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

Background: Health mobile applications (apps) have become very popular, including apps specifically designed to support women during the ante- and postnatal periods. However, there is currently limited evidence for the effectiveness of such apps at improving pregnancy and parenting outcomes. Aim: to assess the effectiveness of a pregnancy and perinatal app, Baby Buddy, in improving maternal self-efficacy at three months post-delivery. Methods: Participants were 16-years and over, first-time pregnant women, 12-16 weeks gestation, recruited from five English study sites. The Tool of Parenting Self-efficacy (TOPSE) (primary outcome) was used to compare mothers at three months post-delivery who had downloaded the Baby Buddy app compared to those who had not downloaded the app, controlling for confounding factors. Results: 488 participants provided valid data at baseline (12-16 weeks gestation), 296 participants provided valid data at 3 months post-birth, 114 (38.5%) of whom reported that they had used the Baby Buddy app. Baby Buddy app users were more likely to use pregnancy or parenting apps (80.7% vs 69.6%, p=.035), more likely to have been introduced to the app by a healthcare professional (p=.005) and have a lower median score for perceived social support (81 vs 83, p=.034) than non-app users. The Baby Buddy app did not illicit a statistically significant change in TOPSE scores from baseline to 3 months post-birth (adjusted OR 1.12, 95%CI 0.59 to 2.13, p=.730). Finding out about the Baby Buddy app from a healthcare professional appeared to grant no additional benefit to app users compared to all other participants in terms of self-efficacy at three months post-birth (adjusted OR 1.16, 95%CI 0.60 to 2.23, p=.666). There were no statistically significant differences in the TOPSE scores for the in-app data between either the type of user who was engaged with the app and non-app users (adjusted OR 0.69, 95%CI 0.22 to 2.16, p=.519) or those who were highly engaged and non-app users (adjusted OR 0.48, 95%CI 0.14t o 1.68, p=.251). Conclusion: This study is one of few, to date, that has investigated the effectiveness of a pregnancy and early parenthood app. No evidence for the effectiveness of the Baby Buddy app was found. New technologies can enhance traditional healthcare services and empower users to take more control over their healthcare but app effectiveness needs to be assessed. Further work is needed to consider, a) how we can best use this new technology to deliver better health outcomes for health service users and, b) methodological issues of evaluating digital health interventions.