Background. Smartphone medical applications have a major role to play in women’s health with their roles being very broad, ranging from improving health behaviours to undertaking personalised tests. Objective(s). Using Medline, Web of Knowledge, and the PRISMA guidelines 15 randomized controlled trials (RCTs) were identified, with mobile interventions being tested on 1603 females, in relation to key aspects of health. Using a similar systematic approach an iPhone database search identified 47 applications (apps) developed to improve women’s health. Findings. Ten RCTs used text messaging or app interventions to support weight loss, with significant improvements being observed in eight studies. For other aspects of women’s health RCTs are needed to determine possible health benefits. iPhone store data analysis identified that a substantial number of women’s health apps did not have star ratings or feedback comments (68 and 49 per cent, resp.), raising concerns about their validity. Conclusion. Peer-review systems, supporting statements of evidence, or certification standards would be beneficial in maintaining the quality and credibility of future health-focused apps. Patient groups should also ideally be involved in the development and testing of mobile medical apps. 1. Introduction Women appear to be taking the lead when it comes to smartphone technology (ST) phone use, with 56 percent owning a smartphone compared with 51 percent men. This also translates when it comes to using health applications (apps) with around 9 percent women more likely to use these compared with 4 percent men [1]. One American survey studying over two thousand people ( ) found that women tend to seek technology that keeps up with their busy lifestyles, with 51 percent owning some form of apple device and 93 percent women keeping their smartphone within arms’ length [2]. It is also becoming clear that certain phases of the life cycle for, example, pregnancy, may also affect the level of ST phone usage. For example, one survey of 203 pregnant women found that 94 percent reported that ST had changed their life for better, with 65 percent reporting that they had downloaded pregnancy apps, with an average of three being downloaded during the gestation period [3]. In low- and middle-income countries smartphones also provide an excellent platform to support and improve the quality of healthcare systems for women [4]. There is also growing interest in harnessing smartphone apps to promote behaviour change. These provide a unique opportunity to help users stay healthy, while potentially
References
[1]
Oglivy Action, Women Taking the Lead When It Comes to Mobile, 2013, http://www.guardian.co.uk/media-network/media-network-blog/2012/aug/06/women-lead-mobile-technology-retail.
[2]
Arbitron & Edison Research, Mums and Media, 2013, http://www.slideshare.net/webby2001/moms-and-media-2012.
[3]
P. Petrie, Pregnancy and the Changing World of Technology, 2013, http://corporate.mumsviews.co.uk/about.php.
[4]
M. J. Rotheram-Borus, M. Tomlinson, D. Swendeman, A. Lee, and E. Jones, “Standardized functions for smartphone applications: examples from maternal and child health,” International Journal of Telemedicine and Applications, vol. 2012, Article ID 973237, 16 pages, 2012.
[5]
K. Wac, “Smartphone as a personal, pervasive health informatics services platform: literature review,” Yearbook of Medical Informatics, vol. 7, no. 1, pp. 83–93, 2012.
[6]
L. Dennison, L. Morrison, G. Conway, and L. Yardley, “Opportunities and challenges for smartphone applications in supporting health behavior change: qualitative study,” Journal of Medical Internet Research, vol. 15, no. 4, article e86, 2013.
[7]
World Health Organisation, “Preventing chronic diseases: a vital investment,” Chronic Disease Report, 2013, http://www.who.int/chp/chronic_disease_report/full_report.pdf.
[8]
S. L. Gortmaker, B. A. Swinburn, D. Levy et al., “Changing the future of obesity: science, policy, and action,” The Lancet, vol. 378, no. 9793, pp. 838–847, 2011.
[9]
A. Towfighi, L. Zheng, and B. Ovbiagele, “Weight of the obesity epidemic: rising stroke rates among middle-aged women in the United States,” Stroke, vol. 41, no. 7, pp. 1371–1375, 2010.
[10]
N. Yang, G. S. Ginsburg, and L. A. Simmons, “Personalized medicine in women's obesity prevention and treatment: implications for research, policy and practice,” Obesity Reviews, vol. 14, no. 2, pp. 145–161, 2013.
[11]
World Health Organisation, “2008–2013 action plan for the global strategy for the prevention and control on noncommunicable diseases,” Action Plan, 2013, http://whqlibdoc.who.int/publications/2009/9789241597418_eng.pdf.
[12]
K. A. Bybee and T. L. Stevens, “Matters of the heart: cardiovascular disease in U.S. women,” Missouri Medicine, vol. 110, no. 1, pp. 65–70, 2013.
[13]
J. E. Shaw, R. A. Sicree, and P. Z. Zimmet, “Global estimates of the prevalence of diabetes for 2010 and 2030,” Diabetes Research and Clinical Practice, vol. 87, no. 1, pp. 4–14, 2010.
[14]
S. S. Coughlin and D. U. Ekwueme, “Breast cancer as a global health concern,” Cancer Epidemiology, vol. 33, no. 5, pp. 315–318, 2009.
[15]
R. E. Noble, “Depression in women,” Metabolism, vol. 54, no. 5, pp. 49–52, 2005.
[16]
North American Menopause Society, “Management of osteoporosis in postmenopausal women: 2010 position statement of The North American Menopause Society,” Menopause, vol. 17, no. 1, pp. 25–54, 2010.
[17]
V. Vodopivec-Jamsek, T. de Jongh, I. Gurol-Urganci, R. Atun, and J. Car, “Mobile phone messaging for preventive health care,” The Cochrane Database of Systematic Reviews, vol. 2012, Article ID CD007457, 2012.
[18]
L. Mertz, “Ultrasound? Fetal monitoring? Spectrometer? There's an app for that!: biomedical smart phone apps are taking healthcare by storm,” IEEE Pulse, vol. 3, no. 2, pp. 16–21, 2012.
[19]
D. Moher, A. Liberati, J. Tetzlaff, and D. G. Altman, “Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement,” BMJ, vol. 339, article b2535, 2009.
[20]
N. A. Lakkis, A. M. Atfeh, Y. R. EL-Zein, D. M. Mahmassani, and G. N. Hamadeh, “The effect of two types of sms-texts on the uptake of screening mammogram: a randomized controlled trial,” Preventive Medicine, vol. 53, no. 4-5, pp. 325–327, 2011.
[21]
M.-J. Park and H.-S. Kim, “Evaluation of mobile phone and Internet intervention on waist circumference and blood pressure in post-menopausal women with abdominal obesity,” International Journal of Medical Informatics, vol. 81, no. 6, pp. 388–394, 2012.
[22]
L. Mehran, P. Nazeri, H. Delshad, P. Mirmiran, Y. Mehrabi, and F. Azizi, “Does a text messaging intervention improve knowledge, attitudes and practice regarding iodine deficiency and iodized salt consumption?” Public Health Nutrition, vol. 15, no. 12, pp. 2320–2325, 2012.
[23]
G. J. Norman, J. K. Kolodziejczyk, M. A. Adams, K. Patrick, and S. J. Marshall, “Fruit and vegetable intake and eating behaviors mediate the effect of a randomized text-message based weight loss program,” Preventive Medicine, vol. 56, pp. 3–7, 2013.
[24]
F. Naughton, A. T. Prevost, H. Gilbert, and S. Sutton, “Randomized controlled trial evaluation of a tailored leaflet and SMS text message self-help intervention for pregnant smokers (MiQuit),” Nicotine & Tobacco Research, vol. 14, no. 5, pp. 569–577, 2012.
[25]
R. Jareethum, V. Titapant, C. Tienthai, S. Viboonchart, P. Chuenwattana, and J. Chatchainoppakhun, “Satisfaction of healthy pregnant women receiving short message service via mobile phone for prenatal support: a randomized controlled trial,” Journal of the Medical Association of Thailand, vol. 91, no. 4, pp. 458–463, 2008.
[26]
E. Brindal, G. Hendrie, J. Freyne, M. Coombe, S. Berkovsky, and M. Noakes, “Design and pilot results of a mobile phone weight-loss application for women starting a meal replacement programme,” Journal of Telemedicine and Telecare, 2013.
[27]
M. C. Carter, V. J. Burley, C. Nykjaer, and J. E. Cade, “Adherence to a smartphone application for weight loss compared to website and paper diary: pilot randomized controlled trial,” Journal of Medical Internet Research, vol. 15, no. 4, article e32, 2013.
[28]
E. L. Donaldson and M. Morris, “A text message based weight management intervention for overweight adults,” Journal of Human Nutrition and Dietetics, 2013.
[29]
M. S. Napolitano, G. G. Bennett, A. K. Ives, and G. D. Foster, “Using Facebook and text messaging to deliver a weight loss program to college students,” Obesity Reviews, vol. 21, pp. 25–31, 2013.
[30]
J. R. Shapiro, T. Koro, N. Doran, N. S, et al., “Text4Diet: a randomized controlled study using text messaging for weight loss behaviors,” Preventive Medicine, vol. 55, no. 5, pp. 412–417, 2012.
[31]
G. Turner-McGrievy and D. Tate, “Tweets, apps, and pods: results of the 6-month mobile pounds off digitally (Mobile POD) randomized weight-loss intervention among adults,” Journal of Medical Internet Research, vol. 13, no. 4, article e120, 2011.
[32]
I. Haapala, N. C. Barengo, S. Biggs, L. Surakka, and P. Manninen, “Weight loss by mobile phone: a 1-year effectiveness study,” Public Health Nutrition, vol. 12, no. 12, pp. 2382–2391, 2009.
[33]
K. Patrick, F. Raab, M. A. Adams et al., “A text message-based intervention for weight loss: randomized controlled trial,” Journal of Medical Internet Research, vol. 11, no. 1, article e1, 2009.
[34]
P. C. Mag, Apple App Store Tops 300,000 Apps, 2013, http://www.pcmag.com/article2/0,2817,2373169,00.asp.
[35]
W. D. Evans, J. L. Wallace, and J. Snider, “Pilot evaluation of the text4baby mobile health program,” BMC Public Health, vol. 12, no. 1031, 2012.
[36]
L. Hebden, A. Cook, H. P. van der Ploeg, and M. Allman-Farinelli, “Development of smartphone applications for nutrition and physical activity behavior change,” JMIR Research Protocols, vol. 1, no. 2, article e9, 2012.
[37]
D. S. Eng and L. M. Lee, “The promise and peril of mobile health applications for diabetes and endocrinology,” Pediatric Diabetes, vol. 14, no. 4, pp. 231–238, 2013.
[38]
A. W. Buijink, B. J. Visser, and L. Marshall, “Medical apps for smartphones: lack of evidence undermines quality and safety,” Evidence-Based Medicine, vol. 18, pp. 90–92, 2013.
[39]
B. J. Visser and A. W. G. Buijink, “Need to peer-review medical applications for smart phones,” Journal of Telemedicine and Telecare, vol. 18, no. 2, article 124, 2012.
[40]
G. R. Zanni, “Medical apps worth having,” The Consultant Pharmacist, vol. 28, pp. 322–324, 2013.
[41]
M. J. Gibney and M. C. Walsh, “The future direction of personalised nutrition: my diet, my phenotype, my genes,” The Proceedings of the Nutrition Society, vol. 72, no. 2, pp. 219–225, 2013.
[42]
B. L. Daugherty, T. E. Schap, R. Ettienne-Gittens, et al., “Novel technologies for assessing dietary intake: evaluating the usability of a mobile telephone food record among adults and adolescents,” Journal of Medical Internet Research, vol. 14, no. 2, article e58, 2012.