Abstract
BackgroundVaccination is a critical step in reducing child mortality; however, vaccination rates have declined in many countries in recent years. This decrease has been associated with an increase in the outbreak of vaccine-preventable diseases. The potential for leveraging mobile platforms to promote vaccination coverage has been investigated in the development of numerous mobile apps. Although many are available for public use, there is little robust evaluation of these apps.ObjectiveThis systematic review aimed to assess the effectiveness of apps supporting childhood vaccinations in improving vaccination uptake, knowledge, and decision making as well as the usability and user perceptions of these apps.MethodsPubMed, Excerpta Medica Database (EMBASE), Web of Science, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and Education Resources Information Center (ERIC) databases were systematically searched for studies published between 2008 and 2019 that evaluated childhood vaccination apps. Two authors screened and selected studies according to the inclusion and exclusion criteria. Data were extracted and analyzed, and the studies were assessed for risk of bias.ResultsA total of 28 studies evaluating 25 apps met the inclusion criteria and were included in this analysis. Overall, 9 studies assessed vaccination uptake, of which 4 reported significant benefits (P<.001 or P=.03) of the implementation of the app. Similarly, 4 studies indicated a significant (P≤.054) impact on knowledge and on vaccination decision making. Patient perceptions, usability, and acceptability were generally positive. The quality of the included studies was found to be moderate to poor, with many aspects of the methodology being unclear.ConclusionsThere is little evidence to support the use of childhood vaccination apps to improve vaccination uptake, knowledge, or decision making. Further research is required to understand the dichotomous effects of vaccination-related information provision and the evaluation of these apps in larger, more robust studies. The methodology of studies must be reported more comprehensively to accurately assess the effectiveness of childhood vaccination apps and the risk of bias of studies.International Registered Report Identifier (IRRID)RR2-10.2196/16929
Highlights
BackgroundIn 2018, it was estimated that immunization prevented 2 to 3 million deaths each year, yet over 19 million children worldwide under the age of 1 year did not receive basic vaccines [1]
Immunization coverage of 9 routine childhood vaccinations declined in England by 0.2% to 1% during 2018 to 2019, compared with the previous year, and 1.3% of children born in 2015 in the United States received no vaccinations by the age of 2 years, compared with 0.9% of those born in 2011 [4,5]
This contrasts with a systematic review and meta-analysis conducted by Harvey et al [14], which revealed a significant benefit of reminder (P
Summary
BackgroundIn 2018, it was estimated that immunization prevented 2 to 3 million deaths each year, yet over 19 million children worldwide under the age of 1 year did not receive basic vaccines [1]. An increase in vaccine-preventable disease outbreaks has been identified in developed countries, which is associated with declining vaccination uptake [2,3,4]. Vaccination is a critical step in reducing child mortality; vaccination rates have declined in many countries in recent years This decrease has been associated with an increase in the outbreak of vaccine-preventable diseases. Objective: This systematic review aimed to assess the effectiveness of apps supporting childhood vaccinations in improving vaccination uptake, knowledge, and decision making as well as the usability and user perceptions of these apps. Conclusions: There is little evidence to support the use of childhood vaccination apps to improve vaccination uptake, knowledge, or decision making. The methodology of studies must be reported more comprehensively to accurately assess the effectiveness of childhood vaccination apps and the risk of bias of studies.
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