Unintentional injuries are bodily harm caused by sudden events, including accidental falls, drowning, burns, suffocation, and poisoning [1]. It is estimated that unintentional injuries are the leading cause of death among children aged 1 to 19 years globally and the fifth leading cause of death among infants aged <1 year [2,3]. The 2019 Global Burden of Disease Study reveals that 205,000 children and adolescents aged 5 to 24 years died from unintentional injuries, with children aged 5 to 9 years facing the highest risk of death. According to China’s Under-5 Child Mortality Surveillance System reports, between 2010 and 2020, a total of 7925 children died from unintentional injuries, and the proportion of deaths among injuries rose from 15.2% in 2010 to 23.8% in 2020 [4]. It not only poses a severe threat to children’s lives and health but also imposes heavy economic burdens and psychological stress on families and society. The occurrence of unintentional injuries involves multiple factors, including the child’s age and developmental stage, the guardians’ educational and supervisory levels, and the safety conditions of the surrounding environment [5-7]. Among all the risk factors, age and developmental stage are important predictors, indicating that injury types and risk factors vary dynamically with the child’s age and developmental stage. For example, young children are more prone to unintentional injuries, and infants aged <1 year are commonly more prone to choking or suffocation; while children over 1 year of age are more likely to experience accidental falls or burns [6]. It is this characteristic that requires interventions for unintentional injuries to be timely adjusted and updated to the child’s age and developmental stage.

The World Health Organization published the World Report on Child Injury Prevention (2008), which outlines key interventions across multiple areas, including legislation, product safety, environmental modification, education, and first aid [8]. However, the strategies, both domestically and internationally, primarily rely on offline approaches that have limited coverage, target smaller populations, and yield short-term effects, wasting time and money and lacking sustainability. With the rapid development of IT, mobile health (mHealth) offers a new perspective and platform for preventing and controlling unintentional childhood injuries. mHealth refers to the use of smartphones, wearable devices, mobile apps, and other technologies to deliver health promotion, disease prevention, and public health management services to the public [9]. This technology offers convenience, real-time access, personalization, and intelligence, enabling dynamic updates to intervention content and long-term tracking, thereby addressing the shortcomings of traditional approaches and aligning with the requirements of unintentional injuries [10]. Currently, mHealth technologies are widely used in areas such as chronic disease management, rehabilitation, cancer care, and perinatal care, and show great promise [11-14].

In the field of child injury prevention, some studies have also attempted to develop mHealth interventions to prevent unintentional injuries in children. For example, Feng et al [15] used WeChat to regularly send information on the prevention of unintentional injuries and emergency strategies to parents. Cooray et al [16] used a mobile app to help parents of children aged <1 year improve their ability to prevent infant falls. Wong et al [17] used serious games to help children learn traffic safety signs and understand potential safety hazards in different areas. Because researchers use different mHealth technologies, the target populations, functional focuses, and intervention outcomes vary. A review is needed to clarify the format, advantages, effectiveness, and potential limitations of each technology. Currently, there are few systematic reviews in this field. Schulze et al [18] conducted a review of mobile apps for unintentional injuries in children aged <7 years, detailing the user groups, specific needs, and evaluation metrics of these apps. However, this study included only 5 papers published before 2021, resulting in limited evidence that does not comprehensively reflect the full scope of the field. Shetty et al [19] reviewed studies on interventions for unintentional injuries in children from 2013 to 2023, including 9 eHealth-based studies; however, they similarly failed to provide detailed descriptions of the technologies’ features. Overall, there remains a lack of systematic reviews that comprehensively describe the current status of mHealth technology applications, the types of technologies, and the effectiveness of interventions for preventing unintentional injuries among children.

This study aims to provide a systematic review of the current status of mHealth technology applications in interventions for unintentional injuries in children. The primary objectives are to (1) summarize the types of mHealth technologies used for unintentional injuries in children through a systematic review of the existing literature and (2) examine how these technologies are used in interventions for unintentional injuries in children, what the outcome measures of these interventions are, and how effective these interventions are.

The review was guided by the following research questions:

The concept of mHealth originates from eHealth, which refers to the use of information and communication technology to support health care services and information dissemination [21]. With the widespread adoption of smartphones and tablets, eHealth services—which previously relied on fixed devices or locations—are gradually shifting toward mobile devices as their primary platform. This study follows the World Health Organization’s definition, which defines mHealth as health care and public health practices supported by mobile devices [9]. Whether a technology falls under the category of mHealth is primarily determined by whether it is accessed via mobile devices such as smartphones and tablets. Accordingly, in addition to common apps and wearable devices, this study includes within the scope of mHealth any technology accessed or operated through mobile portable devices, such as internet platforms, serious games, and virtual reality (VR) technology.

A systematic search was conducted across 5 databases: PubMed, Web of Science, Embase, Cochrane Library, and CINAHL. A combination of subject headings and free-text terms was used, with additional reference tracing. The search covers each database from its inception to December 31, 2025. Search terms included “children,” “child,” “infant,” “child, preschool,” “accidental injuries,” “unintentional injuries,” “accidental,” “injuries,” “mobile applications,” “app,” “mobile phone,” “social media,” “digital health,” “digital media,” “telemedicine,” “internet,” “text messaging,” “virtual,” “digital technology,” “artificial intelligence,” “Web,” “WeChat,” “online social network,” “message,” and “smartphone.” The search terms and strategy used are presented in Multimedia Appendix 2.

Literature inclusion criteria were established based on population, concept, and context principles: (1) the study population comprised children, child caregivers, or child educators; (2) the study concept involved mHealth technology research; (3) the context pertained to studies related to unintentional injuries among children. The study types included original research such as randomized controlled trials, quasi-experimental studies, mixed method studies, and observational studies. Exclusion criteria were as follows: (1) duplicate publications; (2) if there are multiple papers reporting on the same study, only the one reporting the final results will be included; (3) study protocols; (4) publications for which the full text is unavailable; and (5) publications not in Chinese or English.

Literature screening was conducted using NoteExpress software (version 4.1.0.10030; Beijing Aegean Software), with 2 researchers independently performing initial and duplicate screening. Disagreements were resolved through discussion with a third researcher. Extracted data included authors, publication year, country, study type, study subjects, sample size, app type, study duration, specific implementation methods, control group measures, and outcome measures.

The initial search yielded 1085 articles. After removing duplicates and reviews, 929 articles remained. Following a review of titles and abstracts, 882 articles were excluded. After reviewing the full texts, 25 articles were excluded for irrelevant research topics, 2 were excluded as protocols, and 5 could not be retrieved. There were 15 remaining articles, and 1 article was included through reference tracing. Finally, a total of 16 articles were ultimately included. The literature screening process is illustrated in Figure 1.

All included studies were in English. The collection comprised 9 randomized controlled trials [15,17,22-28], 2 quasi-experimental studies [29,30], 3 mixed method studies [16,31,32], 1 qualitative study [33], and 1 descriptive study [34]. Geographically, 6 studies were from China [15,17,25,26,28,30], 3 from the United States [23,24,32], 1 from South Korea [22,29,34], 2 from Australia [16,27], and 1 each from the United Kingdom [33] and Germany [31]. Specific characteristics are shown in Multimedia Appendix 3.

The duration of the included studies varied. Specifically, for studies assessing mHealth interventions, the intervention periods ranged from 1 week to 12 months. In contrast, among studies adopting observational or cross-sectional designs, only 2 reported the study duration: 7-10 days [32] and 3 months [16], respectively.

Eleven studies [15,16,22,24-28,31-33] focused on caregivers of children, covering those caring for children aged 0 to 12 years; 4 studies [17,23,29,30] targeted children directly, with participants ranging in age from 5 to 13 years; and 1 study [34] was conducted with schoolteachers.

Nine studies [15,22,24,25,28,29,32-34] addressed unintentional injuries as a whole, including common types such as choking, aspiration, falls, poisoning, drowning, and burns. The remaining 7 studies focused on specific types of injuries, including 2 on traffic accidents [17,26], 1 on burns and scalds [27], 1 on accidental falls among infants [16], 1 on accidental poisoning [31], and 1 on the prevention of bicycle injuries and animal bites [23].

The included studies drew upon behavior change theory [16,23], Orem’s self-care theory [29], and the Haddon model [15] to guide the design of learning content; Choi and Ahn [22] designed their learning program based on the analysis, design, development, implementation, and evaluation (ADDIE) model; Wong et al [17] developed a game app by integrating social cognitive theory with an experiential game model; Ning et al [25] designed an app by combining behavior change theory, the Haddon model, and the rational analysis framework for mobile education; Müller et al [31] evaluated the app’s perceived usefulness, perceived ease of use, trust, and intention to use based on the technology acceptance model.

The results of this study indicate that mHealth technologies currently used in the field of unintentional childhood injuries include mobile apps, WeChat, mobile-based e-learning programs, VR technology, and wearable devices. Apps and WeChat are primarily targeted at child caregivers, as their busy daily schedules make it difficult to set aside time for in-person training. Apps and WeChat platforms offer convenience and quick access to health information, helping caregivers learn in spare moments or obtain necessary information promptly when needed. Among the mobile apps included in this study, with the exception of the 3 apps cited by Wong et al [17], Dixon et al [23], and Kim and Cho [29], all others were designed for child caregivers, with one specifically targeting teachers. In terms of functional design, health education or regular learning content is primarily delivered through audio, video, text, images, and gamified formats; user forums or comment sections facilitate interaction between users and researchers or health care professionals; check-in features and progress bars are used to monitor users’ learning progress and adherence to safety measures; additionally, some apps include emergency contact information or links to purchase safety products. The results of this study indicate that participants demonstrated high levels of engagement, acceptance, satisfaction, and positive user experience with the apps they used. For children, games and VR technology are currently widely adopted. This study included 2 gaming apps, one VR app combined with wearable devices, and one health education-focused app. Key features included simulations of real-world environments such as streets, residential areas, dog shelters, and parks, designed to help children develop appropriate safety behaviors and prevent traffic accidents and pet bites. The health education-focused app provides children with emergency response knowledge for various situations, covering 8 categories of emergency scenarios: school safety, off-campus safety, responding to violent incidents, traffic accidents, accidental poisoning, basic first aid skills, natural disasters, and evacuation drills—totaling 48 specific emergencies. Each scenario includes a brief description and response recommendations, with some supplemented by instructional videos. Compared with traditional lecture-style education, children demonstrate greater acceptance of this engaging, interactive learning method.

This study describes the effectiveness of mHealth-based interventions in preventing unintentional injuries among children. The results indicate that such interventions have a positive impact on reducing the incidence of unintentional injuries among children, enhancing the safety knowledge of children and caregivers, and improving their safety attitudes and behaviors. However, among the mHealth technologies currently used for interventions targeting unintentional injuries in children, only the Vergiftungsunfälle bei Kindern and Safe City apps are available for download and use via app stores or web browsers. The remaining technologies are either not publicly released or have ceased to be updated and maintained. The development and long-term maintenance of mHealth apps require significant investments of time, effort, and funding, while the actual social and health benefits are relatively limited, making it difficult for many projects to sustain operations [35]. Furthermore, mHealth technologies can overcome spatial and temporal constraints and address the shortfall of caregivers who are unable to participate in in-person training due to time constraints through online interventions. The online intervention model itself may experience low user adherence, with some users potentially losing motivation to continue participating after initial use [36]. Although this study did not assess user adherence, based on the dropout rates reported by Feng et al (24.38%) [15], Ning et al (32.19%) [25], and Burgess et al (51%) [27], long-term user adherence may be relatively low, which could be one of the reasons why mHealth programs fail to operate sustainably over the long term. The World Health Organization advocates that countries incorporate mHealth into their national public health strategies [37]. The “Action Plan for Injury Prevention and Control (2026-2030)” issued by China’s National Center for Disease Control and Prevention also emphasizes exploring and promoting appropriate technologies and strengthening education on child injury prevention and control skills, providing clear policy guidance for mHealth interventions. Therefore, it is recommended that future research leverage national public health programs to conduct long-term, large-scale studies on mHealth technologies. Relying on the public health system to overcome cost and adherence barriers can promote the sustainable application of mHealth interventions.

Regarding the evaluation of the effectiveness of mHealth technologies, most studies have focused on caregivers’ knowledge, attitudes, and behaviors as primary outcome measures, while only 3 studies have primarily examined the incidence of unintentional injuries in children. The occurrence of unintentional injuries in children is influenced by multiple factors, including the home environment, the level of supervision, and the child’s developmental stage. To detect statistically significant differences, large sample sizes and long-term follow-up may be required, resulting in high research costs and significant implementation challenges [38,39]. Most of the studies included in this review had sample sizes ranging from 100 to 200 participants, with intervention durations of approximately 1 week to 3 months, which may not meet the basic requirements for conducting effective statistical tests for this outcome. Furthermore, regarding the selection of assessment tools, the studies included in this review all used self-developed or adapted questionnaires. Since the data rely on self-reports from caregivers, there is potential for bias and subjectivity, which may lead to a lack of comparability across study results [35,40]. Regarding the assessment of mHealth technology usability metrics, the literature included in this study generally reported favorable evaluations of these metrics by children and their caregivers across multiple dimensions, including user acceptance, engagement, user experience, and satisfaction. However, these evaluations were also largely based on assessment tools and criteria developed by the researchers themselves, lacking uniformity and comparability. Only the studies by Kang et al [34] and Müller et al [31] conducted standardized assessments of app usability and user satisfaction using the validated User Interaction Satisfaction Scale and the System Usability Scale, respectively. Currently, the academic community has developed a variety of assessment tools with good reliability and validity for the systematic evaluation of the usability of mHealth technologies. Therefore, it is recommended that future studies adopt these standardized, validated assessment questionnaires wherever possible to enhance the scientific rigor and comparability of research findings [41].

This study is a scoping review, so the quality of the included literature was not assessed. Additionally, the literature search was limited to English-language publications, which may have led to incomplete coverage of studies from certain regions or specific populations. Finally, this study focused on research that has been officially published and contains complete methodological information; gray literature, which often exists in the form of preliminary abstracts or unpublished data, usually does not meet the inclusion criteria for this review, so it was not systematically searched.

This study provides a scoping review of the current use of mHealth technologies for the prevention and control of unintentional injuries among children. The findings indicate that mHealth technologies play a positive role in improving the knowledge, attitudes, and behaviors of children and their caregivers regarding unintentional injuries. However, only 2 mobile apps are currently available to the public. It is recommended that future efforts continue to optimize the functional design of mHealth, strengthen the technology’s sustainability, explore methods that can be implemented over the long term, and conduct large-scale, long-term studies to further evaluate the impact of mHealth on the incidence of unintentional injuries among children.