Smartphone Apps for Parents of Preterm Infants from NICU to Home: A Quality, Evidence-Based Content and Data Protection Assessment

Over one in ten babies are born preterm annually, presenting challenges beyond the neonatology intensive care unit (NICU), including depression and post-traumatic stress for parents. Research has demonstrated that tailored interventions supporting parents transitioning from NICU to home can decrease these adverse outcomes. Parents often seek online answers for children's health before consulting medical professionals. Smartphone applications (apps) supporting parents are being increasingly developed, however, the literature suggests that current apps lack quality and credibility. This study offers a methodical assessment of the quality, level of evidence-based content, and data protection of apps aiming to support parents of premature infants in their transition from NICU to home. The web-based application aggregator Appagg was used to list free and paid Android and iOS apps using keywords such as NICU, preterm, discharge and parenting support in English and in French. The apps were evaluated between March and July 2023. Quality was evaluated using the Mobile Application Rating Scale (MARS) to measure engagement, functionality, aesthetics and information. Then, this study suggests an evidence-based content (EBC) assessment based on the most recent recommendations, guidelines, and scientific literature regarding NICU discharge for premature infants. Finally, the apps' data protection was evaluated in regards to compliance with the European General Data Protection Regulation (GDPR) or GDPR-like regulation. The search yielded a total of 896 unique apps. Screening for title and abstract selected 22 apps. 12 remained for final analysis as 9 were not accessible to Switzerland or needed patient ID for access and one did not work (video content was not working at all). The results showed that three apps (3/12, 25%) received a good MARS score on overall quality (>4.0 out of 5.0), five apps (5/12, 42%) presented good levels of EBC assessment (>= 4 out of 5) and four apps (4/12, 33%) were explicitly compliant to at least one data protection standard (>= 4 out of 5).