diet and physical activity behaviours and prevent obesity in preschool-aged children: protocol for a hybrid design effectiveness-implementation study. BMC Public Health. Nov 23, 2020;20(1):1756. [FREE Full text] [CrossRef] [Medline]47-Sun A, Cheng J, Bui Q, Liang Y, Ng T, Chen J. Home-Based and Technology-Centered Childhood Obesity Prevention for Chinese Mothers With Preschool-Aged Children. J Transcult Nurs. Nov 2017;28(6):616-624. [CrossRef] [Medline]50]

Parent feeding and nutrition
  • Assessment of subcategories: food types and quality, parent feeding and food acceptance, food environment, food and body measurements, and breastfeeding


Food types and quality
  • Youth Risk Behavior Survey questions; The Behavioral Risk Factor Surveillance System Questions [Cullen KW, Thompson D, Chen T. Outcome Evaluation of Family Eats. Health Educ Behav. Feb 2017;44(1):32-40. [CrossRef] [Medline]51]
  • The Willett Questionnaire Harvard Food Frequency; Healthy Eating Index (HEI) [Dodd JM, Louise J, Cramp C, Grivell RM, Moran LJ, Deussen AR. Evaluation of a smartphone nutrition and physical activity application to provide lifestyle advice to pregnant women: The SNAPP randomised trial. Matern Child Nutr. Jan 2018;14(1):e12502. [FREE Full text] [CrossRef] [Medline]45]
  • Healthy Kids Survey [Au LE, Whaley S, Rosen NJ, Meza M, Ritchie LD. Online and In-Person Nutrition Education Improves Breakfast Knowledge, Attitudes, and Behaviors: A Randomized Trial of Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children. J Acad Nutr Diet. Mar 2016;116(3):490-500. [CrossRef] [Medline]52]
  • Food Frequency Questionnaire [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43,Dodd JM, Louise J, Cramp C, Grivell RM, Moran LJ, Deussen AR. Evaluation of a smartphone nutrition and physical activity application to provide lifestyle advice to pregnant women: The SNAPP randomised trial. Matern Child Nutr. Jan 2018;14(1):e12502. [FREE Full text] [CrossRef] [Medline]45,De Lepeleere S, De Bourdeaudhuij I, Cardon G, Verloigne M. The effect of an online video intervention 'Movie Models' on specific parenting practices and parental self-efficacy related to children's physical activity, screen-time and healthy diet: a quasi experimental study. BMC Public Health. Apr 27, 2017;17(1):366. [FREE Full text] [CrossRef] [Medline]48,Zarnowiecki D, Mauch CE, Middleton G, Matwiejczyk L, Watson WL, Dibbs J, et al. A systematic evaluation of digital nutrition promotion websites and apps for supporting parents to influence children's nutrition. Int J Behav Nutr Phys Act. Feb 10, 2020;17(1):17. [FREE Full text] [CrossRef] [Medline]53-Røed M, Medin AC, Vik FN, Hillesund ER, Van Lippevelde W, Campbell K, et al. Effect of a Parent-Focused eHealth Intervention on Children's Fruit, Vegetable, and Discretionary Food Intake (Food4toddlers): Randomized Controlled Trial. J Med Internet Res. Feb 16, 2021;23(2):e18311. [FREE Full text] [CrossRef] [Medline]55]
  • Consumption of fruit, vegetables, water, soft drinks, and snacks [De Lepeleere S, De Bourdeaudhuij I, Cardon G, Verloigne M. The effect of an online video intervention 'Movie Models' on specific parenting practices and parental self-efficacy related to children's physical activity, screen-time and healthy diet: a quasi experimental study. BMC Public Health. Apr 27, 2017;17(1):366. [FREE Full text] [CrossRef] [Medline]48]


Parent feeding and food acceptance
  • Infant Feeding Questionnaire [Russell CG, Denney-Wilson E, Laws RA, Abbott G, Zheng M, Lymer SJ, et al. Impact of the Growing Healthy mHealth Program on Maternal Feeding Practices, Infant Food Preferences, and Satiety Responsiveness: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 25, 2018;6(4):e77. [FREE Full text] [CrossRef] [Medline]56,Gomes AI, Pereira AI, Roberto MS, Boraska K, Barros L. Changing parental feeding practices through web-based interventions: A systematic review and meta-analysis. PLoS One. 2021;16(4):e0250231. [FREE Full text] [CrossRef] [Medline]57]
  • Parent Feeding Practices Scale; Child Feeding Questionnaire (CFQ) [Gomes AI, Pereira AI, Roberto MS, Boraska K, Barros L. Changing parental feeding practices through web-based interventions: A systematic review and meta-analysis. PLoS One. 2021;16(4):e0250231. [FREE Full text] [CrossRef] [Medline]57]
  • Norwegian Mother and Child Cohort Study (MoBa) Questions; Children’s Eating Behaviour Questionnaire (CEBQ); Child Food Neophobia Scale (CFNS) [Helle C, Hillesund ER, Wills AK, Øverby NC. Examining the effects of an eHealth intervention from infant age 6 to 12 months on child eating behaviors and maternal feeding practices one year after cessation: The Norwegian randomized controlled trial Early Food for Future Health. PLoS One. 2019;14(8):e0220437. [FREE Full text] [CrossRef] [Medline]54]
  • Infant Food Exposure and Parental Intentions to Offer Foods [Russell CG, Denney-Wilson E, Laws RA, Abbott G, Zheng M, Lymer SJ, et al. Impact of the Growing Healthy mHealth Program on Maternal Feeding Practices, Infant Food Preferences, and Satiety Responsiveness: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 25, 2018;6(4):e77. [FREE Full text] [CrossRef] [Medline]56]


Food environment
  • The Family Eating and Activity Habits Questionnaire [Sun A, Cheng J, Bui Q, Liang Y, Ng T, Chen J. Home-Based and Technology-Centered Childhood Obesity Prevention for Chinese Mothers With Preschool-Aged Children. J Transcult Nurs. Nov 2017;28(6):616-624. [CrossRef] [Medline]50,Gomes AI, Pereira AI, Roberto MS, Boraska K, Barros L. Changing parental feeding practices through web-based interventions: A systematic review and meta-analysis. PLoS One. 2021;16(4):e0250231. [FREE Full text] [CrossRef] [Medline]57]
  • Self-efficacy scales, food insecurity [Au LE, Whaley S, Rosen NJ, Meza M, Ritchie LD. Online and In-Person Nutrition Education Improves Breakfast Knowledge, Attitudes, and Behaviors: A Randomized Trial of Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children. J Acad Nutr Diet. Mar 2016;116(3):490-500. [CrossRef] [Medline]52]
  • Regulation of Eating Behavior Scale [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43]
  • Postpartum Partner Support Scale (PPSS) [Scott JA, Burns SK, Hauck YL, Giglia RC, Jorgensen AM, White BK, et al. Impact of a Face-To-Face Versus Smartphone App Versus Combined Breastfeeding Intervention Targeting Fathers: Randomized Controlled Trial. JMIR Pediatr Parent. Apr 12, 2021;4(2):e24579. [FREE Full text] [CrossRef] [Medline]58]
  • Parenting Strategies for Eating and Activity Scale, Parenting Feeding Style Questionnaire [De Lepeleere S, De Bourdeaudhuij I, Cardon G, Verloigne M. The effect of an online video intervention 'Movie Models' on specific parenting practices and parental self-efficacy related to children's physical activity, screen-time and healthy diet: a quasi experimental study. BMC Public Health. Apr 27, 2017;17(1):366. [FREE Full text] [CrossRef] [Medline]48]
  • Parenting Practices Questionnaire, Parent Modelling Questionnaire, Family Support [Gomes AI, Pereira AI, Roberto MS, Boraska K, Barros L. Changing parental feeding practices through web-based interventions: A systematic review and meta-analysis. PLoS One. 2021;16(4):e0250231. [FREE Full text] [CrossRef] [Medline]57]
  • Menu planning and shopping practices, healthy restaurant selection practices, family food preparation practices [Cullen KW, Thompson D, Chen T. Outcome Evaluation of Family Eats. Health Educ Behav. Feb 2017;44(1):32-40. [CrossRef] [Medline]51]
  • Australian NOURISH study questionnaire [Helle C, Hillesund ER, Wills AK, Øverby NC. Examining the effects of an eHealth intervention from infant age 6 to 12 months on child eating behaviors and maternal feeding practices one year after cessation: The Norwegian randomized controlled trial Early Food for Future Health. PLoS One. 2019;14(8):e0220437. [FREE Full text] [CrossRef] [Medline]54]
  • Environment and Policy Assessment Observation [Pond N, Finch M, Sutherland R, Wolfenden L, Nathan N, Kingsland M, et al. Cluster randomised controlled trial of an m-health intervention in centre-based childcare services to reduce the packing of discretionary foods in children's lunchboxes: study protocol for the 'SWAP IT Childcare' trial. BMJ Open. Jun 01, 2019;9(5):e026829. [FREE Full text] [CrossRef] [Medline]59]
  • School Food Checklist [Sutherland R, Nathan N, Brown A, Yoong S, Finch M, Lecathelinais C, et al. A randomized controlled trial to assess the potential efficacy, feasibility and acceptability of an m-health intervention targeting parents of school aged children to improve the nutritional quality of foods packed in the lunchbox 'SWAP IT'. Int J Behav Nutr Phys Act. Jul 02, 2019;16(1):54. [FREE Full text] [CrossRef] [Medline]60]


Food measurements
  • Fruit and Vegetable Intake Diary [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43,Zarnowiecki D, Mauch CE, Middleton G, Matwiejczyk L, Watson WL, Dibbs J, et al. A systematic evaluation of digital nutrition promotion websites and apps for supporting parents to influence children's nutrition. Int J Behav Nutr Phys Act. Feb 10, 2020;17(1):17. [FREE Full text] [CrossRef] [Medline]53]
  • 24-hour dietary recall of foods and beverages [Gomes AI, Pereira AI, Roberto MS, Boraska K, Barros L. Changing parental feeding practices through web-based interventions: A systematic review and meta-analysis. PLoS One. 2021;16(4):e0250231. [FREE Full text] [CrossRef] [Medline]57]
  • Food photography and weighed food records [Pond N, Finch M, Sutherland R, Wolfenden L, Nathan N, Kingsland M, et al. Cluster randomised controlled trial of an m-health intervention in centre-based childcare services to reduce the packing of discretionary foods in children's lunchboxes: study protocol for the 'SWAP IT Childcare' trial. BMJ Open. Jun 01, 2019;9(5):e026829. [FREE Full text] [CrossRef] [Medline]59,Sutherland R, Nathan N, Brown A, Yoong S, Finch M, Lecathelinais C, et al. A randomized controlled trial to assess the potential efficacy, feasibility and acceptability of an m-health intervention targeting parents of school aged children to improve the nutritional quality of foods packed in the lunchbox 'SWAP IT'. Int J Behav Nutr Phys Act. Jul 02, 2019;16(1):54. [FREE Full text] [CrossRef] [Medline]60]
  • Caloric counting in kilojoules [Pond N, Finch M, Sutherland R, Wolfenden L, Nathan N, Kingsland M, et al. Cluster randomised controlled trial of an m-health intervention in centre-based childcare services to reduce the packing of discretionary foods in children's lunchboxes: study protocol for the 'SWAP IT Childcare' trial. BMJ Open. Jun 01, 2019;9(5):e026829. [FREE Full text] [CrossRef] [Medline]59,Sutherland R, Nathan N, Brown A, Yoong S, Finch M, Lecathelinais C, et al. A randomized controlled trial to assess the potential efficacy, feasibility and acceptability of an m-health intervention targeting parents of school aged children to improve the nutritional quality of foods packed in the lunchbox 'SWAP IT'. Int J Behav Nutr Phys Act. Jul 02, 2019;16(1):54. [FREE Full text] [CrossRef] [Medline]60]


Body measurements for nutrition
  • Weight reporting [Cullen KW, Thompson D, Chen T. Outcome Evaluation of Family Eats. Health Educ Behav. Feb 2017;44(1):32-40. [CrossRef] [Medline]51]
  • BMI or height and weight [Dodd JM, Louise J, Cramp C, Grivell RM, Moran LJ, Deussen AR. Evaluation of a smartphone nutrition and physical activity application to provide lifestyle advice to pregnant women: The SNAPP randomised trial. Matern Child Nutr. Jan 2018;14(1):e12502. [FREE Full text] [CrossRef] [Medline]45,Henriksson H, Alexandrou C, Henriksson P, Henström M, Bendtsen M, Thomas K, et al. MINISTOP 2.0: a smartphone app integrated in primary child health care to promote healthy diet and physical activity behaviours and prevent obesity in preschool-aged children: protocol for a hybrid design effectiveness-implementation study. BMC Public Health. Nov 23, 2020;20(1):1756. [FREE Full text] [CrossRef] [Medline]47,De Lepeleere S, De Bourdeaudhuij I, Cardon G, Verloigne M. The effect of an online video intervention 'Movie Models' on specific parenting practices and parental self-efficacy related to children's physical activity, screen-time and healthy diet: a quasi experimental study. BMC Public Health. Apr 27, 2017;17(1):366. [FREE Full text] [CrossRef] [Medline]48,Sun A, Cheng J, Bui Q, Liang Y, Ng T, Chen J. Home-Based and Technology-Centered Childhood Obesity Prevention for Chinese Mothers With Preschool-Aged Children. J Transcult Nurs. Nov 2017;28(6):616-624. [CrossRef] [Medline]50,Cullen KW, Thompson D, Chen T. Outcome Evaluation of Family Eats. Health Educ Behav. Feb 2017;44(1):32-40. [CrossRef] [Medline]51,Helle C, Hillesund ER, Wills AK, Øverby NC. Examining the effects of an eHealth intervention from infant age 6 to 12 months on child eating behaviors and maternal feeding practices one year after cessation: The Norwegian randomized controlled trial Early Food for Future Health. PLoS One. 2019;14(8):e0220437. [FREE Full text] [CrossRef] [Medline]54-Russell CG, Denney-Wilson E, Laws RA, Abbott G, Zheng M, Lymer SJ, et al. Impact of the Growing Healthy mHealth Program on Maternal Feeding Practices, Infant Food Preferences, and Satiety Responsiveness: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 25, 2018;6(4):e77. [FREE Full text] [CrossRef] [Medline]56,Laws RA, Denney-Wilson EA, Taki S, Russell CG, Zheng M, Litterbach E, et al. Key Lessons and Impact of the Growing Healthy mHealth Program on Milk Feeding, Timing of Introduction of Solids, and Infant Growth: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 19, 2018;6(4):e78. [FREE Full text] [CrossRef] [Medline]61]
  • Waist circumference [Sun A, Cheng J, Bui Q, Liang Y, Ng T, Chen J. Home-Based and Technology-Centered Childhood Obesity Prevention for Chinese Mothers With Preschool-Aged Children. J Transcult Nurs. Nov 2017;28(6):616-624. [CrossRef] [Medline]50,Gomes AI, Pereira AI, Roberto MS, Boraska K, Barros L. Changing parental feeding practices through web-based interventions: A systematic review and meta-analysis. PLoS One. 2021;16(4):e0250231. [FREE Full text] [CrossRef] [Medline]57]


Breastfeeding
  • WHO duration of exclusive breastfeeding, Breastfeeding Self-Efficacy Scale (BSES-SF) [Scott JA, Burns SK, Hauck YL, Giglia RC, Jorgensen AM, White BK, et al. Impact of a Face-To-Face Versus Smartphone App Versus Combined Breastfeeding Intervention Targeting Fathers: Randomized Controlled Trial. JMIR Pediatr Parent. Apr 12, 2021;4(2):e24579. [FREE Full text] [CrossRef] [Medline]58]
  • Baby Eating Behaviour Questionnaire (BEBQ) [Russell CG, Denney-Wilson E, Laws RA, Abbott G, Zheng M, Lymer SJ, et al. Impact of the Growing Healthy mHealth Program on Maternal Feeding Practices, Infant Food Preferences, and Satiety Responsiveness: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 25, 2018;6(4):e77. [FREE Full text] [CrossRef] [Medline]56]

Dental health
  • Dental Knowledge Attitudes and Practices Questionnaire [Zolfaghari M, Shirmohammadi M, Shahhosseini H, Mokhtaran M, Mohebbi SZ. Development and evaluation of a gamified smart phone mobile health application for oral health promotion in early childhood: a randomized controlled trial. BMC Oral Health. Jan 07, 2021;21(1):18. [FREE Full text] [CrossRef] [Medline]62]
  • Oral health behaviors in children and determinants of the Theory of Planned Behavior [Lozoya CJS, Giblin-Scanlon L, Boyd LD, Nolen S, Vineyard J. Influence of a Smartphone Application on the Oral Health Practices and Behaviors of Parents of Preschool Children. J Dent Hyg. Oct 2019;93(5):6-14. [Medline]63]
  • Purposively sampled qualitative interviews [Lozoya CJS, Giblin-Scanlon L, Boyd LD, Nolen S, Vineyard J. Influence of a Smartphone Application on the Oral Health Practices and Behaviors of Parents of Preschool Children. J Dent Hyg. Oct 2019;93(5):6-14. [Medline]63]

Sleep
  • Customized Sleep Profile (CSP); Brief Infant Sleep Questionnaire–Revised (BISQ-R) [Leichman ES, Gould RA, Williamson AA, Walters RM, Mindell JA. Effectiveness of an mHealth Intervention for Infant Sleep Disturbances. Behav Ther. Jul 2020;51(4):548-558. [FREE Full text] [CrossRef] [Medline]64]
  • Familial risk moderates the association between sleep and zBMIb; activity-based sleep-wake identification; Sleep Habits Questionnaire [Gomes AI, Pereira AI, Roberto MS, Boraska K, Barros L. Changing parental feeding practices through web-based interventions: A systematic review and meta-analysis. PLoS One. 2021;16(4):e0250231. [FREE Full text] [CrossRef] [Medline]57]

Mental health
  • Center for Epidemiological Studies Depression Scale [Choi J, Lee JH, Vittinghoff E, Fukuoka Y. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women. Matern Child Health J. May 2016;20(5):1091-1101. [FREE Full text] [CrossRef] [Medline]44]
  • Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) [Deave T, Ginja S, Goodenough T, Bailey E, Piwek L, Coad J, et al. The Bumps and BaBies Longitudinal Study (BaBBLeS): a multi-site cohort study of first-time mothers to evaluate the effectiveness of the Baby Buddy app. Mhealth. Sep 2019;5:42-42. [FREE Full text] [CrossRef] [Medline]65]
  • Edinburgh Postnatal Depression Scale (EPDS), State Trait Anxiety Inventory (STAI) [Shorey S, Ng YPM, Ng ED, Siew AL, Mörelius E, Yoong J, et al. Effectiveness of a Technology-Based Supportive Educational Parenting Program on Parental Outcomes (Part 1): Randomized Controlled Trial. J Med Internet Res. Feb 13, 2019;21(2):e10816. [FREE Full text] [CrossRef] [Medline]66]

Parent child health
  • Patient activation measure (PAM); Functional, Communicative, Critical Health Literacy Scale [Ledford CJW, Womack JJ, Rider HA, Seehusen AB, Conner SJ, Lauters RA, et al. Unexpected Effects of a System-Distributed Mobile Application in Maternity Care: A Randomized Controlled Trial. Health Educ Behav. Jun 16, 2018;45(3):323-330. [CrossRef] [Medline]67]
  • Patient Education Materials Assessment Tool (PEMAT) [Davis DW, Logsdon MC, Vogt K, Rushton J, Myers J, Lauf A, et al. Parent Education is Changing: A Review of Smartphone Apps. MCN Am J Matern Child Nurs. 2017;42(5):248-256. [CrossRef] [Medline]68]
  • The 21-item Asian Self-Identity Acculturation Scale [Sun A, Cheng J, Bui Q, Liang Y, Ng T, Chen J. Home-Based and Technology-Centered Childhood Obesity Prevention for Chinese Mothers With Preschool-Aged Children. J Transcult Nurs. Nov 2017;28(6):616-624. [CrossRef] [Medline]50]

Healthy environment
  • Safety behaviors and behavioral intentions [McKenzie LB, Roberts KJ, Clark R, McAdams R, Abdel-Rasoul M, Klein EG, et al. A randomized controlled trial to evaluate the Make Safe Happen® app-a mobile technology-based safety behavior change intervention for increasing parents' safety knowledge and actions. Inj Epidemiol. Mar 12, 2018;5(1):5. [FREE Full text] [CrossRef] [Medline]69]
  • Safety knowledge [McKenzie LB, Roberts KJ, Clark R, McAdams R, Abdel-Rasoul M, Klein EG, et al. A randomized controlled trial to evaluate the Make Safe Happen® app-a mobile technology-based safety behavior change intervention for increasing parents' safety knowledge and actions. Inj Epidemiol. Mar 12, 2018;5(1):5. [FREE Full text] [CrossRef] [Medline]69,Roberts KJ, McAdams RJ, Kristel OV, Szymanski AM, McKenzie LB. Qualitative and Quantitative Evaluation of the Make Safe Happen App: Mobile Technology-Based Safety Behavior Change Intervention for Parents. JMIR Pediatr Parent. Mar 14, 2019;2(1):e12022. [FREE Full text] [CrossRef] [Medline]70]
  • Hot beverage scald risk and burn first-aid knowledge [Burgess J, Watt K, Kimble RM, Cameron CM. Combining Technology and Research to Prevent Scald Injuries (the Cool Runnings Intervention): Randomized Controlled Trial. J Med Internet Res. Oct 10, 2018;20(10):e10361. [FREE Full text] [CrossRef] [Medline]71]

Maternal health and parenting
  • Prenatal Interpersonal Processes of Care (PIPC) Scale [Ledford CJW, Womack JJ, Rider HA, Seehusen AB, Conner SJ, Lauters RA, et al. Unexpected Effects of a System-Distributed Mobile Application in Maternity Care: A Randomized Controlled Trial. Health Educ Behav. Jun 16, 2018;45(3):323-330. [CrossRef] [Medline]67]
  • Maternal Self-Efficacy Scale [Sun A, Cheng J, Bui Q, Liang Y, Ng T, Chen J. Home-Based and Technology-Centered Childhood Obesity Prevention for Chinese Mothers With Preschool-Aged Children. J Transcult Nurs. Nov 2017;28(6):616-624. [CrossRef] [Medline]50]
  • Pregnancy Discomfort Checklist [Choi J, Lee JH, Vittinghoff E, Fukuoka Y. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women. Matern Child Health J. May 2016;20(5):1091-1101. [FREE Full text] [CrossRef] [Medline]44]
  • Parenting Self-Efficacy (Tool to Measure Parenting Self-Efficacy [TOPSE]) [Deave T, Ginja S, Goodenough T, Bailey E, Piwek L, Coad J, et al. The Bumps and BaBies Longitudinal Study (BaBBLeS): a multi-site cohort study of first-time mothers to evaluate the effectiveness of the Baby Buddy app. Mhealth. Sep 2019;5:42-42. [FREE Full text] [CrossRef] [Medline]65]
  • Parenting Efficacy Scale, What Being a Parent of a Baby Is Like (WPBL), Perceived Social Support for Parenting (PSSP), Parent-to-Infant Bonding Questionnaire (PIBQ) [Shorey S, Ng YPM, Ng ED, Siew AL, Mörelius E, Yoong J, et al. Effectiveness of a Technology-Based Supportive Educational Parenting Program on Parental Outcomes (Part 1): Randomized Controlled Trial. J Med Internet Res. Feb 13, 2019;21(2):e10816. [FREE Full text] [CrossRef] [Medline]66]

App evaluation
  • Assessment of subcategories: app quality, app usability, and app coverage


App quality
  • Suitability Assessment of Materials (SAM) [Cheng H, Tutt A, Llewellyn C, Size D, Jones J, Taki S, et al. Content and Quality of Infant Feeding Smartphone Apps: Five-Year Update on a Systematic Search and Evaluation. JMIR Mhealth Uhealth. May 27, 2020;8(5):e17300. [FREE Full text] [CrossRef] [Medline]72]
  • Persuasive System Design Model [Meedya S, Win K, Yeatman H, Fahy K, Walton K, Burgess L, et al. Developing and testing a mobile application for breastfeeding support: The Milky Way application. Women Birth. Mar 2021;34(2):e196-e203. [FREE Full text] [CrossRef] [Medline]73]
  • Mobile App Rating Scale (MARS) [Zarnowiecki D, Mauch CE, Middleton G, Matwiejczyk L, Watson WL, Dibbs J, et al. A systematic evaluation of digital nutrition promotion websites and apps for supporting parents to influence children's nutrition. Int J Behav Nutr Phys Act. Feb 10, 2020;17(1):17. [FREE Full text] [CrossRef] [Medline]53,Cheng H, Tutt A, Llewellyn C, Size D, Jones J, Taki S, et al. Content and Quality of Infant Feeding Smartphone Apps: Five-Year Update on a Systematic Search and Evaluation. JMIR Mhealth Uhealth. May 27, 2020;8(5):e17300. [FREE Full text] [CrossRef] [Medline]72,Mauch CE, Laws RA, Prichard I, Maeder AJ, Wycherley TP, Golley RK. Commercially Available Apps to Support Healthy Family Meals: User Testing of App Utility, Acceptability, and Engagement. JMIR Mhealth Uhealth. May 07, 2021;9(5):e22990. [FREE Full text] [CrossRef] [Medline]74]
  • Semistructured and structured interviews [Mauch CE, Laws RA, Prichard I, Maeder AJ, Wycherley TP, Golley RK. Commercially Available Apps to Support Healthy Family Meals: User Testing of App Utility, Acceptability, and Engagement. JMIR Mhealth Uhealth. May 07, 2021;9(5):e22990. [FREE Full text] [CrossRef] [Medline]74,Militello L, Sezgin E, Huang Y, Lin S. Delivering Perinatal Health Information via a Voice Interactive App (SMILE): Mixed Methods Feasibility Study. JMIR Form Res. Mar 01, 2021;5(3):e18240. [FREE Full text] [CrossRef] [Medline]75]
  • Participant app testing [Mauch CE, Laws RA, Prichard I, Maeder AJ, Wycherley TP, Golley RK. Commercially Available Apps to Support Healthy Family Meals: User Testing of App Utility, Acceptability, and Engagement. JMIR Mhealth Uhealth. May 07, 2021;9(5):e22990. [FREE Full text] [CrossRef] [Medline]74,Militello L, Sezgin E, Huang Y, Lin S. Delivering Perinatal Health Information via a Voice Interactive App (SMILE): Mixed Methods Feasibility Study. JMIR Form Res. Mar 01, 2021;5(3):e18240. [FREE Full text] [CrossRef] [Medline]75]

App usability
  • Just-in-time adaptive interventions [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43]
  • Push notifications [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43,Choi J, Lee JH, Vittinghoff E, Fukuoka Y. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women. Matern Child Health J. May 2016;20(5):1091-1101. [FREE Full text] [CrossRef] [Medline]44,Scott JA, Burns SK, Hauck YL, Giglia RC, Jorgensen AM, White BK, et al. Impact of a Face-To-Face Versus Smartphone App Versus Combined Breastfeeding Intervention Targeting Fathers: Randomized Controlled Trial. JMIR Pediatr Parent. Apr 12, 2021;4(2):e24579. [FREE Full text] [CrossRef] [Medline]58]
  • Gamification [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43,Meixner C, Baumann H, Fenger A, Wollesen B. Gamification in health apps to increase physical activity within families. New York, NY. IEEE; Presented at: 2019 International Conference on Wireless and Mobile Computing, Networking and Communications (WiMob); October 21-23, 2019, 2019;21-23; Barcelona, Spain. [CrossRef]46,Scott JA, Burns SK, Hauck YL, Giglia RC, Jorgensen AM, White BK, et al. Impact of a Face-To-Face Versus Smartphone App Versus Combined Breastfeeding Intervention Targeting Fathers: Randomized Controlled Trial. JMIR Pediatr Parent. Apr 12, 2021;4(2):e24579. [FREE Full text] [CrossRef] [Medline]58,Burgess J, Watt K, Kimble RM, Cameron CM. Combining Technology and Research to Prevent Scald Injuries (the Cool Runnings Intervention): Randomized Controlled Trial. J Med Internet Res. Oct 10, 2018;20(10):e10361. [FREE Full text] [CrossRef] [Medline]71,Mauch CE, Laws RA, Prichard I, Maeder AJ, Wycherley TP, Golley RK. Commercially Available Apps to Support Healthy Family Meals: User Testing of App Utility, Acceptability, and Engagement. JMIR Mhealth Uhealth. May 07, 2021;9(5):e22990. [FREE Full text] [CrossRef] [Medline]74]
  • Technology Acceptance Model (TAM) [Taki S, Russell CG, Lymer S, Laws R, Campbell K, Appleton J, et al. A Mixed Methods Study to Explore the Effects of Program Design Elements and Participant Characteristics on Parents' Engagement With an mHealth Program to Promote Healthy Infant Feeding: The Growing Healthy Program. Front Endocrinol (Lausanne). 2019;10:397. [FREE Full text] [CrossRef] [Medline]76]
  • Engagement Index Tool [Militello L, Sezgin E, Huang Y, Lin S. Delivering Perinatal Health Information via a Voice Interactive App (SMILE): Mixed Methods Feasibility Study. JMIR Form Res. Mar 01, 2021;5(3):e18240. [FREE Full text] [CrossRef] [Medline]75]
  • The System Usability Scale (SUS) [Mauch CE, Laws RA, Prichard I, Maeder AJ, Wycherley TP, Golley RK. Commercially Available Apps to Support Healthy Family Meals: User Testing of App Utility, Acceptability, and Engagement. JMIR Mhealth Uhealth. May 07, 2021;9(5):e22990. [FREE Full text] [CrossRef] [Medline]74]

App coverage
  • Health-Related Website Evaluation Form: Developed Quantitative Tool for App Coverage [Cheng H, Tutt A, Llewellyn C, Size D, Jones J, Taki S, et al. Content and Quality of Infant Feeding Smartphone Apps: Five-Year Update on a Systematic Search and Evaluation. JMIR Mhealth Uhealth. May 27, 2020;8(5):e17300. [FREE Full text] [CrossRef] [Medline]72]

aWHO: World Health Organization.

bzBMI: sex- and age-standardized BMI.

Collating, Summarizing, and Reporting Results

The analysis of keywords (1) was conducted from the bibliographic RIS data according to their frequency of appearance. Presentation of the overall findings from the deductive analysis of the study information 2-7 was summarized and detailed in

Multimedia Appendix 2

Detailed summary of results.

DOCX File , 155 KBMultimedia Appendix 2. Within the broad topic(s), ways apps and behaviors were evaluated and study-described outcomes 8-10 and details were analyzed, and then described and summarized in an iterative, inductive process used for the included studies, including a cross-reference between topics and evaluation tools listed within the studies (Table 2).

Reviews were included in this scoping review. For pragmatic organizational reasons, and because some of the primary source data did not fit the scope of our review objectives or fit our inclusion criteria, only the findings of the reviews themselves were included, not the primary literature that they were based on.


Overview

Of the 39 studies included in this review of child health apps for parent use, most stemmed from US-, Australian-, and European-based research. A total of 8 overlapping health promotion topics that were addressed in 28 primary intervention studies, assessed in 6 app feasibility studies, and reviewed in 5 app or literature reviews were identified. The topics found in the inductive analysis were parental feeding and nutrition, physical activity, maternal-child health, parent-child health, healthy environment, dental health, mental health, and sleep. In primary intervention studies, behavior change theories were embedded in 26 studies and evaluations were carried out with a variety of topic-specific, adapted, self-developed, or validated questionnaires and evaluation tools. Methodologically, included studies were summarized and the effects, if any, of interventions were described. Reported study effects varied and used diverse tools to evaluate intervention effects. Alternatively, the feasibility of apps or health behaviors was assessed with a described combination of quantitative evaluation and survey tools along with user input. Included studies cited challenges in assessing healthy behaviors of children though parent apps, specifically in finding the appropriate way to evaluate changes in behavior through apps, recruiting target groups, and retaining app engagement.

Overall, 1040 studies from the 5 selected databases were analyzed and 60 apps and programs were gathered through the expert network. After screening for eligibility and duplication, and adding resources from reviews, 39 studies were included in total; 28 of these were found from databases, 10 were discovered by scrutinizing the bibliographies of included sources, and 1 resource was included from the expert input. An overview of study inclusion can be seen in the PRISMA-ScR flowchart (Figure 1).

Keywords

Keywords of all included studies demonstrated the following terms according to the bibliographic RIS information from the studies. The 11 most frequently used keywords listed in 9 or more included publications (with listed frequency of appearance) were humans (n=19), female (n=14), child (n=13), health promotion (n=12), male (n=12), parents (n=12), mHealth (n=11), smartphone/s (n=10), mobile apps (n=10), adult (n=9) and infant/s (n=9;

Multimedia Appendix 3

Research information system (RIS) keywords from all included studies (occurrence in publications ≥2).

PNG File , 220 KBMultimedia Appendix 3).

Year of Publication and Country of Origin

The included studies were published between 2016 and 2021, with two-thirds published between 2019 and 2021 and an uptick observed in 2019 (

Multimedia Appendix 4

Included scoping review publications (2016-2021).

PNG File , 45 KBMultimedia Appendix 4). Among the upper-middle and high-income countries included, the majority came from the United States (n=15) [Choi J, Lee JH, Vittinghoff E, Fukuoka Y. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women. Matern Child Health J. May 2016;20(5):1091-1101. [FREE Full text] [CrossRef] [Medline]44,Cullen KW, Thompson D, Chen T. Outcome Evaluation of Family Eats. Health Educ Behav. Feb 2017;44(1):32-40. [CrossRef] [Medline]51,Au LE, Whaley S, Rosen NJ, Meza M, Ritchie LD. Online and In-Person Nutrition Education Improves Breakfast Knowledge, Attitudes, and Behaviors: A Randomized Trial of Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children. J Acad Nutr Diet. Mar 2016;116(3):490-500. [CrossRef] [Medline]52,Biviji R. Evaluating the Quality of Mobile Health Apps for Maternal and Child Health (MCH). Indianapolis, IA. Indiana University-Purdue University Indianapolis; 2018.77-Knowlden A, Sharma M. One-Year Efficacy Testing of Enabling Mothers to Prevent Pediatric Obesity Through Web-Based Education and Reciprocal Determinism (EMPOWER) Randomized Control Trial. Health Educ Behav. Feb 2016;43(1):94-106. [CrossRef] [Medline]79], followed by Australia (n=13) [Dodd JM, Louise J, Cramp C, Grivell RM, Moran LJ, Deussen AR. Evaluation of a smartphone nutrition and physical activity application to provide lifestyle advice to pregnant women: The SNAPP randomised trial. Matern Child Nutr. Jan 2018;14(1):e12502. [FREE Full text] [CrossRef] [Medline]45,Trost SG, Brookes DSK. Effectiveness of a novel digital application to promote fundamental movement skills in 3- to 6-year-old children: A randomized controlled trial. J Sports Sci. Feb 27, 2021;39(4):453-459. [CrossRef] [Medline]49,Zarnowiecki D, Mauch CE, Middleton G, Matwiejczyk L, Watson WL, Dibbs J, et al. A systematic evaluation of digital nutrition promotion websites and apps for supporting parents to influence children's nutrition. Int J Behav Nutr Phys Act. Feb 10, 2020;17(1):17. [FREE Full text] [CrossRef] [Medline]53,Russell CG, Denney-Wilson E, Laws RA, Abbott G, Zheng M, Lymer SJ, et al. Impact of the Growing Healthy mHealth Program on Maternal Feeding Practices, Infant Food Preferences, and Satiety Responsiveness: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 25, 2018;6(4):e77. [FREE Full text] [CrossRef] [Medline]56,Scott JA, Burns SK, Hauck YL, Giglia RC, Jorgensen AM, White BK, et al. Impact of a Face-To-Face Versus Smartphone App Versus Combined Breastfeeding Intervention Targeting Fathers: Randomized Controlled Trial. JMIR Pediatr Parent. Apr 12, 2021;4(2):e24579. [FREE Full text] [CrossRef] [Medline]58-Sutherland R, Nathan N, Brown A, Yoong S, Finch M, Lecathelinais C, et al. A randomized controlled trial to assess the potential efficacy, feasibility and acceptability of an m-health intervention targeting parents of school aged children to improve the nutritional quality of foods packed in the lunchbox 'SWAP IT'. Int J Behav Nutr Phys Act. Jul 02, 2019;16(1):54. [FREE Full text] [CrossRef] [Medline]60,Cheng H, Tutt A, Llewellyn C, Size D, Jones J, Taki S, et al. Content and Quality of Infant Feeding Smartphone Apps: Five-Year Update on a Systematic Search and Evaluation. JMIR Mhealth Uhealth. May 27, 2020;8(5):e17300. [FREE Full text] [CrossRef] [Medline]72-Mauch CE, Laws RA, Prichard I, Maeder AJ, Wycherley TP, Golley RK. Commercially Available Apps to Support Healthy Family Meals: User Testing of App Utility, Acceptability, and Engagement. JMIR Mhealth Uhealth. May 07, 2021;9(5):e22990. [FREE Full text] [CrossRef] [Medline]74,Burgess JD, Watt KA, Kimble RM, Cameron CM. Knowledge of childhood burn risks and burn first aid: Cool Runnings. Inj Prev. Aug 2019;25(4):301-306. [CrossRef] [Medline]80-Taki S, Russell CG, Wen LM, Laws RA, Campbell K, Xu H, et al. Consumer Engagement in Mobile Application (App) Interventions Focused on Supporting Infant Feeding Practices for Early Prevention of Childhood Obesity. Front Public Health. 2019;7:60. [FREE Full text] [CrossRef] [Medline]82] and then the European region (n=9) [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43,Meixner C, Baumann H, Fenger A, Wollesen B. Gamification in health apps to increase physical activity within families. New York, NY. IEEE; Presented at: 2019 International Conference on Wireless and Mobile Computing, Networking and Communications (WiMob); October 21-23, 2019, 2019;21-23; Barcelona, Spain. [CrossRef]46-De Lepeleere S, De Bourdeaudhuij I, Cardon G, Verloigne M. The effect of an online video intervention 'Movie Models' on specific parenting practices and parental self-efficacy related to children's physical activity, screen-time and healthy diet: a quasi experimental study. BMC Public Health. Apr 27, 2017;17(1):366. [FREE Full text] [CrossRef] [Medline]48,Helle C, Hillesund ER, Wills AK, Øverby NC. Examining the effects of an eHealth intervention from infant age 6 to 12 months on child eating behaviors and maternal feeding practices one year after cessation: The Norwegian randomized controlled trial Early Food for Future Health. PLoS One. 2019;14(8):e0220437. [FREE Full text] [CrossRef] [Medline]54,Røed M, Medin AC, Vik FN, Hillesund ER, Van Lippevelde W, Campbell K, et al. Effect of a Parent-Focused eHealth Intervention on Children's Fruit, Vegetable, and Discretionary Food Intake (Food4toddlers): Randomized Controlled Trial. J Med Internet Res. Feb 16, 2021;23(2):e18311. [FREE Full text] [CrossRef] [Medline]55,Gomes AI, Pereira AI, Roberto MS, Boraska K, Barros L. Changing parental feeding practices through web-based interventions: A systematic review and meta-analysis. PLoS One. 2021;16(4):e0250231. [FREE Full text] [CrossRef] [Medline]57,Otte RA, van Beukering AJE, Boelens-Brockhuis L. Tracker-Based Personal Advice to Support the Baby's Healthy Development in a Novel Parenting App: Data-Driven Innovation. JMIR Mhealth Uhealth. Jul 24, 2019;7(7):e12666. [FREE Full text] [CrossRef] [Medline]83]. Included European countries with 1 study each were Belgium [De Lepeleere S, De Bourdeaudhuij I, Cardon G, Verloigne M. The effect of an online video intervention 'Movie Models' on specific parenting practices and parental self-efficacy related to children's physical activity, screen-time and healthy diet: a quasi experimental study. BMC Public Health. Apr 27, 2017;17(1):366. [FREE Full text] [CrossRef] [Medline]48], the Netherlands [Otte RA, van Beukering AJE, Boelens-Brockhuis L. Tracker-Based Personal Advice to Support the Baby's Healthy Development in a Novel Parenting App: Data-Driven Innovation. JMIR Mhealth Uhealth. Jul 24, 2019;7(7):e12666. [FREE Full text] [CrossRef] [Medline]83], Portugal [Gomes AI, Pereira AI, Roberto MS, Boraska K, Barros L. Changing parental feeding practices through web-based interventions: A systematic review and meta-analysis. PLoS One. 2021;16(4):e0250231. [FREE Full text] [CrossRef] [Medline]57], Sweden [Henriksson H, Alexandrou C, Henriksson P, Henström M, Bendtsen M, Thomas K, et al. MINISTOP 2.0: a smartphone app integrated in primary child health care to promote healthy diet and physical activity behaviours and prevent obesity in preschool-aged children: protocol for a hybrid design effectiveness-implementation study. BMC Public Health. Nov 23, 2020;20(1):1756. [FREE Full text] [CrossRef] [Medline]47], and the United Kingdom [Otte RA, van Beukering AJE, Boelens-Brockhuis L. Tracker-Based Personal Advice to Support the Baby's Healthy Development in a Novel Parenting App: Data-Driven Innovation. JMIR Mhealth Uhealth. Jul 24, 2019;7(7):e12666. [FREE Full text] [CrossRef] [Medline]83], with 2 studies each in Norway [Helle C, Hillesund ER, Wills AK, Øverby NC. Examining the effects of an eHealth intervention from infant age 6 to 12 months on child eating behaviors and maternal feeding practices one year after cessation: The Norwegian randomized controlled trial Early Food for Future Health. PLoS One. 2019;14(8):e0220437. [FREE Full text] [CrossRef] [Medline]54,Røed M, Medin AC, Vik FN, Hillesund ER, Van Lippevelde W, Campbell K, et al. Effect of a Parent-Focused eHealth Intervention on Children's Fruit, Vegetable, and Discretionary Food Intake (Food4toddlers): Randomized Controlled Trial. J Med Internet Res. Feb 16, 2021;23(2):e18311. [FREE Full text] [CrossRef] [Medline]55] and Germany [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43,Meixner C, Baumann H, Fenger A, Wollesen B. Gamification in health apps to increase physical activity within families. New York, NY. IEEE; Presented at: 2019 International Conference on Wireless and Mobile Computing, Networking and Communications (WiMob); October 21-23, 2019, 2019;21-23; Barcelona, Spain. [CrossRef]46]. Only 2 studies came from countries outside the global North (Singapore [Shorey S, Ng YPM, Ng ED, Siew AL, Mörelius E, Yoong J, et al. Effectiveness of a Technology-Based Supportive Educational Parenting Program on Parental Outcomes (Part 1): Randomized Controlled Trial. J Med Internet Res. Feb 13, 2019;21(2):e10816. [FREE Full text] [CrossRef] [Medline]66] and Iran [Zolfaghari M, Shirmohammadi M, Shahhosseini H, Mokhtaran M, Mohebbi SZ. Development and evaluation of a gamified smart phone mobile health application for oral health promotion in early childhood: a randomized controlled trial. BMC Oral Health. Jan 07, 2021;21(1):18. [FREE Full text] [CrossRef] [Medline]62]).

Aim, Sample Size, and Intervention Type

Specific aims of the studies were diverse and ranged from creating a topic overview of existing studies or apps, assessing the feasibility of developed apps, to evaluating the effectiveness of a child health promoting intervention involving app or web-based content. There were 3 types of interventions that were included in our review: 28 primary studies [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43-Au LE, Whaley S, Rosen NJ, Meza M, Ritchie LD. Online and In-Person Nutrition Education Improves Breakfast Knowledge, Attitudes, and Behaviors: A Randomized Trial of Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children. J Acad Nutr Diet. Mar 2016;116(3):490-500. [CrossRef] [Medline]52,Helle C, Hillesund ER, Wills AK, Øverby NC. Examining the effects of an eHealth intervention from infant age 6 to 12 months on child eating behaviors and maternal feeding practices one year after cessation: The Norwegian randomized controlled trial Early Food for Future Health. PLoS One. 2019;14(8):e0220437. [FREE Full text] [CrossRef] [Medline]54-Russell CG, Denney-Wilson E, Laws RA, Abbott G, Zheng M, Lymer SJ, et al. Impact of the Growing Healthy mHealth Program on Maternal Feeding Practices, Infant Food Preferences, and Satiety Responsiveness: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 25, 2018;6(4):e77. [FREE Full text] [CrossRef] [Medline]56,Scott JA, Burns SK, Hauck YL, Giglia RC, Jorgensen AM, White BK, et al. Impact of a Face-To-Face Versus Smartphone App Versus Combined Breastfeeding Intervention Targeting Fathers: Randomized Controlled Trial. JMIR Pediatr Parent. Apr 12, 2021;4(2):e24579. [FREE Full text] [CrossRef] [Medline]58-Ledford CJW, Womack JJ, Rider HA, Seehusen AB, Conner SJ, Lauters RA, et al. Unexpected Effects of a System-Distributed Mobile Application in Maternity Care: A Randomized Controlled Trial. Health Educ Behav. Jun 16, 2018;45(3):323-330. [CrossRef] [Medline]67,McKenzie LB, Roberts KJ, Clark R, McAdams R, Abdel-Rasoul M, Klein EG, et al. A randomized controlled trial to evaluate the Make Safe Happen® app-a mobile technology-based safety behavior change intervention for increasing parents' safety knowledge and actions. Inj Epidemiol. Mar 12, 2018;5(1):5. [FREE Full text] [CrossRef] [Medline]69,Burgess J, Watt K, Kimble RM, Cameron CM. Combining Technology and Research to Prevent Scald Injuries (the Cool Runnings Intervention): Randomized Controlled Trial. J Med Internet Res. Oct 10, 2018;20(10):e10361. [FREE Full text] [CrossRef] [Medline]71,Cushing CC, Fedele DA, Brannon EE, Kichline T. Parents' Perspectives on the Theoretical Domains Framework Elements Needed in a Pediatric Health Behavior App: A Crowdsourced Social Validity Study. JMIR Mhealth Uhealth. Dec 21, 2018;6(12):e192. [FREE Full text] [CrossRef] [Medline]78,Knowlden A, Sharma M. One-Year Efficacy Testing of Enabling Mothers to Prevent Pediatric Obesity Through Web-Based Education and Reciprocal Determinism (EMPOWER) Randomized Control Trial. Health Educ Behav. Feb 2016;43(1):94-106. [CrossRef] [Medline]79,Taki S, Russell CG, Wen LM, Laws RA, Campbell K, Xu H, et al. Consumer Engagement in Mobile Application (App) Interventions Focused on Supporting Infant Feeding Practices for Early Prevention of Childhood Obesity. Front Public Health. 2019;7:60. [FREE Full text] [CrossRef] [Medline]82], 6 app feasibility studies [Roberts KJ, McAdams RJ, Kristel OV, Szymanski AM, McKenzie LB. Qualitative and Quantitative Evaluation of the Make Safe Happen App: Mobile Technology-Based Safety Behavior Change Intervention for Parents. JMIR Pediatr Parent. Mar 14, 2019;2(1):e12022. [FREE Full text] [CrossRef] [Medline]70,Meedya S, Win K, Yeatman H, Fahy K, Walton K, Burgess L, et al. Developing and testing a mobile application for breastfeeding support: The Milky Way application. Women Birth. Mar 2021;34(2):e196-e203. [FREE Full text] [CrossRef] [Medline]73-Militello L, Sezgin E, Huang Y, Lin S. Delivering Perinatal Health Information via a Voice Interactive App (SMILE): Mixed Methods Feasibility Study. JMIR Form Res. Mar 01, 2021;5(3):e18240. [FREE Full text] [CrossRef] [Medline]75,Otte RA, van Beukering AJE, Boelens-Brockhuis L. Tracker-Based Personal Advice to Support the Baby's Healthy Development in a Novel Parenting App: Data-Driven Innovation. JMIR Mhealth Uhealth. Jul 24, 2019;7(7):e12666. [FREE Full text] [CrossRef] [Medline]83,Venezia AP, Wirth CK, Vinci DM. Active Families at Home: The Development of a Let’s Wiggle With 5-2-1-0 App. TPE. 2019;76(1):224-237. [CrossRef]84], and 5 reviews, of which 2 were literature reviews [Zarnowiecki D, Mauch CE, Middleton G, Matwiejczyk L, Watson WL, Dibbs J, et al. A systematic evaluation of digital nutrition promotion websites and apps for supporting parents to influence children's nutrition. Int J Behav Nutr Phys Act. Feb 10, 2020;17(1):17. [FREE Full text] [CrossRef] [Medline]53,Gomes AI, Pereira AI, Roberto MS, Boraska K, Barros L. Changing parental feeding practices through web-based interventions: A systematic review and meta-analysis. PLoS One. 2021;16(4):e0250231. [FREE Full text] [CrossRef] [Medline]57] and the remaining 3 were app reviews [Davis DW, Logsdon MC, Vogt K, Rushton J, Myers J, Lauf A, et al. Parent Education is Changing: A Review of Smartphone Apps. MCN Am J Matern Child Nurs. 2017;42(5):248-256. [CrossRef] [Medline]68,Cheng H, Tutt A, Llewellyn C, Size D, Jones J, Taki S, et al. Content and Quality of Infant Feeding Smartphone Apps: Five-Year Update on a Systematic Search and Evaluation. JMIR Mhealth Uhealth. May 27, 2020;8(5):e17300. [FREE Full text] [CrossRef] [Medline]72,Biviji R, Vest J, Dixon B, Cullen T, Harle C. Content analysis of behavior change techniques in maternal and infant health apps. Transl Behav Med. Mar 16, 2021;11(2):504-515. [CrossRef] [Medline]85]. In the studies, the number of participants ranged from 7 to 1200. The review of apps included between 29 and 47 apps and the review of studies included 11 studies each. Methodologically, the studies were heterogenous in design and evaluation method. The clinical trial was the most frequent study design type for 21 studies [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43-Dodd JM, Louise J, Cramp C, Grivell RM, Moran LJ, Deussen AR. Evaluation of a smartphone nutrition and physical activity application to provide lifestyle advice to pregnant women: The SNAPP randomised trial. Matern Child Nutr. Jan 2018;14(1):e12502. [FREE Full text] [CrossRef] [Medline]45,Henriksson H, Alexandrou C, Henriksson P, Henström M, Bendtsen M, Thomas K, et al. MINISTOP 2.0: a smartphone app integrated in primary child health care to promote healthy diet and physical activity behaviours and prevent obesity in preschool-aged children: protocol for a hybrid design effectiveness-implementation study. BMC Public Health. Nov 23, 2020;20(1):1756. [FREE Full text] [CrossRef] [Medline]47-Cullen KW, Thompson D, Chen T. Outcome Evaluation of Family Eats. Health Educ Behav. Feb 2017;44(1):32-40. [CrossRef] [Medline]51,Helle C, Hillesund ER, Wills AK, Øverby NC. Examining the effects of an eHealth intervention from infant age 6 to 12 months on child eating behaviors and maternal feeding practices one year after cessation: The Norwegian randomized controlled trial Early Food for Future Health. PLoS One. 2019;14(8):e0220437. [FREE Full text] [CrossRef] [Medline]54-Russell CG, Denney-Wilson E, Laws RA, Abbott G, Zheng M, Lymer SJ, et al. Impact of the Growing Healthy mHealth Program on Maternal Feeding Practices, Infant Food Preferences, and Satiety Responsiveness: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 25, 2018;6(4):e77. [FREE Full text] [CrossRef] [Medline]56,Scott JA, Burns SK, Hauck YL, Giglia RC, Jorgensen AM, White BK, et al. Impact of a Face-To-Face Versus Smartphone App Versus Combined Breastfeeding Intervention Targeting Fathers: Randomized Controlled Trial. JMIR Pediatr Parent. Apr 12, 2021;4(2):e24579. [FREE Full text] [CrossRef] [Medline]58-Zolfaghari M, Shirmohammadi M, Shahhosseini H, Mokhtaran M, Mohebbi SZ. Development and evaluation of a gamified smart phone mobile health application for oral health promotion in early childhood: a randomized controlled trial. BMC Oral Health. Jan 07, 2021;21(1):18. [FREE Full text] [CrossRef] [Medline]62,Shorey S, Ng YPM, Ng ED, Siew AL, Mörelius E, Yoong J, et al. Effectiveness of a Technology-Based Supportive Educational Parenting Program on Parental Outcomes (Part 1): Randomized Controlled Trial. J Med Internet Res. Feb 13, 2019;21(2):e10816. [FREE Full text] [CrossRef] [Medline]66,Ledford CJW, Womack JJ, Rider HA, Seehusen AB, Conner SJ, Lauters RA, et al. Unexpected Effects of a System-Distributed Mobile Application in Maternity Care: A Randomized Controlled Trial. Health Educ Behav. Jun 16, 2018;45(3):323-330. [CrossRef] [Medline]67,McKenzie LB, Roberts KJ, Clark R, McAdams R, Abdel-Rasoul M, Klein EG, et al. A randomized controlled trial to evaluate the Make Safe Happen® app-a mobile technology-based safety behavior change intervention for increasing parents' safety knowledge and actions. Inj Epidemiol. Mar 12, 2018;5(1):5. [FREE Full text] [CrossRef] [Medline]69,Knowlden A, Sharma M. One-Year Efficacy Testing of Enabling Mothers to Prevent Pediatric Obesity Through Web-Based Education and Reciprocal Determinism (EMPOWER) Randomized Control Trial. Health Educ Behav. Feb 2016;43(1):94-106. [CrossRef] [Medline]79,Burgess JD, Watt KA, Kimble RM, Cameron CM. Knowledge of childhood burn risks and burn first aid: Cool Runnings. Inj Prev. Aug 2019;25(4):301-306. [CrossRef] [Medline]80] with most using the randomized controlled trial (n=15) and others with pilot, nonrandomization or experimental designs (n=6). Four of the included studies [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43,Henriksson H, Alexandrou C, Henriksson P, Henström M, Bendtsen M, Thomas K, et al. MINISTOP 2.0: a smartphone app integrated in primary child health care to promote healthy diet and physical activity behaviours and prevent obesity in preschool-aged children: protocol for a hybrid design effectiveness-implementation study. BMC Public Health. Nov 23, 2020;20(1):1756. [FREE Full text] [CrossRef] [Medline]47,Pond N, Finch M, Sutherland R, Wolfenden L, Nathan N, Kingsland M, et al. Cluster randomised controlled trial of an m-health intervention in centre-based childcare services to reduce the packing of discretionary foods in children's lunchboxes: study protocol for the 'SWAP IT Childcare' trial. BMJ Open. Jun 01, 2019;9(5):e026829. [FREE Full text] [CrossRef] [Medline]59,McKenzie LB, Roberts KJ, Clark R, McAdams R, Abdel-Rasoul M, Klein EG, et al. A randomized controlled trial to evaluate the Make Safe Happen® app-a mobile technology-based safety behavior change intervention for increasing parents' safety knowledge and actions. Inj Epidemiol. Mar 12, 2018;5(1):5. [FREE Full text] [CrossRef] [Medline]69] published protocols of studies yet to be undertaken. The second most frequently undertaken type of evaluation was feasibility studies connected to the evaluation of app design features, testing, and functioning [Zarnowiecki D, Mauch CE, Middleton G, Matwiejczyk L, Watson WL, Dibbs J, et al. A systematic evaluation of digital nutrition promotion websites and apps for supporting parents to influence children's nutrition. Int J Behav Nutr Phys Act. Feb 10, 2020;17(1):17. [FREE Full text] [CrossRef] [Medline]53,Roberts KJ, McAdams RJ, Kristel OV, Szymanski AM, McKenzie LB. Qualitative and Quantitative Evaluation of the Make Safe Happen App: Mobile Technology-Based Safety Behavior Change Intervention for Parents. JMIR Pediatr Parent. Mar 14, 2019;2(1):e12022. [FREE Full text] [CrossRef] [Medline]70,Meedya S, Win K, Yeatman H, Fahy K, Walton K, Burgess L, et al. Developing and testing a mobile application for breastfeeding support: The Milky Way application. Women Birth. Mar 2021;34(2):e196-e203. [FREE Full text] [CrossRef] [Medline]73-Militello L, Sezgin E, Huang Y, Lin S. Delivering Perinatal Health Information via a Voice Interactive App (SMILE): Mixed Methods Feasibility Study. JMIR Form Res. Mar 01, 2021;5(3):e18240. [FREE Full text] [CrossRef] [Medline]75,Otte RA, van Beukering AJE, Boelens-Brockhuis L. Tracker-Based Personal Advice to Support the Baby's Healthy Development in a Novel Parenting App: Data-Driven Innovation. JMIR Mhealth Uhealth. Jul 24, 2019;7(7):e12666. [FREE Full text] [CrossRef] [Medline]83,Venezia AP, Wirth CK, Vinci DM. Active Families at Home: The Development of a Let’s Wiggle With 5-2-1-0 App. TPE. 2019;76(1):224-237. [CrossRef]84]. Quantitative and qualitative results were combined in the mixed method designs of 7 of the included primary (n=3) [Lozoya CJS, Giblin-Scanlon L, Boyd LD, Nolen S, Vineyard J. Influence of a Smartphone Application on the Oral Health Practices and Behaviors of Parents of Preschool Children. J Dent Hyg. Oct 2019;93(5):6-14. [Medline]63,Deave T, Ginja S, Goodenough T, Bailey E, Piwek L, Coad J, et al. The Bumps and BaBies Longitudinal Study (BaBBLeS): a multi-site cohort study of first-time mothers to evaluate the effectiveness of the Baby Buddy app. Mhealth. Sep 2019;5:42-42. [FREE Full text] [CrossRef] [Medline]65,Roberts KJ, McAdams RJ, Kristel OV, Szymanski AM, McKenzie LB. Qualitative and Quantitative Evaluation of the Make Safe Happen App: Mobile Technology-Based Safety Behavior Change Intervention for Parents. JMIR Pediatr Parent. Mar 14, 2019;2(1):e12022. [FREE Full text] [CrossRef] [Medline]70] and feasibility (n=4) [Meedya S, Win K, Yeatman H, Fahy K, Walton K, Burgess L, et al. Developing and testing a mobile application for breastfeeding support: The Milky Way application. Women Birth. Mar 2021;34(2):e196-e203. [FREE Full text] [CrossRef] [Medline]73,Militello L, Sezgin E, Huang Y, Lin S. Delivering Perinatal Health Information via a Voice Interactive App (SMILE): Mixed Methods Feasibility Study. JMIR Form Res. Mar 01, 2021;5(3):e18240. [FREE Full text] [CrossRef] [Medline]75,Taki S, Russell CG, Lymer S, Laws R, Campbell K, Appleton J, et al. A Mixed Methods Study to Explore the Effects of Program Design Elements and Participant Characteristics on Parents' Engagement With an mHealth Program to Promote Healthy Infant Feeding: The Growing Healthy Program. Front Endocrinol (Lausanne). 2019;10:397. [FREE Full text] [CrossRef] [Medline]76,Otte RA, van Beukering AJE, Boelens-Brockhuis L. Tracker-Based Personal Advice to Support the Baby's Healthy Development in a Novel Parenting App: Data-Driven Innovation. JMIR Mhealth Uhealth. Jul 24, 2019;7(7):e12666. [FREE Full text] [CrossRef] [Medline]83] studies. A predominantly qualitative design was undertaken by 2 studies [Lozoya CJS, Giblin-Scanlon L, Boyd LD, Nolen S, Vineyard J. Influence of a Smartphone Application on the Oral Health Practices and Behaviors of Parents of Preschool Children. J Dent Hyg. Oct 2019;93(5):6-14. [Medline]63,Venezia AP, Wirth CK, Vinci DM. Active Families at Home: The Development of a Let’s Wiggle With 5-2-1-0 App. TPE. 2019;76(1):224-237. [CrossRef]84]. Of the 32 single studies, 25 individual project names were listed, of which 3 projects had 2 publications (Make Safe Happen [McKenzie LB, Roberts KJ, Clark R, McAdams R, Abdel-Rasoul M, Klein EG, et al. A randomized controlled trial to evaluate the Make Safe Happen® app-a mobile technology-based safety behavior change intervention for increasing parents' safety knowledge and actions. Inj Epidemiol. Mar 12, 2018;5(1):5. [FREE Full text] [CrossRef] [Medline]69,Roberts KJ, McAdams RJ, Kristel OV, Szymanski AM, McKenzie LB. Qualitative and Quantitative Evaluation of the Make Safe Happen App: Mobile Technology-Based Safety Behavior Change Intervention for Parents. JMIR Pediatr Parent. Mar 14, 2019;2(1):e12022. [FREE Full text] [CrossRef] [Medline]70], Swap It [Pond N, Finch M, Sutherland R, Wolfenden L, Nathan N, Kingsland M, et al. Cluster randomised controlled trial of an m-health intervention in centre-based childcare services to reduce the packing of discretionary foods in children's lunchboxes: study protocol for the 'SWAP IT Childcare' trial. BMJ Open. Jun 01, 2019;9(5):e026829. [FREE Full text] [CrossRef] [Medline]59,Sutherland R, Nathan N, Brown A, Yoong S, Finch M, Lecathelinais C, et al. A randomized controlled trial to assess the potential efficacy, feasibility and acceptability of an m-health intervention targeting parents of school aged children to improve the nutritional quality of foods packed in the lunchbox 'SWAP IT'. Int J Behav Nutr Phys Act. Jul 02, 2019;16(1):54. [FREE Full text] [CrossRef] [Medline]60], and the Growing Healthy Program [Russell CG, Denney-Wilson E, Laws RA, Abbott G, Zheng M, Lymer SJ, et al. Impact of the Growing Healthy mHealth Program on Maternal Feeding Practices, Infant Food Preferences, and Satiety Responsiveness: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 25, 2018;6(4):e77. [FREE Full text] [CrossRef] [Medline]56,Taki S, Russell CG, Lymer S, Laws R, Campbell K, Appleton J, et al. A Mixed Methods Study to Explore the Effects of Program Design Elements and Participant Characteristics on Parents' Engagement With an mHealth Program to Promote Healthy Infant Feeding: The Growing Healthy Program. Front Endocrinol (Lausanne). 2019;10:397. [FREE Full text] [CrossRef] [Medline]76]) and 4 did not list a specific name [Zolfaghari M, Shirmohammadi M, Shahhosseini H, Mokhtaran M, Mohebbi SZ. Development and evaluation of a gamified smart phone mobile health application for oral health promotion in early childhood: a randomized controlled trial. BMC Oral Health. Jan 07, 2021;21(1):18. [FREE Full text] [CrossRef] [Medline]62,Lozoya CJS, Giblin-Scanlon L, Boyd LD, Nolen S, Vineyard J. Influence of a Smartphone Application on the Oral Health Practices and Behaviors of Parents of Preschool Children. J Dent Hyg. Oct 2019;93(5):6-14. [Medline]63,Ledford CJW, Womack JJ, Rider HA, Seehusen AB, Conner SJ, Lauters RA, et al. Unexpected Effects of a System-Distributed Mobile Application in Maternity Care: A Randomized Controlled Trial. Health Educ Behav. Jun 16, 2018;45(3):323-330. [CrossRef] [Medline]67,Cushing CC, Fedele DA, Brannon EE, Kichline T. Parents' Perspectives on the Theoretical Domains Framework Elements Needed in a Pediatric Health Behavior App: A Crowdsourced Social Validity Study. JMIR Mhealth Uhealth. Dec 21, 2018;6(12):e192. [FREE Full text] [CrossRef] [Medline]78]. An overview and summary of the included studies can be found in

Multimedia Appendix 2

Detailed summary of results.

DOCX File , 155 KBMultimedia Appendix 2.

Broad Topics

The studies included could be sorted into 8 main prevention and child health promoting topics: parental feeding and nutrition (n=19) [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43,Dodd JM, Louise J, Cramp C, Grivell RM, Moran LJ, Deussen AR. Evaluation of a smartphone nutrition and physical activity application to provide lifestyle advice to pregnant women: The SNAPP randomised trial. Matern Child Nutr. Jan 2018;14(1):e12502. [FREE Full text] [CrossRef] [Medline]45,Henriksson H, Alexandrou C, Henriksson P, Henström M, Bendtsen M, Thomas K, et al. MINISTOP 2.0: a smartphone app integrated in primary child health care to promote healthy diet and physical activity behaviours and prevent obesity in preschool-aged children: protocol for a hybrid design effectiveness-implementation study. BMC Public Health. Nov 23, 2020;20(1):1756. [FREE Full text] [CrossRef] [Medline]47,De Lepeleere S, De Bourdeaudhuij I, Cardon G, Verloigne M. The effect of an online video intervention 'Movie Models' on specific parenting practices and parental self-efficacy related to children's physical activity, screen-time and healthy diet: a quasi experimental study. BMC Public Health. Apr 27, 2017;17(1):366. [FREE Full text] [CrossRef] [Medline]48,Cullen KW, Thompson D, Chen T. Outcome Evaluation of Family Eats. Health Educ Behav. Feb 2017;44(1):32-40. [CrossRef] [Medline]51-Zarnowiecki D, Mauch CE, Middleton G, Matwiejczyk L, Watson WL, Dibbs J, et al. A systematic evaluation of digital nutrition promotion websites and apps for supporting parents to influence children's nutrition. Int J Behav Nutr Phys Act. Feb 10, 2020;17(1):17. [FREE Full text] [CrossRef] [Medline]53,Røed M, Medin AC, Vik FN, Hillesund ER, Van Lippevelde W, Campbell K, et al. Effect of a Parent-Focused eHealth Intervention on Children's Fruit, Vegetable, and Discretionary Food Intake (Food4toddlers): Randomized Controlled Trial. J Med Internet Res. Feb 16, 2021;23(2):e18311. [FREE Full text] [CrossRef] [Medline]55-Laws RA, Denney-Wilson EA, Taki S, Russell CG, Zheng M, Litterbach E, et al. Key Lessons and Impact of the Growing Healthy mHealth Program on Milk Feeding, Timing of Introduction of Solids, and Infant Growth: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 19, 2018;6(4):e78. [FREE Full text] [CrossRef] [Medline]61,Cheng H, Tutt A, Llewellyn C, Size D, Jones J, Taki S, et al. Content and Quality of Infant Feeding Smartphone Apps: Five-Year Update on a Systematic Search and Evaluation. JMIR Mhealth Uhealth. May 27, 2020;8(5):e17300. [FREE Full text] [CrossRef] [Medline]72-Mauch CE, Laws RA, Prichard I, Maeder AJ, Wycherley TP, Golley RK. Commercially Available Apps to Support Healthy Family Meals: User Testing of App Utility, Acceptability, and Engagement. JMIR Mhealth Uhealth. May 07, 2021;9(5):e22990. [FREE Full text] [CrossRef] [Medline]74,Taki S, Russell CG, Wen LM, Laws RA, Campbell K, Xu H, et al. Consumer Engagement in Mobile Application (App) Interventions Focused on Supporting Infant Feeding Practices for Early Prevention of Childhood Obesity. Front Public Health. 2019;7:60. [FREE Full text] [CrossRef] [Medline]82,Helle C, Hillesund ER, Omholt ML, Øverby NC. Early food for future health: a randomized controlled trial evaluating the effect of an eHealth intervention aiming to promote healthy food habits from early childhood. BMC Public Health. Sep 20, 2017;17(1):729. [FREE Full text] [CrossRef] [Medline]86], physical activity (n=8) [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43-Trost SG, Brookes DSK. Effectiveness of a novel digital application to promote fundamental movement skills in 3- to 6-year-old children: A randomized controlled trial. J Sports Sci. Feb 27, 2021;39(4):453-459. [CrossRef] [Medline]49,Venezia AP, Wirth CK, Vinci DM. Active Families at Home: The Development of a Let’s Wiggle With 5-2-1-0 App. TPE. 2019;76(1):224-237. [CrossRef]84], maternal-child health (n=6) [Choi J, Lee JH, Vittinghoff E, Fukuoka Y. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women. Matern Child Health J. May 2016;20(5):1091-1101. [FREE Full text] [CrossRef] [Medline]44,Dodd JM, Louise J, Cramp C, Grivell RM, Moran LJ, Deussen AR. Evaluation of a smartphone nutrition and physical activity application to provide lifestyle advice to pregnant women: The SNAPP randomised trial. Matern Child Nutr. Jan 2018;14(1):e12502. [FREE Full text] [CrossRef] [Medline]45,Deave T, Ginja S, Goodenough T, Bailey E, Piwek L, Coad J, et al. The Bumps and BaBies Longitudinal Study (BaBBLeS): a multi-site cohort study of first-time mothers to evaluate the effectiveness of the Baby Buddy app. Mhealth. Sep 2019;5:42-42. [FREE Full text] [CrossRef] [Medline]65,Ledford CJW, Womack JJ, Rider HA, Seehusen AB, Conner SJ, Lauters RA, et al. Unexpected Effects of a System-Distributed Mobile Application in Maternity Care: A Randomized Controlled Trial. Health Educ Behav. Jun 16, 2018;45(3):323-330. [CrossRef] [Medline]67,Militello L, Sezgin E, Huang Y, Lin S. Delivering Perinatal Health Information via a Voice Interactive App (SMILE): Mixed Methods Feasibility Study. JMIR Form Res. Mar 01, 2021;5(3):e18240. [FREE Full text] [CrossRef] [Medline]75,Biviji R, Vest J, Dixon B, Cullen T, Harle C. Content analysis of behavior change techniques in maternal and infant health apps. Transl Behav Med. Mar 16, 2021;11(2):504-515. [CrossRef] [Medline]85], parent-child health (n=5) [Shorey S, Ng YPM, Ng ED, Siew AL, Mörelius E, Yoong J, et al. Effectiveness of a Technology-Based Supportive Educational Parenting Program on Parental Outcomes (Part 1): Randomized Controlled Trial. J Med Internet Res. Feb 13, 2019;21(2):e10816. [FREE Full text] [CrossRef] [Medline]66,Davis DW, Logsdon MC, Vogt K, Rushton J, Myers J, Lauf A, et al. Parent Education is Changing: A Review of Smartphone Apps. MCN Am J Matern Child Nurs. 2017;42(5):248-256. [CrossRef] [Medline]68,Cushing CC, Fedele DA, Brannon EE, Kichline T. Parents' Perspectives on the Theoretical Domains Framework Elements Needed in a Pediatric Health Behavior App: A Crowdsourced Social Validity Study. JMIR Mhealth Uhealth. Dec 21, 2018;6(12):e192. [FREE Full text] [CrossRef] [Medline]78,Knowlden A, Sharma M. One-Year Efficacy Testing of Enabling Mothers to Prevent Pediatric Obesity Through Web-Based Education and Reciprocal Determinism (EMPOWER) Randomized Control Trial. Health Educ Behav. Feb 2016;43(1):94-106. [CrossRef] [Medline]79,Otte RA, van Beukering AJE, Boelens-Brockhuis L. Tracker-Based Personal Advice to Support the Baby's Healthy Development in a Novel Parenting App: Data-Driven Innovation. JMIR Mhealth Uhealth. Jul 24, 2019;7(7):e12666. [FREE Full text] [CrossRef] [Medline]83], healthy environment (n=3) [McKenzie LB, Roberts KJ, Clark R, McAdams R, Abdel-Rasoul M, Klein EG, et al. A randomized controlled trial to evaluate the Make Safe Happen® app-a mobile technology-based safety behavior change intervention for increasing parents' safety knowledge and actions. Inj Epidemiol. Mar 12, 2018;5(1):5. [FREE Full text] [CrossRef] [Medline]69-Burgess J, Watt K, Kimble RM, Cameron CM. Combining Technology and Research to Prevent Scald Injuries (the Cool Runnings Intervention): Randomized Controlled Trial. J Med Internet Res. Oct 10, 2018;20(10):e10361. [FREE Full text] [CrossRef] [Medline]71], dental health (n=2) [Zolfaghari M, Shirmohammadi M, Shahhosseini H, Mokhtaran M, Mohebbi SZ. Development and evaluation of a gamified smart phone mobile health application for oral health promotion in early childhood: a randomized controlled trial. BMC Oral Health. Jan 07, 2021;21(1):18. [FREE Full text] [CrossRef] [Medline]62,Lozoya CJS, Giblin-Scanlon L, Boyd LD, Nolen S, Vineyard J. Influence of a Smartphone Application on the Oral Health Practices and Behaviors of Parents of Preschool Children. J Dent Hyg. Oct 2019;93(5):6-14. [Medline]63], mental health (n=1) [Shorey S, Ng YPM, Ng ED, Siew AL, Mörelius E, Yoong J, et al. Effectiveness of a Technology-Based Supportive Educational Parenting Program on Parental Outcomes (Part 1): Randomized Controlled Trial. J Med Internet Res. Feb 13, 2019;21(2):e10816. [FREE Full text] [CrossRef] [Medline]66], and sleep (n=1) [Leichman ES, Gould RA, Williamson AA, Walters RM, Mindell JA. Effectiveness of an mHealth Intervention for Infant Sleep Disturbances. Behav Ther. Jul 2020;51(4):548-558. [FREE Full text] [CrossRef] [Medline]64]. A crossover of these inductively derived topics occurred in some studies and these were not mutually exclusive; if a study descriptively included more than 1 topic, then the study was included in both topics. This occurred most frequently with studies that addressed parental feeding or nutrition and physical activity: this combination of topics was found for 7 of the studies. In 2 studies physical activity was addressed in combination with maternal health. Parental feeding and nutrition addressed nutritional intake for a range of ages: starting with nutrition in pregnancy [Dodd JM, Louise J, Cramp C, Grivell RM, Moran LJ, Deussen AR. Evaluation of a smartphone nutrition and physical activity application to provide lifestyle advice to pregnant women: The SNAPP randomised trial. Matern Child Nutr. Jan 2018;14(1):e12502. [FREE Full text] [CrossRef] [Medline]45]; feeding practices and nutrition for infants and young children, whether through breastfeeding or solid food [Henriksson H, Alexandrou C, Henriksson P, Henström M, Bendtsen M, Thomas K, et al. MINISTOP 2.0: a smartphone app integrated in primary child health care to promote healthy diet and physical activity behaviours and prevent obesity in preschool-aged children: protocol for a hybrid design effectiveness-implementation study. BMC Public Health. Nov 23, 2020;20(1):1756. [FREE Full text] [CrossRef] [Medline]47,De Lepeleere S, De Bourdeaudhuij I, Cardon G, Verloigne M. The effect of an online video intervention 'Movie Models' on specific parenting practices and parental self-efficacy related to children's physical activity, screen-time and healthy diet: a quasi experimental study. BMC Public Health. Apr 27, 2017;17(1):366. [FREE Full text] [CrossRef] [Medline]48,Helle C, Hillesund ER, Wills AK, Øverby NC. Examining the effects of an eHealth intervention from infant age 6 to 12 months on child eating behaviors and maternal feeding practices one year after cessation: The Norwegian randomized controlled trial Early Food for Future Health. PLoS One. 2019;14(8):e0220437. [FREE Full text] [CrossRef] [Medline]54-Gomes AI, Pereira AI, Roberto MS, Boraska K, Barros L. Changing parental feeding practices through web-based interventions: A systematic review and meta-analysis. PLoS One. 2021;16(4):e0250231. [FREE Full text] [CrossRef] [Medline]57,Laws RA, Denney-Wilson EA, Taki S, Russell CG, Zheng M, Litterbach E, et al. Key Lessons and Impact of the Growing Healthy mHealth Program on Milk Feeding, Timing of Introduction of Solids, and Infant Growth: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 19, 2018;6(4):e78. [FREE Full text] [CrossRef] [Medline]61,Cheng H, Tutt A, Llewellyn C, Size D, Jones J, Taki S, et al. Content and Quality of Infant Feeding Smartphone Apps: Five-Year Update on a Systematic Search and Evaluation. JMIR Mhealth Uhealth. May 27, 2020;8(5):e17300. [FREE Full text] [CrossRef] [Medline]72,Meedya S, Win K, Yeatman H, Fahy K, Walton K, Burgess L, et al. Developing and testing a mobile application for breastfeeding support: The Milky Way application. Women Birth. Mar 2021;34(2):e196-e203. [FREE Full text] [CrossRef] [Medline]73,Taki S, Russell CG, Lymer S, Laws R, Campbell K, Appleton J, et al. A Mixed Methods Study to Explore the Effects of Program Design Elements and Participant Characteristics on Parents' Engagement With an mHealth Program to Promote Healthy Infant Feeding: The Growing Healthy Program. Front Endocrinol (Lausanne). 2019;10:397. [FREE Full text] [CrossRef] [Medline]76]; or promotion of healthier school meals or family nutrition [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43,Cullen KW, Thompson D, Chen T. Outcome Evaluation of Family Eats. Health Educ Behav. Feb 2017;44(1):32-40. [CrossRef] [Medline]51-Zarnowiecki D, Mauch CE, Middleton G, Matwiejczyk L, Watson WL, Dibbs J, et al. A systematic evaluation of digital nutrition promotion websites and apps for supporting parents to influence children's nutrition. Int J Behav Nutr Phys Act. Feb 10, 2020;17(1):17. [FREE Full text] [CrossRef] [Medline]53,Pond N, Finch M, Sutherland R, Wolfenden L, Nathan N, Kingsland M, et al. Cluster randomised controlled trial of an m-health intervention in centre-based childcare services to reduce the packing of discretionary foods in children's lunchboxes: study protocol for the 'SWAP IT Childcare' trial. BMJ Open. Jun 01, 2019;9(5):e026829. [FREE Full text] [CrossRef] [Medline]59,Sutherland R, Nathan N, Brown A, Yoong S, Finch M, Lecathelinais C, et al. A randomized controlled trial to assess the potential efficacy, feasibility and acceptability of an m-health intervention targeting parents of school aged children to improve the nutritional quality of foods packed in the lunchbox 'SWAP IT'. Int J Behav Nutr Phys Act. Jul 02, 2019;16(1):54. [FREE Full text] [CrossRef] [Medline]60,Mauch CE, Laws RA, Prichard I, Maeder AJ, Wycherley TP, Golley RK. Commercially Available Apps to Support Healthy Family Meals: User Testing of App Utility, Acceptability, and Engagement. JMIR Mhealth Uhealth. May 07, 2021;9(5):e22990. [FREE Full text] [CrossRef] [Medline]74,Meinert E, Rahman E, Potter A, Lawrence W, Van Velthoven M. Acceptability and Usability of the Mobile Digital Health App NoObesity for Families and Health Care Professionals: Protocol for a Feasibility Study. JMIR Res Protoc. Jul 22, 2020;9(7):e18068. [FREE Full text] [CrossRef] [Medline]87]. Included studies that broached physical activity were interested in either tracking the movement as part of the app-based intervention [Choi J, Lee JH, Vittinghoff E, Fukuoka Y. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women. Matern Child Health J. May 2016;20(5):1091-1101. [FREE Full text] [CrossRef] [Medline]44,Dodd JM, Louise J, Cramp C, Grivell RM, Moran LJ, Deussen AR. Evaluation of a smartphone nutrition and physical activity application to provide lifestyle advice to pregnant women: The SNAPP randomised trial. Matern Child Nutr. Jan 2018;14(1):e12502. [FREE Full text] [CrossRef] [Medline]45,Henriksson H, Alexandrou C, Henriksson P, Henström M, Bendtsen M, Thomas K, et al. MINISTOP 2.0: a smartphone app integrated in primary child health care to promote healthy diet and physical activity behaviours and prevent obesity in preschool-aged children: protocol for a hybrid design effectiveness-implementation study. BMC Public Health. Nov 23, 2020;20(1):1756. [FREE Full text] [CrossRef] [Medline]47] or physical activity as part of obesity prevention, comprehensive child fitness, or overall family health [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43,Meixner C, Baumann H, Fenger A, Wollesen B. Gamification in health apps to increase physical activity within families. New York, NY. IEEE; Presented at: 2019 International Conference on Wireless and Mobile Computing, Networking and Communications (WiMob); October 21-23, 2019, 2019;21-23; Barcelona, Spain. [CrossRef]46,De Lepeleere S, De Bourdeaudhuij I, Cardon G, Verloigne M. The effect of an online video intervention 'Movie Models' on specific parenting practices and parental self-efficacy related to children's physical activity, screen-time and healthy diet: a quasi experimental study. BMC Public Health. Apr 27, 2017;17(1):366. [FREE Full text] [CrossRef] [Medline]48-Sun A, Cheng J, Bui Q, Liang Y, Ng T, Chen J. Home-Based and Technology-Centered Childhood Obesity Prevention for Chinese Mothers With Preschool-Aged Children. J Transcult Nurs. Nov 2017;28(6):616-624. [CrossRef] [Medline]50,Venezia AP, Wirth CK, Vinci DM. Active Families at Home: The Development of a Let’s Wiggle With 5-2-1-0 App. TPE. 2019;76(1):224-237. [CrossRef]84]. All studies with a topical focus on maternal-child health targeted women in pregnancy. The parent-child health app studies included had an educative or informational focus on parenting and child health. Included apps promoting a healthy environment targeted home safety and accident prevention, while studies addressing dental health were concerned with caries prevention and dental hygiene. Mental health was addressed from the standpoint of overall child well-being and the sleep app studies included assessed the parent tracking of infant sleep schedules.

Parent Mobile App Evaluation

Evaluation of Behavior Change in Apps

Many of the study evaluations assessed changes in intentions, knowledge, or behavior over time. In total, 26 studies listed at least one specific behavior change theory that the study evaluation was based on: Social Cognitive Theory was mentioned in 9 studies [Choi J, Lee JH, Vittinghoff E, Fukuoka Y. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women. Matern Child Health J. May 2016;20(5):1091-1101. [FREE Full text] [CrossRef] [Medline]44,Henriksson H, Alexandrou C, Henriksson P, Henström M, Bendtsen M, Thomas K, et al. MINISTOP 2.0: a smartphone app integrated in primary child health care to promote healthy diet and physical activity behaviours and prevent obesity in preschool-aged children: protocol for a hybrid design effectiveness-implementation study. BMC Public Health. Nov 23, 2020;20(1):1756. [FREE Full text] [CrossRef] [Medline]47,De Lepeleere S, De Bourdeaudhuij I, Cardon G, Verloigne M. The effect of an online video intervention 'Movie Models' on specific parenting practices and parental self-efficacy related to children's physical activity, screen-time and healthy diet: a quasi experimental study. BMC Public Health. Apr 27, 2017;17(1):366. [FREE Full text] [CrossRef] [Medline]48,Cullen KW, Thompson D, Chen T. Outcome Evaluation of Family Eats. Health Educ Behav. Feb 2017;44(1):32-40. [CrossRef] [Medline]51,Helle C, Hillesund ER, Wills AK, Øverby NC. Examining the effects of an eHealth intervention from infant age 6 to 12 months on child eating behaviors and maternal feeding practices one year after cessation: The Norwegian randomized controlled trial Early Food for Future Health. PLoS One. 2019;14(8):e0220437. [FREE Full text] [CrossRef] [Medline]54,Røed M, Medin AC, Vik FN, Hillesund ER, Van Lippevelde W, Campbell K, et al. Effect of a Parent-Focused eHealth Intervention on Children's Fruit, Vegetable, and Discretionary Food Intake (Food4toddlers): Randomized Controlled Trial. J Med Internet Res. Feb 16, 2021;23(2):e18311. [FREE Full text] [CrossRef] [Medline]55,Scott JA, Burns SK, Hauck YL, Giglia RC, Jorgensen AM, White BK, et al. Impact of a Face-To-Face Versus Smartphone App Versus Combined Breastfeeding Intervention Targeting Fathers: Randomized Controlled Trial. JMIR Pediatr Parent. Apr 12, 2021;4(2):e24579. [FREE Full text] [CrossRef] [Medline]58,Shorey S, Ng YPM, Ng ED, Siew AL, Mörelius E, Yoong J, et al. Effectiveness of a Technology-Based Supportive Educational Parenting Program on Parental Outcomes (Part 1): Randomized Controlled Trial. J Med Internet Res. Feb 13, 2019;21(2):e10816. [FREE Full text] [CrossRef] [Medline]66,Knowlden A, Sharma M. One-Year Efficacy Testing of Enabling Mothers to Prevent Pediatric Obesity Through Web-Based Education and Reciprocal Determinism (EMPOWER) Randomized Control Trial. Health Educ Behav. Feb 2016;43(1):94-106. [CrossRef] [Medline]79] and in 1 meta-analysis [Gomes AI, Pereira AI, Roberto MS, Boraska K, Barros L. Changing parental feeding practices through web-based interventions: A systematic review and meta-analysis. PLoS One. 2021;16(4):e0250231. [FREE Full text] [CrossRef] [Medline]57]; Self-efficacy Theory was mentioned in 3 studies [Zarnowiecki D, Mauch CE, Middleton G, Matwiejczyk L, Watson WL, Dibbs J, et al. A systematic evaluation of digital nutrition promotion websites and apps for supporting parents to influence children's nutrition. Int J Behav Nutr Phys Act. Feb 10, 2020;17(1):17. [FREE Full text] [CrossRef] [Medline]53,Deave T, Ginja S, Goodenough T, Bailey E, Piwek L, Coad J, et al. The Bumps and BaBies Longitudinal Study (BaBBLeS): a multi-site cohort study of first-time mothers to evaluate the effectiveness of the Baby Buddy app. Mhealth. Sep 2019;5:42-42. [FREE Full text] [CrossRef] [Medline]65,Shorey S, Ng YPM, Ng ED, Siew AL, Mörelius E, Yoong J, et al. Effectiveness of a Technology-Based Supportive Educational Parenting Program on Parental Outcomes (Part 1): Randomized Controlled Trial. J Med Internet Res. Feb 13, 2019;21(2):e10816. [FREE Full text] [CrossRef] [Medline]66]; Social Determination Theory also in 3 studies [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43,De Lepeleere S, De Bourdeaudhuij I, Cardon G, Verloigne M. The effect of an online video intervention 'Movie Models' on specific parenting practices and parental self-efficacy related to children's physical activity, screen-time and healthy diet: a quasi experimental study. BMC Public Health. Apr 27, 2017;17(1):366. [FREE Full text] [CrossRef] [Medline]48,Ledford CJW, Womack JJ, Rider HA, Seehusen AB, Conner SJ, Lauters RA, et al. Unexpected Effects of a System-Distributed Mobile Application in Maternity Care: A Randomized Controlled Trial. Health Educ Behav. Jun 16, 2018;45(3):323-330. [CrossRef] [Medline]67]; and the Behavior Change Wheel in 4 studies [Meixner C, Baumann H, Fenger A, Wollesen B. Gamification in health apps to increase physical activity within families. New York, NY. IEEE; Presented at: 2019 International Conference on Wireless and Mobile Computing, Networking and Communications (WiMob); October 21-23, 2019, 2019;21-23; Barcelona, Spain. [CrossRef]46,Pond N, Finch M, Sutherland R, Wolfenden L, Nathan N, Kingsland M, et al. Cluster randomised controlled trial of an m-health intervention in centre-based childcare services to reduce the packing of discretionary foods in children's lunchboxes: study protocol for the 'SWAP IT Childcare' trial. BMJ Open. Jun 01, 2019;9(5):e026829. [FREE Full text] [CrossRef] [Medline]59,Laws RA, Denney-Wilson EA, Taki S, Russell CG, Zheng M, Litterbach E, et al. Key Lessons and Impact of the Growing Healthy mHealth Program on Milk Feeding, Timing of Introduction of Solids, and Infant Growth: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 19, 2018;6(4):e78. [FREE Full text] [CrossRef] [Medline]61,Mauch CE, Laws RA, Prichard I, Maeder AJ, Wycherley TP, Golley RK. Commercially Available Apps to Support Healthy Family Meals: User Testing of App Utility, Acceptability, and Engagement. JMIR Mhealth Uhealth. May 07, 2021;9(5):e22990. [FREE Full text] [CrossRef] [Medline]74]. Some studies also used BCTs in their interventions (n=6) [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43,Henriksson H, Alexandrou C, Henriksson P, Henström M, Bendtsen M, Thomas K, et al. MINISTOP 2.0: a smartphone app integrated in primary child health care to promote healthy diet and physical activity behaviours and prevent obesity in preschool-aged children: protocol for a hybrid design effectiveness-implementation study. BMC Public Health. Nov 23, 2020;20(1):1756. [FREE Full text] [CrossRef] [Medline]47,Gomes AI, Pereira AI, Roberto MS, Boraska K, Barros L. Changing parental feeding practices through web-based interventions: A systematic review and meta-analysis. PLoS One. 2021;16(4):e0250231. [FREE Full text] [CrossRef] [Medline]57,Pond N, Finch M, Sutherland R, Wolfenden L, Nathan N, Kingsland M, et al. Cluster randomised controlled trial of an m-health intervention in centre-based childcare services to reduce the packing of discretionary foods in children's lunchboxes: study protocol for the 'SWAP IT Childcare' trial. BMJ Open. Jun 01, 2019;9(5):e026829. [FREE Full text] [CrossRef] [Medline]59,Cushing CC, Fedele DA, Brannon EE, Kichline T. Parents' Perspectives on the Theoretical Domains Framework Elements Needed in a Pediatric Health Behavior App: A Crowdsourced Social Validity Study. JMIR Mhealth Uhealth. Dec 21, 2018;6(12):e192. [FREE Full text] [CrossRef] [Medline]78,Biviji R, Vest J, Dixon B, Cullen T, Harle C. Content analysis of behavior change techniques in maternal and infant health apps. Transl Behav Med. Mar 16, 2021;11(2):504-515. [CrossRef] [Medline]85]. While most studies do not explicitly name the individual BCTs (n=20), 10 of these studies used BCTs. Among studies that mentioned techniques of behavior change, the most frequently cited were the BCT taxonomy by Michie et al [Michie S, Richardson M, Johnston M, Abraham C, Francis J, Hardeman W, et al. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med. Aug 2013;46(1):81-95. [FREE Full text] [CrossRef] [Medline]88], which was cited in 2 studies [Henriksson H, Alexandrou C, Henriksson P, Henström M, Bendtsen M, Thomas K, et al. MINISTOP 2.0: a smartphone app integrated in primary child health care to promote healthy diet and physical activity behaviours and prevent obesity in preschool-aged children: protocol for a hybrid design effectiveness-implementation study. BMC Public Health. Nov 23, 2020;20(1):1756. [FREE Full text] [CrossRef] [Medline]47,Gomes AI, Pereira AI, Roberto MS, Boraska K, Barros L. Changing parental feeding practices through web-based interventions: A systematic review and meta-analysis. PLoS One. 2021;16(4):e0250231. [FREE Full text] [CrossRef] [Medline]57], and the mHealth theory–based taxonomy for mobile apps, which was also cited in 2 studies [Cushing CC, Fedele DA, Brannon EE, Kichline T. Parents' Perspectives on the Theoretical Domains Framework Elements Needed in a Pediatric Health Behavior App: A Crowdsourced Social Validity Study. JMIR Mhealth Uhealth. Dec 21, 2018;6(12):e192. [FREE Full text] [CrossRef] [Medline]78,Biviji R, Vest J, Dixon B, Cullen T, Harle C. Content analysis of behavior change techniques in maternal and infant health apps. Transl Behav Med. Mar 16, 2021;11(2):504-515. [CrossRef] [Medline]85]. Individual BCTs mentioned in the included studies were shaping knowledge, identification of self as a role model, demonstration of the behavior, self-monitoring of behavior, self-belief, prompts/cues, goal setting (behavior and outcome), identity, and social support.

To measure the potential for change in behavior, multiple questionnaires were used that cut across topics. Some questionnaires that assessed changes in behavior were self-developed [Cullen KW, Thompson D, Chen T. Outcome Evaluation of Family Eats. Health Educ Behav. Feb 2017;44(1):32-40. [CrossRef] [Medline]51,Helle C, Hillesund ER, Wills AK, Øverby NC. Examining the effects of an eHealth intervention from infant age 6 to 12 months on child eating behaviors and maternal feeding practices one year after cessation: The Norwegian randomized controlled trial Early Food for Future Health. PLoS One. 2019;14(8):e0220437. [FREE Full text] [CrossRef] [Medline]54,Røed M, Medin AC, Vik FN, Hillesund ER, Van Lippevelde W, Campbell K, et al. Effect of a Parent-Focused eHealth Intervention on Children's Fruit, Vegetable, and Discretionary Food Intake (Food4toddlers): Randomized Controlled Trial. J Med Internet Res. Feb 16, 2021;23(2):e18311. [FREE Full text] [CrossRef] [Medline]55,Biviji R, Vest J, Dixon B, Cullen T, Harle C. Content analysis of behavior change techniques in maternal and infant health apps. Transl Behav Med. Mar 16, 2021;11(2):504-515. [CrossRef] [Medline]85] or developed out of other validated questionnaires [De Lepeleere S, De Bourdeaudhuij I, Cardon G, Verloigne M. The effect of an online video intervention 'Movie Models' on specific parenting practices and parental self-efficacy related to children's physical activity, screen-time and healthy diet: a quasi experimental study. BMC Public Health. Apr 27, 2017;17(1):366. [FREE Full text] [CrossRef] [Medline]48,Pond N, Finch M, Sutherland R, Wolfenden L, Nathan N, Kingsland M, et al. Cluster randomised controlled trial of an m-health intervention in centre-based childcare services to reduce the packing of discretionary foods in children's lunchboxes: study protocol for the 'SWAP IT Childcare' trial. BMJ Open. Jun 01, 2019;9(5):e026829. [FREE Full text] [CrossRef] [Medline]59,Zolfaghari M, Shirmohammadi M, Shahhosseini H, Mokhtaran M, Mohebbi SZ. Development and evaluation of a gamified smart phone mobile health application for oral health promotion in early childhood: a randomized controlled trial. BMC Oral Health. Jan 07, 2021;21(1):18. [FREE Full text] [CrossRef] [Medline]62]. As an essential part of most behavior change models, the most frequently used validated questionnaires in the studies assessed self-efficacy as a predictor for changes in behavior for different topics such as motherhood, nutrition, breastfeeding, and physical activity. Measures for changes in self-efficacy or knowledge before and after the intervention were described to give an outlook for the continuation of the new behavior. Listed validated questionnaires used to evaluate behavior changes were the 10-item COM-B Self-Evaluation Survey (healthy family meals) [Mauch CE, Laws RA, Prichard I, Maeder AJ, Wycherley TP, Golley RK. Commercially Available Apps to Support Healthy Family Meals: User Testing of App Utility, Acceptability, and Engagement. JMIR Mhealth Uhealth. May 07, 2021;9(5):e22990. [FREE Full text] [CrossRef] [Medline]74], Maternal Self-Efficacy Scale (a 12-item scale measuring the mother’s self-efficacy for promoting healthy eating, physical activity, and in limiting noncore foods) [Sun A, Cheng J, Bui Q, Liang Y, Ng T, Chen J. Home-Based and Technology-Centered Childhood Obesity Prevention for Chinese Mothers With Preschool-Aged Children. J Transcult Nurs. Nov 2017;28(6):616-624. [CrossRef] [Medline]50], the 14-item short form Breastfeeding Self-Efficacy Scale [Scott JA, Burns SK, Hauck YL, Giglia RC, Jorgensen AM, White BK, et al. Impact of a Face-To-Face Versus Smartphone App Versus Combined Breastfeeding Intervention Targeting Fathers: Randomized Controlled Trial. JMIR Pediatr Parent. Apr 12, 2021;4(2):e24579. [FREE Full text] [CrossRef] [Medline]58] assessing breastfeeding confidence, Self-Efficacy for Physical Activity [Choi J, Lee JH, Vittinghoff E, Fukuoka Y. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women. Matern Child Health J. May 2016;20(5):1091-1101. [FREE Full text] [CrossRef] [Medline]44], the 10-item Parenting Efficacy Scale [Shorey S, Ng YPM, Ng ED, Siew AL, Mörelius E, Yoong J, et al. Effectiveness of a Technology-Based Supportive Educational Parenting Program on Parental Outcomes (Part 1): Randomized Controlled Trial. J Med Internet Res. Feb 13, 2019;21(2):e10816. [FREE Full text] [CrossRef] [Medline]66], and 36-item Parenting Self-Efficacy (Tool to Measure Parenting Self-Efficacy [TOPSE]) [Deave T, Ginja S, Goodenough T, Bailey E, Piwek L, Coad J, et al. The Bumps and BaBies Longitudinal Study (BaBBLeS): a multi-site cohort study of first-time mothers to evaluate the effectiveness of the Baby Buddy app. Mhealth. Sep 2019;5:42-42. [FREE Full text] [CrossRef] [Medline]65]. Increasing knowledge cut across topics, ranging from a healthy environment [McKenzie LB, Roberts KJ, Clark R, McAdams R, Abdel-Rasoul M, Klein EG, et al. A randomized controlled trial to evaluate the Make Safe Happen® app-a mobile technology-based safety behavior change intervention for increasing parents' safety knowledge and actions. Inj Epidemiol. Mar 12, 2018;5(1):5. [FREE Full text] [CrossRef] [Medline]69,Roberts KJ, McAdams RJ, Kristel OV, Szymanski AM, McKenzie LB. Qualitative and Quantitative Evaluation of the Make Safe Happen App: Mobile Technology-Based Safety Behavior Change Intervention for Parents. JMIR Pediatr Parent. Mar 14, 2019;2(1):e12022. [FREE Full text] [CrossRef] [Medline]70,Burgess JD, Watt KA, Kimble RM, Cameron CM. Knowledge of childhood burn risks and burn first aid: Cool Runnings. Inj Prev. Aug 2019;25(4):301-306. [CrossRef] [Medline]80], physical activity or nutrition [Henriksson H, Alexandrou C, Henriksson P, Henström M, Bendtsen M, Thomas K, et al. MINISTOP 2.0: a smartphone app integrated in primary child health care to promote healthy diet and physical activity behaviours and prevent obesity in preschool-aged children: protocol for a hybrid design effectiveness-implementation study. BMC Public Health. Nov 23, 2020;20(1):1756. [FREE Full text] [CrossRef] [Medline]47,Au LE, Whaley S, Rosen NJ, Meza M, Ritchie LD. Online and In-Person Nutrition Education Improves Breakfast Knowledge, Attitudes, and Behaviors: A Randomized Trial of Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children. J Acad Nutr Diet. Mar 2016;116(3):490-500. [CrossRef] [Medline]52,Helle C, Hillesund ER, Wills AK, Øverby NC. Examining the effects of an eHealth intervention from infant age 6 to 12 months on child eating behaviors and maternal feeding practices one year after cessation: The Norwegian randomized controlled trial Early Food for Future Health. PLoS One. 2019;14(8):e0220437. [FREE Full text] [CrossRef] [Medline]54,Cushing CC, Fedele DA, Brannon EE, Kichline T. Parents' Perspectives on the Theoretical Domains Framework Elements Needed in a Pediatric Health Behavior App: A Crowdsourced Social Validity Study. JMIR Mhealth Uhealth. Dec 21, 2018;6(12):e192. [FREE Full text] [CrossRef] [Medline]78], dental health [Zolfaghari M, Shirmohammadi M, Shahhosseini H, Mokhtaran M, Mohebbi SZ. Development and evaluation of a gamified smart phone mobile health application for oral health promotion in early childhood: a randomized controlled trial. BMC Oral Health. Jan 07, 2021;21(1):18. [FREE Full text] [CrossRef] [Medline]62,Lozoya CJS, Giblin-Scanlon L, Boyd LD, Nolen S, Vineyard J. Influence of a Smartphone Application on the Oral Health Practices and Behaviors of Parents of Preschool Children. J Dent Hyg. Oct 2019;93(5):6-14. [Medline]63] parenting for health [Sun A, Cheng J, Bui Q, Liang Y, Ng T, Chen J. Home-Based and Technology-Centered Childhood Obesity Prevention for Chinese Mothers With Preschool-Aged Children. J Transcult Nurs. Nov 2017;28(6):616-624. [CrossRef] [Medline]50,Deave T, Ginja S, Goodenough T, Bailey E, Piwek L, Coad J, et al. The Bumps and BaBies Longitudinal Study (BaBBLeS): a multi-site cohort study of first-time mothers to evaluate the effectiveness of the Baby Buddy app. Mhealth. Sep 2019;5:42-42. [FREE Full text] [CrossRef] [Medline]65], or sleep [Leichman ES, Gould RA, Williamson AA, Walters RM, Mindell JA. Effectiveness of an mHealth Intervention for Infant Sleep Disturbances. Behav Ther. Jul 2020;51(4):548-558. [FREE Full text] [CrossRef] [Medline]64,Cushing CC, Fedele DA, Brannon EE, Kichline T. Parents' Perspectives on the Theoretical Domains Framework Elements Needed in a Pediatric Health Behavior App: A Crowdsourced Social Validity Study. JMIR Mhealth Uhealth. Dec 21, 2018;6(12):e192. [FREE Full text] [CrossRef] [Medline]78]. Despite the objective to increase health knowledge of parents, not all studies undertook explicit evaluations to measure knowledge change.

Assessment tools were mentioned and used for specific topics. An entire overview of assessment tools for evaluating data and parameters can be found in Table 2.

Physical Activity

Physical activity was assessed through different means: 10 studies used physical activity measures [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43-Sun A, Cheng J, Bui Q, Liang Y, Ng T, Chen J. Home-Based and Technology-Centered Childhood Obesity Prevention for Chinese Mothers With Preschool-Aged Children. J Transcult Nurs. Nov 2017;28(6):616-624. [CrossRef] [Medline]50,Cushing CC, Fedele DA, Brannon EE, Kichline T. Parents' Perspectives on the Theoretical Domains Framework Elements Needed in a Pediatric Health Behavior App: A Crowdsourced Social Validity Study. JMIR Mhealth Uhealth. Dec 21, 2018;6(12):e192. [FREE Full text] [CrossRef] [Medline]78,Venezia AP, Wirth CK, Vinci DM. Active Families at Home: The Development of a Let’s Wiggle With 5-2-1-0 App. TPE. 2019;76(1):224-237. [CrossRef]84]. We identified 21 separate measures that evaluated physical activity in 3 ways: specific behaviors as they related to quantified movement (ie, accelerometer), those that predicted or moderated the physical activity undertaken (ie, self-efficacy), and measures of the outcomes of physical activity (ie, BMI or weight over time). Of these tools, 17 used validated measures to assess physical activity. Wunsch et al [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43] and Choi et al [Choi J, Lee JH, Vittinghoff E, Fukuoka Y. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women. Matern Child Health J. May 2016;20(5):1091-1101. [FREE Full text] [CrossRef] [Medline]44] measured the self-efficacy of physical activity specifically. Accelerometer to track steps and physical movement were used or planned in several studies [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43,Choi J, Lee JH, Vittinghoff E, Fukuoka Y. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women. Matern Child Health J. May 2016;20(5):1091-1101. [FREE Full text] [CrossRef] [Medline]44,Sun A, Cheng J, Bui Q, Liang Y, Ng T, Chen J. Home-Based and Technology-Centered Childhood Obesity Prevention for Chinese Mothers With Preschool-Aged Children. J Transcult Nurs. Nov 2017;28(6):616-624. [CrossRef] [Medline]50]. BMI calculations were investigated in 6 studies [Choi J, Lee JH, Vittinghoff E, Fukuoka Y. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women. Matern Child Health J. May 2016;20(5):1091-1101. [FREE Full text] [CrossRef] [Medline]44,Dodd JM, Louise J, Cramp C, Grivell RM, Moran LJ, Deussen AR. Evaluation of a smartphone nutrition and physical activity application to provide lifestyle advice to pregnant women: The SNAPP randomised trial. Matern Child Nutr. Jan 2018;14(1):e12502. [FREE Full text] [CrossRef] [Medline]45,Henriksson H, Alexandrou C, Henriksson P, Henström M, Bendtsen M, Thomas K, et al. MINISTOP 2.0: a smartphone app integrated in primary child health care to promote healthy diet and physical activity behaviours and prevent obesity in preschool-aged children: protocol for a hybrid design effectiveness-implementation study. BMC Public Health. Nov 23, 2020;20(1):1756. [FREE Full text] [CrossRef] [Medline]47-Sun A, Cheng J, Bui Q, Liang Y, Ng T, Chen J. Home-Based and Technology-Centered Childhood Obesity Prevention for Chinese Mothers With Preschool-Aged Children. J Transcult Nurs. Nov 2017;28(6):616-624. [CrossRef] [Medline]50] evaluating physical activity, especially when combined with the topic of nutrition and as a secondary parameter. In studies with small children, the evaluation measurements and intervention for physical activity were frequently given by the parents or primary caregivers. For instance, in the studies by Trost and Brookes [Trost SG, Brookes DSK. Effectiveness of a novel digital application to promote fundamental movement skills in 3- to 6-year-old children: A randomized controlled trial. J Sports Sci. Feb 27, 2021;39(4):453-459. [CrossRef] [Medline]49] and De Lepeleere et al [De Lepeleere S, De Bourdeaudhuij I, Cardon G, Verloigne M. The effect of an online video intervention 'Movie Models' on specific parenting practices and parental self-efficacy related to children's physical activity, screen-time and healthy diet: a quasi experimental study. BMC Public Health. Apr 27, 2017;17(1):366. [FREE Full text] [CrossRef] [Medline]48], the parental support for Physical Activity Scale was used. A strong connection of studies researching the topics of nutrition and physical activity demonstrated a crossover in evaluation tools used for body measurement, such as BMI calculated from height and weight [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43,Dodd JM, Louise J, Cramp C, Grivell RM, Moran LJ, Deussen AR. Evaluation of a smartphone nutrition and physical activity application to provide lifestyle advice to pregnant women: The SNAPP randomised trial. Matern Child Nutr. Jan 2018;14(1):e12502. [FREE Full text] [CrossRef] [Medline]45,Henriksson H, Alexandrou C, Henriksson P, Henström M, Bendtsen M, Thomas K, et al. MINISTOP 2.0: a smartphone app integrated in primary child health care to promote healthy diet and physical activity behaviours and prevent obesity in preschool-aged children: protocol for a hybrid design effectiveness-implementation study. BMC Public Health. Nov 23, 2020;20(1):1756. [FREE Full text] [CrossRef] [Medline]47,De Lepeleere S, De Bourdeaudhuij I, Cardon G, Verloigne M. The effect of an online video intervention 'Movie Models' on specific parenting practices and parental self-efficacy related to children's physical activity, screen-time and healthy diet: a quasi experimental study. BMC Public Health. Apr 27, 2017;17(1):366. [FREE Full text] [CrossRef] [Medline]48,Sun A, Cheng J, Bui Q, Liang Y, Ng T, Chen J. Home-Based and Technology-Centered Childhood Obesity Prevention for Chinese Mothers With Preschool-Aged Children. J Transcult Nurs. Nov 2017;28(6):616-624. [CrossRef] [Medline]50]. Combined nutrition and physical activity likewise evaluated parent preferences within theory-guided domains for healthy goal setting [Cushing CC, Fedele DA, Brannon EE, Kichline T. Parents' Perspectives on the Theoretical Domains Framework Elements Needed in a Pediatric Health Behavior App: A Crowdsourced Social Validity Study. JMIR Mhealth Uhealth. Dec 21, 2018;6(12):e192. [FREE Full text] [CrossRef] [Medline]78].

Parent Feeding and Nutrition

In total, 20 studies [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43,Dodd JM, Louise J, Cramp C, Grivell RM, Moran LJ, Deussen AR. Evaluation of a smartphone nutrition and physical activity application to provide lifestyle advice to pregnant women: The SNAPP randomised trial. Matern Child Nutr. Jan 2018;14(1):e12502. [FREE Full text] [CrossRef] [Medline]45,Henriksson H, Alexandrou C, Henriksson P, Henström M, Bendtsen M, Thomas K, et al. MINISTOP 2.0: a smartphone app integrated in primary child health care to promote healthy diet and physical activity behaviours and prevent obesity in preschool-aged children: protocol for a hybrid design effectiveness-implementation study. BMC Public Health. Nov 23, 2020;20(1):1756. [FREE Full text] [CrossRef] [Medline]47,De Lepeleere S, De Bourdeaudhuij I, Cardon G, Verloigne M. The effect of an online video intervention 'Movie Models' on specific parenting practices and parental self-efficacy related to children's physical activity, screen-time and healthy diet: a quasi experimental study. BMC Public Health. Apr 27, 2017;17(1):366. [FREE Full text] [CrossRef] [Medline]48,Cullen KW, Thompson D, Chen T. Outcome Evaluation of Family Eats. Health Educ Behav. Feb 2017;44(1):32-40. [CrossRef] [Medline]51-Laws RA, Denney-Wilson EA, Taki S, Russell CG, Zheng M, Litterbach E, et al. Key Lessons and Impact of the Growing Healthy mHealth Program on Milk Feeding, Timing of Introduction of Solids, and Infant Growth: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 19, 2018;6(4):e78. [FREE Full text] [CrossRef] [Medline]61,Cheng H, Tutt A, Llewellyn C, Size D, Jones J, Taki S, et al. Content and Quality of Infant Feeding Smartphone Apps: Five-Year Update on a Systematic Search and Evaluation. JMIR Mhealth Uhealth. May 27, 2020;8(5):e17300. [FREE Full text] [CrossRef] [Medline]72-Mauch CE, Laws RA, Prichard I, Maeder AJ, Wycherley TP, Golley RK. Commercially Available Apps to Support Healthy Family Meals: User Testing of App Utility, Acceptability, and Engagement. JMIR Mhealth Uhealth. May 07, 2021;9(5):e22990. [FREE Full text] [CrossRef] [Medline]74,Taki S, Russell CG, Lymer S, Laws R, Campbell K, Appleton J, et al. A Mixed Methods Study to Explore the Effects of Program Design Elements and Participant Characteristics on Parents' Engagement With an mHealth Program to Promote Healthy Infant Feeding: The Growing Healthy Program. Front Endocrinol (Lausanne). 2019;10:397. [FREE Full text] [CrossRef] [Medline]76,Cushing CC, Fedele DA, Brannon EE, Kichline T. Parents' Perspectives on the Theoretical Domains Framework Elements Needed in a Pediatric Health Behavior App: A Crowdsourced Social Validity Study. JMIR Mhealth Uhealth. Dec 21, 2018;6(12):e192. [FREE Full text] [CrossRef] [Medline]78] fell into the topic of parent feeding or nutrition and had the largest number of individual assessments. Overall, we were able to identify 41 assessment tools used in the studies that fit into 1 of 6 separate evaluative purposes (see as referenced in Table 2): measuring food amounts, taking body measurements for nutrition (often also for evaluating physical activity), assessing the ways and environment in which food is consumed, evaluating the quality of food consumed, examining parent feeding and young child food acceptance, or assessing breastfeeding-specific practice. Of the 41 assessment tools and questionnaires used, the majority (n=32) were validated tools. Six tools were self-developed specifically for the study and 3 further assessments were listed in the reviews and their origin was unclear. The Child Feeding Questionnaire was found to be the most frequently used questionnaire to assess parental feeding practices [Sun A, Cheng J, Bui Q, Liang Y, Ng T, Chen J. Home-Based and Technology-Centered Childhood Obesity Prevention for Chinese Mothers With Preschool-Aged Children. J Transcult Nurs. Nov 2017;28(6):616-624. [CrossRef] [Medline]50,Helle C, Hillesund ER, Wills AK, Øverby NC. Examining the effects of an eHealth intervention from infant age 6 to 12 months on child eating behaviors and maternal feeding practices one year after cessation: The Norwegian randomized controlled trial Early Food for Future Health. PLoS One. 2019;14(8):e0220437. [FREE Full text] [CrossRef] [Medline]54,Gomes AI, Pereira AI, Roberto MS, Boraska K, Barros L. Changing parental feeding practices through web-based interventions: A systematic review and meta-analysis. PLoS One. 2021;16(4):e0250231. [FREE Full text] [CrossRef] [Medline]57]. An instrument most frequently used for evaluating nutrition was the Food Frequency Questionnaire [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43,De Lepeleere S, De Bourdeaudhuij I, Cardon G, Verloigne M. The effect of an online video intervention 'Movie Models' on specific parenting practices and parental self-efficacy related to children's physical activity, screen-time and healthy diet: a quasi experimental study. BMC Public Health. Apr 27, 2017;17(1):366. [FREE Full text] [CrossRef] [Medline]48,Helle C, Hillesund ER, Wills AK, Øverby NC. Examining the effects of an eHealth intervention from infant age 6 to 12 months on child eating behaviors and maternal feeding practices one year after cessation: The Norwegian randomized controlled trial Early Food for Future Health. PLoS One. 2019;14(8):e0220437. [FREE Full text] [CrossRef] [Medline]54,Røed M, Medin AC, Vik FN, Hillesund ER, Van Lippevelde W, Campbell K, et al. Effect of a Parent-Focused eHealth Intervention on Children's Fruit, Vegetable, and Discretionary Food Intake (Food4toddlers): Randomized Controlled Trial. J Med Internet Res. Feb 16, 2021;23(2):e18311. [FREE Full text] [CrossRef] [Medline]55,Gomes AI, Pereira AI, Roberto MS, Boraska K, Barros L. Changing parental feeding practices through web-based interventions: A systematic review and meta-analysis. PLoS One. 2021;16(4):e0250231. [FREE Full text] [CrossRef] [Medline]57,Pond N, Finch M, Sutherland R, Wolfenden L, Nathan N, Kingsland M, et al. Cluster randomised controlled trial of an m-health intervention in centre-based childcare services to reduce the packing of discretionary foods in children's lunchboxes: study protocol for the 'SWAP IT Childcare' trial. BMJ Open. Jun 01, 2019;9(5):e026829. [FREE Full text] [CrossRef] [Medline]59].

Dental Health

Four studies evaluated parameters of dental health. In the dental study by Zolfaghari et al [Zolfaghari M, Shirmohammadi M, Shahhosseini H, Mokhtaran M, Mohebbi SZ. Development and evaluation of a gamified smart phone mobile health application for oral health promotion in early childhood: a randomized controlled trial. BMC Oral Health. Jan 07, 2021;21(1):18. [FREE Full text] [CrossRef] [Medline]62], for instance, the authors used a self-developed questionnaire to assess parent knowledge and practices that combined the self-developed questions with other validated questionnaires [Mohebbi SZ, Rabiei S, Yazdani R, Nieminen P, Virtanen JI. Evaluation of an educational intervention in oral health for primary care physicians: a cluster randomized controlled study. BMC Oral Health. Dec 14, 2018;18(1):218. [FREE Full text] [CrossRef] [Medline]89-Jain R, Oswal K, Chitguppi R. Knowledge, attitude and practices of mothers toward their children′s oral health: A questionnaire survey among subpopulation in Mumbai (India). J Dent Res Sci Develop. 2014;1(2):40-45. [CrossRef]91]. A 24-item validated questionnaire designed by Van den Branden et al [Van den Branden S, Van den Broucke S, Leroy R, Declerck D, Hoppenbrouwers K. Predicting oral health-related behaviour in the parents of preschool children: An application of the Theory of Planned Behaviour. Health Education Journal. May 05, 2014;74(2):221-230. [CrossRef]92] to measure oral health behaviors in children and the Theory of Planned Behavior determinants was used, with permission, prior to and following use of the app [Lozoya CJS, Giblin-Scanlon L, Boyd LD, Nolen S, Vineyard J. Influence of a Smartphone Application on the Oral Health Practices and Behaviors of Parents of Preschool Children. J Dent Hyg. Oct 2019;93(5):6-14. [Medline]63].

Sleep

Only 1 study [Leichman ES, Gould RA, Williamson AA, Walters RM, Mindell JA. Effectiveness of an mHealth Intervention for Infant Sleep Disturbances. Behav Ther. Jul 2020;51(4):548-558. [FREE Full text] [CrossRef] [Medline]64] specifically evaluated sleep as an mHealth intervention. This specifically assessed the sleep of infants and babies with a Brief Infant Sleep Questionnaire-Revised. However, an evaluation of the sex- and age-standardized BMI (zBMI) was found in Gomes et al’s [Gomes AI, Pereira AI, Roberto MS, Boraska K, Barros L. Changing parental feeding practices through web-based interventions: A systematic review and meta-analysis. PLoS One. 2021;16(4):e0250231. [FREE Full text] [CrossRef] [Medline]57] review of parental feeding practices and as part of a parent information needs assessment [Cushing CC, Fedele DA, Brannon EE, Kichline T. Parents' Perspectives on the Theoretical Domains Framework Elements Needed in a Pediatric Health Behavior App: A Crowdsourced Social Validity Study. JMIR Mhealth Uhealth. Dec 21, 2018;6(12):e192. [FREE Full text] [CrossRef] [Medline]78].

Mental Health

Mental health was assessed in 3 of the included studies [Choi J, Lee JH, Vittinghoff E, Fukuoka Y. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women. Matern Child Health J. May 2016;20(5):1091-1101. [FREE Full text] [CrossRef] [Medline]44,Deave T, Ginja S, Goodenough T, Bailey E, Piwek L, Coad J, et al. The Bumps and BaBies Longitudinal Study (BaBBLeS): a multi-site cohort study of first-time mothers to evaluate the effectiveness of the Baby Buddy app. Mhealth. Sep 2019;5:42-42. [FREE Full text] [CrossRef] [Medline]65,Shorey S, Ng YPM, Ng ED, Siew AL, Mörelius E, Yoong J, et al. Effectiveness of a Technology-Based Supportive Educational Parenting Program on Parental Outcomes (Part 1): Randomized Controlled Trial. J Med Internet Res. Feb 13, 2019;21(2):e10816. [FREE Full text] [CrossRef] [Medline]66]. The Warwick-Edinburgh Mental Well-Being Scale, a validated measure, was used by Deave et al [Deave T, Ginja S, Goodenough T, Bailey E, Piwek L, Coad J, et al. The Bumps and BaBies Longitudinal Study (BaBBLeS): a multi-site cohort study of first-time mothers to evaluate the effectiveness of the Baby Buddy app. Mhealth. Sep 2019;5:42-42. [FREE Full text] [CrossRef] [Medline]65], using a 14-item scale of subjective mental well-being and psychological functioning. Choi et al [Choi J, Lee JH, Vittinghoff E, Fukuoka Y. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women. Matern Child Health J. May 2016;20(5):1091-1101. [FREE Full text] [CrossRef] [Medline]44] used the Center for Epidemiological Studies Depression Scale to assess the mental health.

Parent Child Health

A total of 8 studies [Sun A, Cheng J, Bui Q, Liang Y, Ng T, Chen J. Home-Based and Technology-Centered Childhood Obesity Prevention for Chinese Mothers With Preschool-Aged Children. J Transcult Nurs. Nov 2017;28(6):616-624. [CrossRef] [Medline]50,Shorey S, Ng YPM, Ng ED, Siew AL, Mörelius E, Yoong J, et al. Effectiveness of a Technology-Based Supportive Educational Parenting Program on Parental Outcomes (Part 1): Randomized Controlled Trial. J Med Internet Res. Feb 13, 2019;21(2):e10816. [FREE Full text] [CrossRef] [Medline]66-Davis DW, Logsdon MC, Vogt K, Rushton J, Myers J, Lauf A, et al. Parent Education is Changing: A Review of Smartphone Apps. MCN Am J Matern Child Nurs. 2017;42(5):248-256. [CrossRef] [Medline]68,Burgess J, Watt K, Kimble RM, Cameron CM. Combining Technology and Research to Prevent Scald Injuries (the Cool Runnings Intervention): Randomized Controlled Trial. J Med Internet Res. Oct 10, 2018;20(10):e10361. [FREE Full text] [CrossRef] [Medline]71,Cushing CC, Fedele DA, Brannon EE, Kichline T. Parents' Perspectives on the Theoretical Domains Framework Elements Needed in a Pediatric Health Behavior App: A Crowdsourced Social Validity Study. JMIR Mhealth Uhealth. Dec 21, 2018;6(12):e192. [FREE Full text] [CrossRef] [Medline]78,Knowlden A, Sharma M. One-Year Efficacy Testing of Enabling Mothers to Prevent Pediatric Obesity Through Web-Based Education and Reciprocal Determinism (EMPOWER) Randomized Control Trial. Health Educ Behav. Feb 2016;43(1):94-106. [CrossRef] [Medline]79,Otte RA, van Beukering AJE, Boelens-Brockhuis L. Tracker-Based Personal Advice to Support the Baby's Healthy Development in a Novel Parenting App: Data-Driven Innovation. JMIR Mhealth Uhealth. Jul 24, 2019;7(7):e12666. [FREE Full text] [CrossRef] [Medline]83] were found to address parent-child health interactions, including the health of families, identity, and family-based evaluations. None of the evaluation tools broadly assessed the parent-child health interactions, but rather concentrated on the specific topic of interest for the parent-child interaction. For instance, Knowlden and Sharma [Knowlden A, Sharma M. One-Year Efficacy Testing of Enabling Mothers to Prevent Pediatric Obesity Through Web-Based Education and Reciprocal Determinism (EMPOWER) Randomized Control Trial. Health Educ Behav. Feb 2016;43(1):94-106. [CrossRef] [Medline]79] used the most general assessment. The authors developed separate evaluations of maternal-facilitated and child-behavior constructs based on Social Cognitive Theory to evaluate the parent-child health interaction [Knowlden A, Sharma M. One-Year Efficacy Testing of Enabling Mothers to Prevent Pediatric Obesity Through Web-Based Education and Reciprocal Determinism (EMPOWER) Randomized Control Trial. Health Educ Behav. Feb 2016;43(1):94-106. [CrossRef] [Medline]79] with an aim to address healthy child nutrition and physical activity. Other topic-oriented parent-child health parameters were also found that focused on evaluating educative [Shorey S, Ng YPM, Ng ED, Siew AL, Mörelius E, Yoong J, et al. Effectiveness of a Technology-Based Supportive Educational Parenting Program on Parental Outcomes (Part 1): Randomized Controlled Trial. J Med Internet Res. Feb 13, 2019;21(2):e10816. [FREE Full text] [CrossRef] [Medline]66-Davis DW, Logsdon MC, Vogt K, Rushton J, Myers J, Lauf A, et al. Parent Education is Changing: A Review of Smartphone Apps. MCN Am J Matern Child Nurs. 2017;42(5):248-256. [CrossRef] [Medline]68,Burgess J, Watt K, Kimble RM, Cameron CM. Combining Technology and Research to Prevent Scald Injuries (the Cool Runnings Intervention): Randomized Controlled Trial. J Med Internet Res. Oct 10, 2018;20(10):e10361. [FREE Full text] [CrossRef] [Medline]71,Otte RA, van Beukering AJE, Boelens-Brockhuis L. Tracker-Based Personal Advice to Support the Baby's Healthy Development in a Novel Parenting App: Data-Driven Innovation. JMIR Mhealth Uhealth. Jul 24, 2019;7(7):e12666. [FREE Full text] [CrossRef] [Medline]83] or identity parameters [Sun A, Cheng J, Bui Q, Liang Y, Ng T, Chen J. Home-Based and Technology-Centered Childhood Obesity Prevention for Chinese Mothers With Preschool-Aged Children. J Transcult Nurs. Nov 2017;28(6):616-624. [CrossRef] [Medline]50].

Healthy Environment

Three studies [McKenzie LB, Roberts KJ, Clark R, McAdams R, Abdel-Rasoul M, Klein EG, et al. A randomized controlled trial to evaluate the Make Safe Happen® app-a mobile technology-based safety behavior change intervention for increasing parents' safety knowledge and actions. Inj Epidemiol. Mar 12, 2018;5(1):5. [FREE Full text] [CrossRef] [Medline]69,Roberts KJ, McAdams RJ, Kristel OV, Szymanski AM, McKenzie LB. Qualitative and Quantitative Evaluation of the Make Safe Happen App: Mobile Technology-Based Safety Behavior Change Intervention for Parents. JMIR Pediatr Parent. Mar 14, 2019;2(1):e12022. [FREE Full text] [CrossRef] [Medline]70,Burgess JD, Watt KA, Kimble RM, Cameron CM. Knowledge of childhood burn risks and burn first aid: Cool Runnings. Inj Prev. Aug 2019;25(4):301-306. [CrossRef] [Medline]80] specifically evaluated healthy environment through evaluations of safety behavior and first-aid knowledge.

Maternal Health and Parenting

Six studies [Choi J, Lee JH, Vittinghoff E, Fukuoka Y. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women. Matern Child Health J. May 2016;20(5):1091-1101. [FREE Full text] [CrossRef] [Medline]44,Dodd JM, Louise J, Cramp C, Grivell RM, Moran LJ, Deussen AR. Evaluation of a smartphone nutrition and physical activity application to provide lifestyle advice to pregnant women: The SNAPP randomised trial. Matern Child Nutr. Jan 2018;14(1):e12502. [FREE Full text] [CrossRef] [Medline]45,Deave T, Ginja S, Goodenough T, Bailey E, Piwek L, Coad J, et al. The Bumps and BaBies Longitudinal Study (BaBBLeS): a multi-site cohort study of first-time mothers to evaluate the effectiveness of the Baby Buddy app. Mhealth. Sep 2019;5:42-42. [FREE Full text] [CrossRef] [Medline]65,Ledford CJW, Womack JJ, Rider HA, Seehusen AB, Conner SJ, Lauters RA, et al. Unexpected Effects of a System-Distributed Mobile Application in Maternity Care: A Randomized Controlled Trial. Health Educ Behav. Jun 16, 2018;45(3):323-330. [CrossRef] [Medline]67,Militello L, Sezgin E, Huang Y, Lin S. Delivering Perinatal Health Information via a Voice Interactive App (SMILE): Mixed Methods Feasibility Study. JMIR Form Res. Mar 01, 2021;5(3):e18240. [FREE Full text] [CrossRef] [Medline]75,Biviji R, Vest J, Dixon B, Cullen T, Harle C. Content analysis of behavior change techniques in maternal and infant health apps. Transl Behav Med. Mar 16, 2021;11(2):504-515. [CrossRef] [Medline]85] addressed evaluations of maternal health and 7 studies [De Lepeleere S, De Bourdeaudhuij I, Cardon G, Verloigne M. The effect of an online video intervention 'Movie Models' on specific parenting practices and parental self-efficacy related to children's physical activity, screen-time and healthy diet: a quasi experimental study. BMC Public Health. Apr 27, 2017;17(1):366. [FREE Full text] [CrossRef] [Medline]48,Deave T, Ginja S, Goodenough T, Bailey E, Piwek L, Coad J, et al. The Bumps and BaBies Longitudinal Study (BaBBLeS): a multi-site cohort study of first-time mothers to evaluate the effectiveness of the Baby Buddy app. Mhealth. Sep 2019;5:42-42. [FREE Full text] [CrossRef] [Medline]65,Shorey S, Ng YPM, Ng ED, Siew AL, Mörelius E, Yoong J, et al. Effectiveness of a Technology-Based Supportive Educational Parenting Program on Parental Outcomes (Part 1): Randomized Controlled Trial. J Med Internet Res. Feb 13, 2019;21(2):e10816. [FREE Full text] [CrossRef] [Medline]66,Davis DW, Logsdon MC, Vogt K, Rushton J, Myers J, Lauf A, et al. Parent Education is Changing: A Review of Smartphone Apps. MCN Am J Matern Child Nurs. 2017;42(5):248-256. [CrossRef] [Medline]68,Militello L, Sezgin E, Huang Y, Lin S. Delivering Perinatal Health Information via a Voice Interactive App (SMILE): Mixed Methods Feasibility Study. JMIR Form Res. Mar 01, 2021;5(3):e18240. [FREE Full text] [CrossRef] [Medline]75,Cushing CC, Fedele DA, Brannon EE, Kichline T. Parents' Perspectives on the Theoretical Domains Framework Elements Needed in a Pediatric Health Behavior App: A Crowdsourced Social Validity Study. JMIR Mhealth Uhealth. Dec 21, 2018;6(12):e192. [FREE Full text] [CrossRef] [Medline]78,Knowlden A, Sharma M. One-Year Efficacy Testing of Enabling Mothers to Prevent Pediatric Obesity Through Web-Based Education and Reciprocal Determinism (EMPOWER) Randomized Control Trial. Health Educ Behav. Feb 2016;43(1):94-106. [CrossRef] [Medline]79] looked at specific parenting parameters. In 1 study [Deave T, Ginja S, Goodenough T, Bailey E, Piwek L, Coad J, et al. The Bumps and BaBies Longitudinal Study (BaBBLeS): a multi-site cohort study of first-time mothers to evaluate the effectiveness of the Baby Buddy app. Mhealth. Sep 2019;5:42-42. [FREE Full text] [CrossRef] [Medline]65], the parenting self-efficacy was measured with the TOPSE. The TOPSE was used to compare mothers at 3 months after birth who had downloaded the Baby Buddy app with those who had not downloaded the app, controlling for confounding factors. The postnatal mental state was measured in Shorey et al [Shorey S, Ng YPM, Ng ED, Siew AL, Mörelius E, Yoong J, et al. Effectiveness of a Technology-Based Supportive Educational Parenting Program on Parental Outcomes (Part 1): Randomized Controlled Trial. J Med Internet Res. Feb 13, 2019;21(2):e10816. [FREE Full text] [CrossRef] [Medline]66] with a crossover of mental health and parenting and infant bonding tools.

App Feasibility (Quality and Usability)

The most frequent way by which child health apps for parents were assessed was through the Mobile App Rating Scale [Zarnowiecki D, Mauch CE, Middleton G, Matwiejczyk L, Watson WL, Dibbs J, et al. A systematic evaluation of digital nutrition promotion websites and apps for supporting parents to influence children's nutrition. Int J Behav Nutr Phys Act. Feb 10, 2020;17(1):17. [FREE Full text] [CrossRef] [Medline]53,Cheng H, Tutt A, Llewellyn C, Size D, Jones J, Taki S, et al. Content and Quality of Infant Feeding Smartphone Apps: Five-Year Update on a Systematic Search and Evaluation. JMIR Mhealth Uhealth. May 27, 2020;8(5):e17300. [FREE Full text] [CrossRef] [Medline]72,Mauch CE, Laws RA, Prichard I, Maeder AJ, Wycherley TP, Golley RK. Commercially Available Apps to Support Healthy Family Meals: User Testing of App Utility, Acceptability, and Engagement. JMIR Mhealth Uhealth. May 07, 2021;9(5):e22990. [FREE Full text] [CrossRef] [Medline]74], developed by Stoyanov and colleagues [Stoyanov SR, Hides L, Kavanagh DJ, Zelenko O, Tjondronegoro D, Mani M. Mobile app rating scale: a new tool for assessing the quality of health mobile apps. JMIR Mhealth Uhealth. Mar 11, 2015;3(1):e27. [FREE Full text] [CrossRef] [Medline]93]. To further assess the feasibility and quality of parent apps, a mixed methods approach was used for further development and contextual adaptation of feedback through interviews, where mostly semistructured interviews were conducted [Meedya S, Win K, Yeatman H, Fahy K, Walton K, Burgess L, et al. Developing and testing a mobile application for breastfeeding support: The Milky Way application. Women Birth. Mar 2021;34(2):e196-e203. [FREE Full text] [CrossRef] [Medline]73-Militello L, Sezgin E, Huang Y, Lin S. Delivering Perinatal Health Information via a Voice Interactive App (SMILE): Mixed Methods Feasibility Study. JMIR Form Res. Mar 01, 2021;5(3):e18240. [FREE Full text] [CrossRef] [Medline]75,Otte RA, van Beukering AJE, Boelens-Brockhuis L. Tracker-Based Personal Advice to Support the Baby's Healthy Development in a Novel Parenting App: Data-Driven Innovation. JMIR Mhealth Uhealth. Jul 24, 2019;7(7):e12666. [FREE Full text] [CrossRef] [Medline]83,Venezia AP, Wirth CK, Vinci DM. Active Families at Home: The Development of a Let’s Wiggle With 5-2-1-0 App. TPE. 2019;76(1):224-237. [CrossRef]84]. Qualitative assessments of the apps used in in-person, online, and telephone [Meedya S, Win K, Yeatman H, Fahy K, Walton K, Burgess L, et al. Developing and testing a mobile application for breastfeeding support: The Milky Way application. Women Birth. Mar 2021;34(2):e196-e203. [FREE Full text] [CrossRef] [Medline]73] semistructured interviews or focus groups were analyzed by a stated inductive or thematic analysis. Whereas app development approaches guided the qualitative interview data collection [Meedya S, Win K, Yeatman H, Fahy K, Walton K, Burgess L, et al. Developing and testing a mobile application for breastfeeding support: The Milky Way application. Women Birth. Mar 2021;34(2):e196-e203. [FREE Full text] [CrossRef] [Medline]73,Militello L, Sezgin E, Huang Y, Lin S. Delivering Perinatal Health Information via a Voice Interactive App (SMILE): Mixed Methods Feasibility Study. JMIR Form Res. Mar 01, 2021;5(3):e18240. [FREE Full text] [CrossRef] [Medline]75], explicit stating of the qualitative theoretical approaches for the interviews themselves was notably lacking in some studies [Otte RA, van Beukering AJE, Boelens-Brockhuis L. Tracker-Based Personal Advice to Support the Baby's Healthy Development in a Novel Parenting App: Data-Driven Innovation. JMIR Mhealth Uhealth. Jul 24, 2019;7(7):e12666. [FREE Full text] [CrossRef] [Medline]83,Venezia AP, Wirth CK, Vinci DM. Active Families at Home: The Development of a Let’s Wiggle With 5-2-1-0 App. TPE. 2019;76(1):224-237. [CrossRef]84]. Braun and Clark was the most frequently cited theoretical approach [Roberts KJ, McAdams RJ, Kristel OV, Szymanski AM, McKenzie LB. Qualitative and Quantitative Evaluation of the Make Safe Happen App: Mobile Technology-Based Safety Behavior Change Intervention for Parents. JMIR Pediatr Parent. Mar 14, 2019;2(1):e12022. [FREE Full text] [CrossRef] [Medline]70,Mauch CE, Laws RA, Prichard I, Maeder AJ, Wycherley TP, Golley RK. Commercially Available Apps to Support Healthy Family Meals: User Testing of App Utility, Acceptability, and Engagement. JMIR Mhealth Uhealth. May 07, 2021;9(5):e22990. [FREE Full text] [CrossRef] [Medline]74,Militello L, Sezgin E, Huang Y, Lin S. Delivering Perinatal Health Information via a Voice Interactive App (SMILE): Mixed Methods Feasibility Study. JMIR Form Res. Mar 01, 2021;5(3):e18240. [FREE Full text] [CrossRef] [Medline]75]. Furthermore, data analytic tools for coverage, usability, and engagement were used by several studies of apps [Cheng H, Tutt A, Llewellyn C, Size D, Jones J, Taki S, et al. Content and Quality of Infant Feeding Smartphone Apps: Five-Year Update on a Systematic Search and Evaluation. JMIR Mhealth Uhealth. May 27, 2020;8(5):e17300. [FREE Full text] [CrossRef] [Medline]72,Mauch CE, Laws RA, Prichard I, Maeder AJ, Wycherley TP, Golley RK. Commercially Available Apps to Support Healthy Family Meals: User Testing of App Utility, Acceptability, and Engagement. JMIR Mhealth Uhealth. May 07, 2021;9(5):e22990. [FREE Full text] [CrossRef] [Medline]74-Taki S, Russell CG, Lymer S, Laws R, Campbell K, Appleton J, et al. A Mixed Methods Study to Explore the Effects of Program Design Elements and Participant Characteristics on Parents' Engagement With an mHealth Program to Promote Healthy Infant Feeding: The Growing Healthy Program. Front Endocrinol (Lausanne). 2019;10:397. [FREE Full text] [CrossRef] [Medline]76]. Additionally, features of apps such as push notifications, gamification, and just-in-time adaptive interventions were used or listed for apps to retain engagement [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43,Choi J, Lee JH, Vittinghoff E, Fukuoka Y. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women. Matern Child Health J. May 2016;20(5):1091-1101. [FREE Full text] [CrossRef] [Medline]44,Meixner C, Baumann H, Fenger A, Wollesen B. Gamification in health apps to increase physical activity within families. New York, NY. IEEE; Presented at: 2019 International Conference on Wireless and Mobile Computing, Networking and Communications (WiMob); October 21-23, 2019, 2019;21-23; Barcelona, Spain. [CrossRef]46,Scott JA, Burns SK, Hauck YL, Giglia RC, Jorgensen AM, White BK, et al. Impact of a Face-To-Face Versus Smartphone App Versus Combined Breastfeeding Intervention Targeting Fathers: Randomized Controlled Trial. JMIR Pediatr Parent. Apr 12, 2021;4(2):e24579. [FREE Full text] [CrossRef] [Medline]58,Burgess J, Watt K, Kimble RM, Cameron CM. Combining Technology and Research to Prevent Scald Injuries (the Cool Runnings Intervention): Randomized Controlled Trial. J Med Internet Res. Oct 10, 2018;20(10):e10361. [FREE Full text] [CrossRef] [Medline]71,Mauch CE, Laws RA, Prichard I, Maeder AJ, Wycherley TP, Golley RK. Commercially Available Apps to Support Healthy Family Meals: User Testing of App Utility, Acceptability, and Engagement. JMIR Mhealth Uhealth. May 07, 2021;9(5):e22990. [FREE Full text] [CrossRef] [Medline]74].

Parent Mobile App Outcomes

Reported Evaluation Outcomes Based on Topics

The manner in which parent-based apps and interventions reported on outcomes in the primary studies was mixed. The study-reported effectiveness of an intervention was cited by many to depend on the length of the intervention, the intended intervention that was targeted, and whether an app included in-person support. Apps increasing knowledge seemed to be a particularly effective means to create a healthy environment with children [Roberts KJ, McAdams RJ, Kristel OV, Szymanski AM, McKenzie LB. Qualitative and Quantitative Evaluation of the Make Safe Happen App: Mobile Technology-Based Safety Behavior Change Intervention for Parents. JMIR Pediatr Parent. Mar 14, 2019;2(1):e12022. [FREE Full text] [CrossRef] [Medline]70,Burgess J, Watt K, Kimble RM, Cameron CM. Combining Technology and Research to Prevent Scald Injuries (the Cool Runnings Intervention): Randomized Controlled Trial. J Med Internet Res. Oct 10, 2018;20(10):e10361. [FREE Full text] [CrossRef] [Medline]71] or to increase knowledge on child oral health [Zolfaghari M, Shirmohammadi M, Shahhosseini H, Mokhtaran M, Mohebbi SZ. Development and evaluation of a gamified smart phone mobile health application for oral health promotion in early childhood: a randomized controlled trial. BMC Oral Health. Jan 07, 2021;21(1):18. [FREE Full text] [CrossRef] [Medline]62]. An increase in physical activity of pregnant women was cited by 2 studies [Choi J, Lee JH, Vittinghoff E, Fukuoka Y. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women. Matern Child Health J. May 2016;20(5):1091-1101. [FREE Full text] [CrossRef] [Medline]44,Sun A, Cheng J, Bui Q, Liang Y, Ng T, Chen J. Home-Based and Technology-Centered Childhood Obesity Prevention for Chinese Mothers With Preschool-Aged Children. J Transcult Nurs. Nov 2017;28(6):616-624. [CrossRef] [Medline]50] and an 8-week app intervention was able to increase the physical activity performed by children, but this was not a significant outcome [Trost SG, Brookes DSK. Effectiveness of a novel digital application to promote fundamental movement skills in 3- to 6-year-old children: A randomized controlled trial. J Sports Sci. Feb 27, 2021;39(4):453-459. [CrossRef] [Medline]49]. Increasing knowledge on nutrition was demonstrated in 1 study [Au LE, Whaley S, Rosen NJ, Meza M, Ritchie LD. Online and In-Person Nutrition Education Improves Breakfast Knowledge, Attitudes, and Behaviors: A Randomized Trial of Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children. J Acad Nutr Diet. Mar 2016;116(3):490-500. [CrossRef] [Medline]52]; however, this intervention was coupled with in-person support classes. For nutrition outcomes, a reported increase in motivation or the consumption of fruit and vegetables in a child’s diet was reported by several studies [De Lepeleere S, De Bourdeaudhuij I, Cardon G, Verloigne M. The effect of an online video intervention 'Movie Models' on specific parenting practices and parental self-efficacy related to children's physical activity, screen-time and healthy diet: a quasi experimental study. BMC Public Health. Apr 27, 2017;17(1):366. [FREE Full text] [CrossRef] [Medline]48,Cullen KW, Thompson D, Chen T. Outcome Evaluation of Family Eats. Health Educ Behav. Feb 2017;44(1):32-40. [CrossRef] [Medline]51,Røed M, Medin AC, Vik FN, Hillesund ER, Van Lippevelde W, Campbell K, et al. Effect of a Parent-Focused eHealth Intervention on Children's Fruit, Vegetable, and Discretionary Food Intake (Food4toddlers): Randomized Controlled Trial. J Med Internet Res. Feb 16, 2021;23(2):e18311. [FREE Full text] [CrossRef] [Medline]55] and healthier lunches saw less discretionary foods packed by parents who used an app [Sutherland R, Nathan N, Brown A, Yoong S, Finch M, Lecathelinais C, et al. A randomized controlled trial to assess the potential efficacy, feasibility and acceptability of an m-health intervention targeting parents of school aged children to improve the nutritional quality of foods packed in the lunchbox 'SWAP IT'. Int J Behav Nutr Phys Act. Jul 02, 2019;16(1):54. [FREE Full text] [CrossRef] [Medline]60]. Most improved outcomes with the interventions were not simply attributed to the use of the app alone, however. For example, a trial on dental hygiene demonstrated improvement for app users with a high level of perceived behavioral control, especially when coupled with regular dental checkups [Lozoya CJS, Giblin-Scanlon L, Boyd LD, Nolen S, Vineyard J. Influence of a Smartphone Application on the Oral Health Practices and Behaviors of Parents of Preschool Children. J Dent Hyg. Oct 2019;93(5):6-14. [Medline]63]. App-only outcomes demonstrated some positive effects for new parents of infants with sleep problems [Leichman ES, Gould RA, Williamson AA, Walters RM, Mindell JA. Effectiveness of an mHealth Intervention for Infant Sleep Disturbances. Behav Ther. Jul 2020;51(4):548-558. [FREE Full text] [CrossRef] [Medline]64] and for improving parent bonding and self-efficacy after birth [Shorey S, Ng YPM, Ng ED, Siew AL, Mörelius E, Yoong J, et al. Effectiveness of a Technology-Based Supportive Educational Parenting Program on Parental Outcomes (Part 1): Randomized Controlled Trial. J Med Internet Res. Feb 13, 2019;21(2):e10816. [FREE Full text] [CrossRef] [Medline]66]. Outcomes in nutrition studies that relied on longer term growth outcomes saw little sustained or no positive effect over time with app use [Helle C, Hillesund ER, Wills AK, Øverby NC. Examining the effects of an eHealth intervention from infant age 6 to 12 months on child eating behaviors and maternal feeding practices one year after cessation: The Norwegian randomized controlled trial Early Food for Future Health. PLoS One. 2019;14(8):e0220437. [FREE Full text] [CrossRef] [Medline]54,Russell CG, Denney-Wilson E, Laws RA, Abbott G, Zheng M, Lymer SJ, et al. Impact of the Growing Healthy mHealth Program on Maternal Feeding Practices, Infant Food Preferences, and Satiety Responsiveness: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 25, 2018;6(4):e77. [FREE Full text] [CrossRef] [Medline]56,Laws RA, Denney-Wilson EA, Taki S, Russell CG, Zheng M, Litterbach E, et al. Key Lessons and Impact of the Growing Healthy mHealth Program on Milk Feeding, Timing of Introduction of Solids, and Infant Growth: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 19, 2018;6(4):e78. [FREE Full text] [CrossRef] [Medline]61,Knowlden A, Sharma M. One-Year Efficacy Testing of Enabling Mothers to Prevent Pediatric Obesity Through Web-Based Education and Reciprocal Determinism (EMPOWER) Randomized Control Trial. Health Educ Behav. Feb 2016;43(1):94-106. [CrossRef] [Medline]79]. Indeed, studies on app-based interventions for baby food introduction and sustained healthy eating in early childhood highlighted the difficulty of achieving any sustained positive effect over time [Helle C, Hillesund ER, Wills AK, Øverby NC. Examining the effects of an eHealth intervention from infant age 6 to 12 months on child eating behaviors and maternal feeding practices one year after cessation: The Norwegian randomized controlled trial Early Food for Future Health. PLoS One. 2019;14(8):e0220437. [FREE Full text] [CrossRef] [Medline]54-Russell CG, Denney-Wilson E, Laws RA, Abbott G, Zheng M, Lymer SJ, et al. Impact of the Growing Healthy mHealth Program on Maternal Feeding Practices, Infant Food Preferences, and Satiety Responsiveness: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 25, 2018;6(4):e77. [FREE Full text] [CrossRef] [Medline]56]. Across other topics, app support for partners of breastfeeding women or lifestyle advice for pregnant women resulted in no changed outcome with the apps and eHealth interventions [Dodd JM, Louise J, Cramp C, Grivell RM, Moran LJ, Deussen AR. Evaluation of a smartphone nutrition and physical activity application to provide lifestyle advice to pregnant women: The SNAPP randomised trial. Matern Child Nutr. Jan 2018;14(1):e12502. [FREE Full text] [CrossRef] [Medline]45,Scott JA, Burns SK, Hauck YL, Giglia RC, Jorgensen AM, White BK, et al. Impact of a Face-To-Face Versus Smartphone App Versus Combined Breastfeeding Intervention Targeting Fathers: Randomized Controlled Trial. JMIR Pediatr Parent. Apr 12, 2021;4(2):e24579. [FREE Full text] [CrossRef] [Medline]58], or even saw negative outcomes in the group receiving an app-supported intervention (ie, intervention group) to aid pregnant women decision-making [Ledford CJW, Womack JJ, Rider HA, Seehusen AB, Conner SJ, Lauters RA, et al. Unexpected Effects of a System-Distributed Mobile Application in Maternity Care: A Randomized Controlled Trial. Health Educ Behav. Jun 16, 2018;45(3):323-330. [CrossRef] [Medline]67]. This outcome supports a recommendation given in multiple interventions to use real-world interaction and support interventions in conjunction with the app [Sun A, Cheng J, Bui Q, Liang Y, Ng T, Chen J. Home-Based and Technology-Centered Childhood Obesity Prevention for Chinese Mothers With Preschool-Aged Children. J Transcult Nurs. Nov 2017;28(6):616-624. [CrossRef] [Medline]50,Røed M, Medin AC, Vik FN, Hillesund ER, Van Lippevelde W, Campbell K, et al. Effect of a Parent-Focused eHealth Intervention on Children's Fruit, Vegetable, and Discretionary Food Intake (Food4toddlers): Randomized Controlled Trial. J Med Internet Res. Feb 16, 2021;23(2):e18311. [FREE Full text] [CrossRef] [Medline]55,Laws RA, Denney-Wilson EA, Taki S, Russell CG, Zheng M, Litterbach E, et al. Key Lessons and Impact of the Growing Healthy mHealth Program on Milk Feeding, Timing of Introduction of Solids, and Infant Growth: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 19, 2018;6(4):e78. [FREE Full text] [CrossRef] [Medline]61,Deave T, Ginja S, Goodenough T, Bailey E, Piwek L, Coad J, et al. The Bumps and BaBies Longitudinal Study (BaBBLeS): a multi-site cohort study of first-time mothers to evaluate the effectiveness of the Baby Buddy app. Mhealth. Sep 2019;5:42-42. [FREE Full text] [CrossRef] [Medline]65,Shorey S, Ng YPM, Ng ED, Siew AL, Mörelius E, Yoong J, et al. Effectiveness of a Technology-Based Supportive Educational Parenting Program on Parental Outcomes (Part 1): Randomized Controlled Trial. J Med Internet Res. Feb 13, 2019;21(2):e10816. [FREE Full text] [CrossRef] [Medline]66]. Recruitment posed its own challenges. Particularly, in studies that aimed at healthier behaviors for children that were facilitated and necessitated parental support, authors employed several strategies: some recruited children but evaluated data from parents [Pond N, Finch M, Sutherland R, Wolfenden L, Nathan N, Kingsland M, et al. Cluster randomised controlled trial of an m-health intervention in centre-based childcare services to reduce the packing of discretionary foods in children's lunchboxes: study protocol for the 'SWAP IT Childcare' trial. BMJ Open. Jun 01, 2019;9(5):e026829. [FREE Full text] [CrossRef] [Medline]59], some spoke of parent-child dyads [Sun A, Cheng J, Bui Q, Liang Y, Ng T, Chen J. Home-Based and Technology-Centered Childhood Obesity Prevention for Chinese Mothers With Preschool-Aged Children. J Transcult Nurs. Nov 2017;28(6):616-624. [CrossRef] [Medline]50,Røed M, Medin AC, Vik FN, Hillesund ER, Van Lippevelde W, Campbell K, et al. Effect of a Parent-Focused eHealth Intervention on Children's Fruit, Vegetable, and Discretionary Food Intake (Food4toddlers): Randomized Controlled Trial. J Med Internet Res. Feb 16, 2021;23(2):e18311. [FREE Full text] [CrossRef] [Medline]55,Laws RA, Denney-Wilson EA, Taki S, Russell CG, Zheng M, Litterbach E, et al. Key Lessons and Impact of the Growing Healthy mHealth Program on Milk Feeding, Timing of Introduction of Solids, and Infant Growth: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 19, 2018;6(4):e78. [FREE Full text] [CrossRef] [Medline]61], while others focused on the recruitment of families [Cullen KW, Thompson D, Chen T. Outcome Evaluation of Family Eats. Health Educ Behav. Feb 2017;44(1):32-40. [CrossRef] [Medline]51]. Some studies reported parents having higher education levels and potentially greater willingness to engage with the technology than a targeted population that would most benefit from the intervention [Dodd JM, Louise J, Cramp C, Grivell RM, Moran LJ, Deussen AR. Evaluation of a smartphone nutrition and physical activity application to provide lifestyle advice to pregnant women: The SNAPP randomised trial. Matern Child Nutr. Jan 2018;14(1):e12502. [FREE Full text] [CrossRef] [Medline]45,De Lepeleere S, De Bourdeaudhuij I, Cardon G, Verloigne M. The effect of an online video intervention 'Movie Models' on specific parenting practices and parental self-efficacy related to children's physical activity, screen-time and healthy diet: a quasi experimental study. BMC Public Health. Apr 27, 2017;17(1):366. [FREE Full text] [CrossRef] [Medline]48,Helle C, Hillesund ER, Wills AK, Øverby NC. Examining the effects of an eHealth intervention from infant age 6 to 12 months on child eating behaviors and maternal feeding practices one year after cessation: The Norwegian randomized controlled trial Early Food for Future Health. PLoS One. 2019;14(8):e0220437. [FREE Full text] [CrossRef] [Medline]54,Scott JA, Burns SK, Hauck YL, Giglia RC, Jorgensen AM, White BK, et al. Impact of a Face-To-Face Versus Smartphone App Versus Combined Breastfeeding Intervention Targeting Fathers: Randomized Controlled Trial. JMIR Pediatr Parent. Apr 12, 2021;4(2):e24579. [FREE Full text] [CrossRef] [Medline]58,Laws RA, Denney-Wilson EA, Taki S, Russell CG, Zheng M, Litterbach E, et al. Key Lessons and Impact of the Growing Healthy mHealth Program on Milk Feeding, Timing of Introduction of Solids, and Infant Growth: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 19, 2018;6(4):e78. [FREE Full text] [CrossRef] [Medline]61,Lozoya CJS, Giblin-Scanlon L, Boyd LD, Nolen S, Vineyard J. Influence of a Smartphone Application on the Oral Health Practices and Behaviors of Parents of Preschool Children. J Dent Hyg. Oct 2019;93(5):6-14. [Medline]63,Knowlden A, Sharma M. One-Year Efficacy Testing of Enabling Mothers to Prevent Pediatric Obesity Through Web-Based Education and Reciprocal Determinism (EMPOWER) Randomized Control Trial. Health Educ Behav. Feb 2016;43(1):94-106. [CrossRef] [Medline]79].

App Evaluations of Behavior Changes and Parent Experience

A few studies highlighted the difficulty of customizing BCTs to their app content that combined the aims of the intervention with potential needs of parents and the ability to effectively evaluate these measures [Russell CG, Denney-Wilson E, Laws RA, Abbott G, Zheng M, Lymer SJ, et al. Impact of the Growing Healthy mHealth Program on Maternal Feeding Practices, Infant Food Preferences, and Satiety Responsiveness: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 25, 2018;6(4):e77. [FREE Full text] [CrossRef] [Medline]56,Deave T, Ginja S, Goodenough T, Bailey E, Piwek L, Coad J, et al. The Bumps and BaBies Longitudinal Study (BaBBLeS): a multi-site cohort study of first-time mothers to evaluate the effectiveness of the Baby Buddy app. Mhealth. Sep 2019;5:42-42. [FREE Full text] [CrossRef] [Medline]65,Cushing CC, Fedele DA, Brannon EE, Kichline T. Parents' Perspectives on the Theoretical Domains Framework Elements Needed in a Pediatric Health Behavior App: A Crowdsourced Social Validity Study. JMIR Mhealth Uhealth. Dec 21, 2018;6(12):e192. [FREE Full text] [CrossRef] [Medline]78], a point that was discussed in additional detail in the reviews by both Gomes et al [Gomes AI, Pereira AI, Roberto MS, Boraska K, Barros L. Changing parental feeding practices through web-based interventions: A systematic review and meta-analysis. PLoS One. 2021;16(4):e0250231. [FREE Full text] [CrossRef] [Medline]57] and Biviji et al [Biviji R, Vest J, Dixon B, Cullen T, Harle C. Content analysis of behavior change techniques in maternal and infant health apps. Transl Behav Med. Mar 16, 2021;11(2):504-515. [CrossRef] [Medline]85]. Particularly, the app reviews and a few studies underscored the gap of evidence-based apps with best practices among available apps for parents across health promotion topics [Cheng H, Tutt A, Llewellyn C, Size D, Jones J, Taki S, et al. Content and Quality of Infant Feeding Smartphone Apps: Five-Year Update on a Systematic Search and Evaluation. JMIR Mhealth Uhealth. May 27, 2020;8(5):e17300. [FREE Full text] [CrossRef] [Medline]72,Cushing CC, Fedele DA, Brannon EE, Kichline T. Parents' Perspectives on the Theoretical Domains Framework Elements Needed in a Pediatric Health Behavior App: A Crowdsourced Social Validity Study. JMIR Mhealth Uhealth. Dec 21, 2018;6(12):e192. [FREE Full text] [CrossRef] [Medline]78,Otte RA, van Beukering AJE, Boelens-Brockhuis L. Tracker-Based Personal Advice to Support the Baby's Healthy Development in a Novel Parenting App: Data-Driven Innovation. JMIR Mhealth Uhealth. Jul 24, 2019;7(7):e12666. [FREE Full text] [CrossRef] [Medline]83]. Tracking of growth, pregnancy development, breastfeeding, dental hygiene, and diet were features that parents enjoyed, especially if these contents were tailored to the health parameters [Zarnowiecki D, Mauch CE, Middleton G, Matwiejczyk L, Watson WL, Dibbs J, et al. A systematic evaluation of digital nutrition promotion websites and apps for supporting parents to influence children's nutrition. Int J Behav Nutr Phys Act. Feb 10, 2020;17(1):17. [FREE Full text] [CrossRef] [Medline]53,Lozoya CJS, Giblin-Scanlon L, Boyd LD, Nolen S, Vineyard J. Influence of a Smartphone Application on the Oral Health Practices and Behaviors of Parents of Preschool Children. J Dent Hyg. Oct 2019;93(5):6-14. [Medline]63,Biviji R. Evaluating the Quality of Mobile Health Apps for Maternal and Child Health (MCH). Indianapolis, IA. Indiana University-Purdue University Indianapolis; 2018.77,Otte RA, van Beukering AJE, Boelens-Brockhuis L. Tracker-Based Personal Advice to Support the Baby's Healthy Development in a Novel Parenting App: Data-Driven Innovation. JMIR Mhealth Uhealth. Jul 24, 2019;7(7):e12666. [FREE Full text] [CrossRef] [Medline]83]. At the same time, features such as chat functions [Zarnowiecki D, Mauch CE, Middleton G, Matwiejczyk L, Watson WL, Dibbs J, et al. A systematic evaluation of digital nutrition promotion websites and apps for supporting parents to influence children's nutrition. Int J Behav Nutr Phys Act. Feb 10, 2020;17(1):17. [FREE Full text] [CrossRef] [Medline]53,Meedya S, Win K, Yeatman H, Fahy K, Walton K, Burgess L, et al. Developing and testing a mobile application for breastfeeding support: The Milky Way application. Women Birth. Mar 2021;34(2):e196-e203. [FREE Full text] [CrossRef] [Medline]73] or diaries [Choi J, Lee JH, Vittinghoff E, Fukuoka Y. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women. Matern Child Health J. May 2016;20(5):1091-1101. [FREE Full text] [CrossRef] [Medline]44] had mixed reviews or negative desirability by parents in the studies.

App Content Delivery and Technical Features

Keeping parents motivated to use the app was a challenge reported in multiple studies [Dodd JM, Louise J, Cramp C, Grivell RM, Moran LJ, Deussen AR. Evaluation of a smartphone nutrition and physical activity application to provide lifestyle advice to pregnant women: The SNAPP randomised trial. Matern Child Nutr. Jan 2018;14(1):e12502. [FREE Full text] [CrossRef] [Medline]45,Russell CG, Denney-Wilson E, Laws RA, Abbott G, Zheng M, Lymer SJ, et al. Impact of the Growing Healthy mHealth Program on Maternal Feeding Practices, Infant Food Preferences, and Satiety Responsiveness: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 25, 2018;6(4):e77. [FREE Full text] [CrossRef] [Medline]56]. Other content delivery mechanisms, such as audio recordings (podcasts) [Militello L, Sezgin E, Huang Y, Lin S. Delivering Perinatal Health Information via a Voice Interactive App (SMILE): Mixed Methods Feasibility Study. JMIR Form Res. Mar 01, 2021;5(3):e18240. [FREE Full text] [CrossRef] [Medline]75] or videos [De Lepeleere S, De Bourdeaudhuij I, Cardon G, Verloigne M. The effect of an online video intervention 'Movie Models' on specific parenting practices and parental self-efficacy related to children's physical activity, screen-time and healthy diet: a quasi experimental study. BMC Public Health. Apr 27, 2017;17(1):366. [FREE Full text] [CrossRef] [Medline]48], saw a high level of adherence in terms of the content consumption. Technical problems, interface challenges, or the inability to appropriately tailor app features were feedback highlighted by several studies [Russell CG, Denney-Wilson E, Laws RA, Abbott G, Zheng M, Lymer SJ, et al. Impact of the Growing Healthy mHealth Program on Maternal Feeding Practices, Infant Food Preferences, and Satiety Responsiveness: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 25, 2018;6(4):e77. [FREE Full text] [CrossRef] [Medline]56,Scott JA, Burns SK, Hauck YL, Giglia RC, Jorgensen AM, White BK, et al. Impact of a Face-To-Face Versus Smartphone App Versus Combined Breastfeeding Intervention Targeting Fathers: Randomized Controlled Trial. JMIR Pediatr Parent. Apr 12, 2021;4(2):e24579. [FREE Full text] [CrossRef] [Medline]58,Laws RA, Denney-Wilson EA, Taki S, Russell CG, Zheng M, Litterbach E, et al. Key Lessons and Impact of the Growing Healthy mHealth Program on Milk Feeding, Timing of Introduction of Solids, and Infant Growth: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 19, 2018;6(4):e78. [FREE Full text] [CrossRef] [Medline]61]. The engagement with the apps by parents was described in a few studies to have the highest relevance for first-time parents [Shorey S, Ng YPM, Ng ED, Siew AL, Mörelius E, Yoong J, et al. Effectiveness of a Technology-Based Supportive Educational Parenting Program on Parental Outcomes (Part 1): Randomized Controlled Trial. J Med Internet Res. Feb 13, 2019;21(2):e10816. [FREE Full text] [CrossRef] [Medline]66,Taki S, Russell CG, Lymer S, Laws R, Campbell K, Appleton J, et al. A Mixed Methods Study to Explore the Effects of Program Design Elements and Participant Characteristics on Parents' Engagement With an mHealth Program to Promote Healthy Infant Feeding: The Growing Healthy Program. Front Endocrinol (Lausanne). 2019;10:397. [FREE Full text] [CrossRef] [Medline]76] and retaining app or program engagement, particularly for the group targeted, was a challenge cited in multiple studies [Meixner C, Baumann H, Fenger A, Wollesen B. Gamification in health apps to increase physical activity within families. New York, NY. IEEE; Presented at: 2019 International Conference on Wireless and Mobile Computing, Networking and Communications (WiMob); October 21-23, 2019, 2019;21-23; Barcelona, Spain. [CrossRef]46,Russell CG, Denney-Wilson E, Laws RA, Abbott G, Zheng M, Lymer SJ, et al. Impact of the Growing Healthy mHealth Program on Maternal Feeding Practices, Infant Food Preferences, and Satiety Responsiveness: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 25, 2018;6(4):e77. [FREE Full text] [CrossRef] [Medline]56,Laws RA, Denney-Wilson EA, Taki S, Russell CG, Zheng M, Litterbach E, et al. Key Lessons and Impact of the Growing Healthy mHealth Program on Milk Feeding, Timing of Introduction of Solids, and Infant Growth: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 19, 2018;6(4):e78. [FREE Full text] [CrossRef] [Medline]61]. Features such as push notifications were seen as helpful delivery tools to maintain engagement with the app [Choi J, Lee JH, Vittinghoff E, Fukuoka Y. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women. Matern Child Health J. May 2016;20(5):1091-1101. [FREE Full text] [CrossRef] [Medline]44,Scott JA, Burns SK, Hauck YL, Giglia RC, Jorgensen AM, White BK, et al. Impact of a Face-To-Face Versus Smartphone App Versus Combined Breastfeeding Intervention Targeting Fathers: Randomized Controlled Trial. JMIR Pediatr Parent. Apr 12, 2021;4(2):e24579. [FREE Full text] [CrossRef] [Medline]58,Sutherland R, Nathan N, Brown A, Yoong S, Finch M, Lecathelinais C, et al. A randomized controlled trial to assess the potential efficacy, feasibility and acceptability of an m-health intervention targeting parents of school aged children to improve the nutritional quality of foods packed in the lunchbox 'SWAP IT'. Int J Behav Nutr Phys Act. Jul 02, 2019;16(1):54. [FREE Full text] [CrossRef] [Medline]60,Laws RA, Denney-Wilson EA, Taki S, Russell CG, Zheng M, Litterbach E, et al. Key Lessons and Impact of the Growing Healthy mHealth Program on Milk Feeding, Timing of Introduction of Solids, and Infant Growth: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 19, 2018;6(4):e78. [FREE Full text] [CrossRef] [Medline]61,Taki S, Russell CG, Lymer S, Laws R, Campbell K, Appleton J, et al. A Mixed Methods Study to Explore the Effects of Program Design Elements and Participant Characteristics on Parents' Engagement With an mHealth Program to Promote Healthy Infant Feeding: The Growing Healthy Program. Front Endocrinol (Lausanne). 2019;10:397. [FREE Full text] [CrossRef] [Medline]76] and gamification was seen to have some success in achieving this goal [Meixner C, Baumann H, Fenger A, Wollesen B. Gamification in health apps to increase physical activity within families. New York, NY. IEEE; Presented at: 2019 International Conference on Wireless and Mobile Computing, Networking and Communications (WiMob); October 21-23, 2019, 2019;21-23; Barcelona, Spain. [CrossRef]46,Zolfaghari M, Shirmohammadi M, Shahhosseini H, Mokhtaran M, Mohebbi SZ. Development and evaluation of a gamified smart phone mobile health application for oral health promotion in early childhood: a randomized controlled trial. BMC Oral Health. Jan 07, 2021;21(1):18. [FREE Full text] [CrossRef] [Medline]62,Burgess J, Watt K, Kimble RM, Cameron CM. Combining Technology and Research to Prevent Scald Injuries (the Cool Runnings Intervention): Randomized Controlled Trial. J Med Internet Res. Oct 10, 2018;20(10):e10361. [FREE Full text] [CrossRef] [Medline]71]. Future designs for engaging parents reference increasingly developed “just-in-time” features to enhance practicability and interaction [Wunsch K, Eckert T, Fiedler J, Cleven L, Niermann C, Reiterer H, et al. Effects of a Collective Family-Based Mobile Health Intervention Called "SMARTFAMILY" on Promoting Physical Activity and Healthy Eating: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. Nov 11, 2020;9(11):e20534. [FREE Full text] [CrossRef] [Medline]43,Mauch CE, Laws RA, Prichard I, Maeder AJ, Wycherley TP, Golley RK. Commercially Available Apps to Support Healthy Family Meals: User Testing of App Utility, Acceptability, and Engagement. JMIR Mhealth Uhealth. May 07, 2021;9(5):e22990. [FREE Full text] [CrossRef] [Medline]74,Taki S, Russell CG, Lymer S, Laws R, Campbell K, Appleton J, et al. A Mixed Methods Study to Explore the Effects of Program Design Elements and Participant Characteristics on Parents' Engagement With an mHealth Program to Promote Healthy Infant Feeding: The Growing Healthy Program. Front Endocrinol (Lausanne). 2019;10:397. [FREE Full text] [CrossRef] [Medline]76].


Principal Findings

The 39 studies that met the inclusion criteria for this review reflected a wide range of child health topics: parental feeding and nutrition, physical activity, maternal-child health, parent-child health, healthy environment, dental health, mental health, and sleep. The 8 individual topics were concluded by an inductive analysis. Behavior change theories guided the research of 26 studies and topic-specific, adapted, self-developed, or validated questionnaires and evaluation tools were used to assess and report study outcomes. At the same time, challenges were reported in effectively evaluating changes in behavior through apps, recruiting target groups, and retaining app engagement.

An overall increase of publications on the topic may reflect the growing number of apps developed in general. The lower number of the published studies during 2020 may be an influence of the COVID-19 pandemic, a trend that we saw increase in a swift subsequent spot search in each of the included databases (see

Multimedia Appendix 1

Search strategy details.

DOCX File , 24 KBMultimedia Appendix 1). Since this review was conducted, 3 additional study results from included study protocols were published [Pearson N, Finch M, Sutherland R, Kingsland M, Wolfenden L, Wedesweiler T, et al. An mHealth Intervention to Reduce the Packing of Discretionary Foods in Children's Lunch Boxes in Early Childhood Education and Care Services: Cluster Randomized Controlled Trial. J Med Internet Res. Mar 17, 2022;24(3):e27760. [FREE Full text] [CrossRef] [Medline]94-Alexandrou C, Henriksson H, Henström M, Henriksson P, Delisle Nyström C, Bendtsen M, et al. Effectiveness of a Smartphone App (MINISTOP 2.0) integrated in primary child health care to promote healthy diet and physical activity behaviors and prevent obesity in preschool-aged children: randomized controlled trial. Int J Behav Nutr Phys Act. Feb 21, 2023;20(1):22. [FREE Full text] [CrossRef] [Medline]96]. The demand and need for addressing child health promotion have only grown since the start of the COVID-19 pandemic [Lachman P. Where to make a difference: research and the social determinants in pediatrics and child health in the COVID-19 era. Pediatr Res. Jan 10, 2021;89(2):259-262. [FREE Full text] [CrossRef] [Medline]97] and digital mHealth solutions are forecasted to continue to grow [Grand View Research. Digital Health Market Size, Share & Trends Analysis Report By Technology (Healthcare Analytics, mHealth, Tele-healthcare, Digital Health Systems), By Component (Software, Hardware, Services), By Region, And Segment Forecasts, 2023-2030. San Francisco, CA. Grand View Research; Nov 2022;1-100.98]. The greater opportunity to digitally support child health through parents solidifies the need to make sure that parents have access to health promotion apps that are embedded in scientific evidence and best practices. Generally, the regulation of recruitment strategies was very bound to the study context and was a challenge highlighted by the studies in our findings. Varied descriptions of how potential participants were recruited and who was recruited detailed a level of complexity requiring consideration for study designs with multiple sites (homes and schools, for instance) and studied parties (children and parents).

Our findings highlighted the complexity of compiling evidence of behavior changes that are supported by apps and web-based programs for child health. When app interventions evaluated parents’ knowledge after use as a primary outcome, evaluation of the knowledge increase was easily assessed [Au LE, Whaley S, Rosen NJ, Meza M, Ritchie LD. Online and In-Person Nutrition Education Improves Breakfast Knowledge, Attitudes, and Behaviors: A Randomized Trial of Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children. J Acad Nutr Diet. Mar 2016;116(3):490-500. [CrossRef] [Medline]52,Zolfaghari M, Shirmohammadi M, Shahhosseini H, Mokhtaran M, Mohebbi SZ. Development and evaluation of a gamified smart phone mobile health application for oral health promotion in early childhood: a randomized controlled trial. BMC Oral Health. Jan 07, 2021;21(1):18. [FREE Full text] [CrossRef] [Medline]62,McKenzie LB, Roberts KJ, Clark R, McAdams R, Abdel-Rasoul M, Klein EG, et al. A randomized controlled trial to evaluate the Make Safe Happen® app-a mobile technology-based safety behavior change intervention for increasing parents' safety knowledge and actions. Inj Epidemiol. Mar 12, 2018;5(1):5. [FREE Full text] [CrossRef] [Medline]69-Burgess J, Watt K, Kimble RM, Cameron CM. Combining Technology and Research to Prevent Scald Injuries (the Cool Runnings Intervention): Randomized Controlled Trial. J Med Internet Res. Oct 10, 2018;20(10):e10361. [FREE Full text] [CrossRef] [Medline]71]. Evaluating the effectiveness of more complex interventions of health promotion as described in the included studies requires multiple evaluation tools and behavior-specific tailoring in order to see potential effects that may or may not continue in the long term. Prevention interventions in primary care with young children have been found to be exceptionally challenging to sustain over time, requiring complex interventions and involvement of multiple actors [Alexander KE, Brijnath B, Biezen R, Hampton K, Mazza D. Preventive healthcare for young children: A systematic review of interventions in primary care. Prev Med. Jun 2017;99:236-250. [CrossRef] [Medline]99]. One additional impediment for long-term measurable changes could derive from the need for a clear theoretical underpinning and health mode within health promotion apps. With the absence of illness in the prevention setting, apps for health promotion could benefit from a health psychology theory–based development with a systematic evaluation in order to lead to substantial positive changes in behaviors [Kaplan RM, Anderson JP. A general health policy model: update and applications. Health Serv Res. Jun 1988;23(2):203-235. [FREE Full text] [Medline]100]. The studies included in this review had varying degrees of theory embedded into the app design, which can provide a framework for evaluation. The most frequently used framework in the included studies was the Behavior Change Taxonomy [Michie S, Richardson M, Johnston M, Abraham C, Francis J, Hardeman W, et al. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med. Aug 2013;46(1):81-95. [FREE Full text] [CrossRef] [Medline]88] and its adapted version for mobile apps [Yardley L, Spring B, Riper H, Morrison L, Crane D, Curtis K, et al. Understanding and Promoting Effective Engagement With Digital Behavior Change Interventions. Am J Prev Med. Nov 2016;51(5):833-842. [FREE Full text] [CrossRef] [Medline]20,Webb TL, Joseph J, Yardley L, Michie S. Using the internet to promote health behavior change: a systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy. J Med Internet Res. Feb 17, 2010;12(1):e4. [FREE Full text] [CrossRef] [Medline]101], which was itself developed from an expert collaboration. Many of the included studies were not transparent in reporting the link between the theory of behaviors and the evaluation parameters assessed or app features developed. On the whole, the multipronged strategies required for developing and evaluating apps for parents exhibit methodological agility and interdisciplinary collaboration. Interventions with demonstratable effectiveness were able to do this, as was markedly evident in the included studies compiled and reviewed on the topics of maternal child health, parent feeding, and lunch box nutrition [Zarnowiecki D, Mauch CE, Middleton G, Matwiejczyk L, Watson WL, Dibbs J, et al. A systematic evaluation of digital nutrition promotion websites and apps for supporting parents to influence children's nutrition. Int J Behav Nutr Phys Act. Feb 10, 2020;17(1):17. [FREE Full text] [CrossRef] [Medline]53,Gomes AI, Pereira AI, Roberto MS, Boraska K, Barros L. Changing parental feeding practices through web-based interventions: A systematic review and meta-analysis. PLoS One. 2021;16(4):e0250231. [FREE Full text] [CrossRef] [Medline]57,Biviji R. Evaluating the Quality of Mobile Health Apps for Maternal and Child Health (MCH). Indianapolis, IA. Indiana University-Purdue University Indianapolis; 2018.77].

Involvement of stakeholders is an imperative first step in the development of apps. Health experts bring expertise and scientific basis to the interventions for child health promotion and such expertise can be built on to further develop and adapt apps to changing evidence and circumstances. An example of this adaptation is the Growing Healthy program, where an initial study on childhood obesity prevention starting in infancy was published [Laws RA, Denney-Wilson EA, Taki S, Russell CG, Zheng M, Litterbach E, et al. Key Lessons and Impact of the Growing Healthy mHealth Program on Milk Feeding, Timing of Introduction of Solids, and Infant Growth: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 19, 2018;6(4):e78. [FREE Full text] [CrossRef] [Medline]61,Denney-Wilson E, Laws R, Russell CG, Ong K, Taki S, Elliot R, et al. Preventing obesity in infants: the Growing healthy feasibility trial protocol. BMJ Open. Nov 30, 2015;5(11):e009258. [FREE Full text] [CrossRef] [Medline]102] and then compared in an upscaled study with another intervention [Russell CG, Denney-Wilson E, Laws RA, Abbott G, Zheng M, Lymer SJ, et al. Impact of the Growing Healthy mHealth Program on Maternal Feeding Practices, Infant Food Preferences, and Satiety Responsiveness: Quasi-Experimental Study. JMIR Mhealth Uhealth. Apr 25, 2018;6(4):e77. [FREE Full text] [CrossRef] [Medline]56] and followed by parent insights and feedback that were able to be integrated back into the app development in order to make them more intuitive and adaptive to specific engagement levels and identified target groups [Taki S, Russell CG, Lymer S, Laws R, Campbell K, Appleton J, et al. A Mixed Methods Study to Explore the Effects of Program Design Elements and Participant Characteristics on Parents' Engagement With an mHealth Program to Promote Healthy Infant Feeding: The Growing Healthy Program. Front Endocrinol (Lausanne). 2019;10:397. [FREE Full text] [CrossRef] [Medline]76]. Parent feedback demonstrates that the apps are used most when the intuitive apps and features can address their needs and questions they have about their child’s health at the point when they need answers. While parents in the included studies were not always able to imagine what theoretical features would be useful [Meixner C, Baumann H, Fenger A, Wollesen B. Gamification in health apps to increase physical activity within families. New York, NY. IEEE; Presented at: 2019 International Conference on Wireless and Mobile Computing, Networking and Communications (WiMob); October 21-23, 2019, 2019;21-23; Barcelona, Spain. [CrossRef]46,Cushing CC, Fedele DA, Brannon EE, Kichline T. Parents' Perspectives on the Theoretical Domains Framework Elements Needed in a Pediatric Health Behavior App: A Crowdsourced Social Validity Study. JMIR Mhealth Uhealth. Dec 21, 2018;6(12):e192. [FREE Full text] [CrossRef] [Medline]78], they provided strong feedback when asked for (for instance, [Zarnowiecki D, Mauch CE, Middleton G, Matwiejczyk L, Watson WL, Dibbs J, et al. A systematic evaluation of digital nutrition promotion websites and apps for supporting parents to influence children's nutrition. Int J Behav Nutr Phys Act. Feb 10, 2020;17(1):17. [FREE Full text] [CrossRef] [Medline]53,Roberts KJ, McAdams RJ, Kristel OV, Szymanski AM, McKenzie LB. Qualitative and Quantitative Evaluation of the Make Safe Happen App: Mobile Technology-Based Safety Behavior Change Intervention for Parents. JMIR Pediatr Parent. Mar 14, 2019;2(1):e12022. [FREE Full text] [CrossRef] [Medline]70,Mauch CE, Laws RA, Prichard I, Maeder AJ, Wycherley TP, Golley RK. Commercially Available Apps to Support Healthy Family Meals: User Testing of App Utility, Acceptability, and Engagement. JMIR Mhealth Uhealth. May 07, 2021;9(5):e22990. [FREE Full text] [CrossRef] [Medline]74,Otte RA, van Beukering AJE, Boelens-Brockhuis L. Tracker-Based Personal Advice to Support the Baby's Healthy Development in a Novel Parenting App: Data-Driven Innovation. JMIR Mhealth Uhealth. Jul 24, 2019;7(7):e12666. [FREE Full text] [CrossRef] [Medline]83,Venezia AP, Wirth CK, Vinci DM. Active Families at Home: The Development of a Let’s Wiggle With 5-2-1-0 App. TPE. 2019;76(1):224-237. [CrossRef]84]).

Strengths and Limitations

This scoping review provides the first comprehensive overview of available mobile apps and web-based programs for use by parents aimed at the health promotion of their children. The 39 included studies were systematically categorized, provide a thorough summary of current evidence, describe some of the best practices for app development on this topic, and give a strong foundation for further research.

Despite this, this review is not without limitations. Inclusion criteria for this review were purposefully phrased broadly to be as inclusive as possible for apps aimed at parents. However, the multiplicity of study types was not foreseen and may have been more succinctly described. For instance, only including primary studies may have facilitated greater clarity in study summary. This methodological choice also hindered greater comparison between the studies. This study did not include an evaluation of outcomes, a step that would be helpful in future research to evaluate measured changes in behavior or effectiveness that the parent apps had. We also purposefully only included apps and programs from middle- and upper-income countries, apps that targeted healthy children without a diagnosis, and only studies published after 2015. This limitation may have therefore excluded apps or programs in other contexts that may have had broader and more global application. A future review would benefit from a systematic evaluation of app outcomes that includes only primary studies with inclusion of middle- and lower-income countries to be more generalizable and relevant to a larger population. Despite our attempts to include potential gray literature and expert input, no unpublished app evaluations were found. Despite our best efforts to include studies from other disciplines, most apps for parents, which were aimed at the health of their children, were found and evaluated within the health field. Access to published analysis of apps with detailed information evaluation is likely a further limitation of this study, because of the assumption that most apps developed in a scientific context are motivated to publish on the development and evaluation findings. It must be recognized that apps are developed out of many contexts and future reviews would benefit from the inclusion of parent apps developed from other fields (eg, marketing, industry, governmental or nongovernmental organizations, or other interest groups). Our own attempt to bridge this gap with the addition of extending and tapping into an expert network only saw limited methodological success.

Conclusions

Existing apps and web-based programs aimed at parents to promote the health of their children cover a broad range of topics. Most aim to modify the nutrition and physical activity behavior—important for lifelong prevention of illness. New parents are a key target group for apps, whether to increase their knowledge or parental self-efficacy. Evaluating apps for child health promotion provides a special challenge and must be tailored to the needs of parents, context of the topic, and are ideally rooted in a transparent theoretical framework. Given the increasing digitalization of health and expanding focus of health policy on prevention measures, parent apps are guaranteed a role in our lives. Lessons learned can be garnered from existing research studies that tailor developed content to target group needs, include intuitive and adaptive features, and embed well-founded parameters for evaluations able to investigate long-term effects of parent apps on child health.

Acknowledgments

We thank Janina Everding for her tenacious help with the manuscript formatting. Funding for this scoping review was supported by funding from the Federal Ministry for Economic Affairs and Climate Action “Zentrales Innovationsprogramm Mittelstand” Program for small- and medium-sized enterprises under the grant number 16KN0732.

Authors' Contributions

SBB was responsible for methodology, validation, formal analysis, investigation, data curation, writing, review and editing, visualization, and project administration. KV performed validation, formal analysis, writing, review and editing. IH performed investigation and data curation. WS was responsible for methodology, conceptualization, validation, formal analysis, review and editing, supervision, and project administration. GS was responsible for conceptualization, validation, resources, review and editing, supervision, funding acquisition, and project administration.

Conflicts of Interest

None to declare.

Multimedia Appendix 1

Search strategy details.

DOCX File , 24 KB

Multimedia Appendix 2

Detailed summary of results.

DOCX File , 155 KB

Multimedia Appendix 3

Research information system (RIS) keywords from all included studies (occurrence in publications ≥2).

PNG File , 220 KB

Multimedia Appendix 4

Included scoping review publications (2016-2021).

PNG File , 45 KB

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MARS: Mobile App Rating Scale
mHealth: mobile health
PES: Tool to Measure Parenting Self-Efficacy
PRISMA-ScR: Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews
RIS: research information system
zBMI: sex- and age-standardized BMI


Edited by L Buis; submitted 27.05.22; peer-reviewed by A Gomes, MS Liew; comments to author 25.07.22; revised version received 12.11.22; accepted 02.05.23; published 20.07.23.

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©Sarah B Blakeslee, Kristin Vieler, Ingo Horak, Wiebke Stritter, Georg Seifert. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 20.07.2023.

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