BabyThrive: Development and validation of a child feeding mobile gaming app for teenage mothers in Nigeria (Preprint)

Abstract

Undernutrition is an underlying factor in nearly 50% of one million estimated annual deaths in Nigerian children < 5 years. Inappropriate maternal infant and young child feeding (IYCF) practices are basic contributors to child undernutrition. Teenage motherhood exacerbates the problem of inadequate child feeding. One possible intervention method to improve IYCF knowledge and practices of teenage mothers is the utilization of mobile gaming technologies. Despite extreme poverty in developing countries, a ubiquity of mobile phone networks exists.

This study developed and validated a mobile gaming app, called BabyThrive, to train Nigerian teenage mothers on appropriate infant and young child feeding.

To identify gaps in current IYCF practices in northern Nigeria, an extensive search of the literature, and two focus group interviews were conducted with 16 low-income, teenage mothers. An initial app content design was then created, and content validity was established by ten nutrition experts. An app prototype was developed, and assessed for quality and usability by seven nutrition and mobile gaming experts, and 90 teenage mothers from rural areas in Abuja, Nigeria, respectively. The final app, BabyThrive, is a 2D, mobile game that is fully functional offline and available in the English and Hausa languages. The efficacy of the BabyThrive app was assessed by IYCF knowledge scores obtained from administration of a validated Teen Moms Child Feeding Questionnaire for Sub-Saharan Africa. Construct validity was established via crossover design, by comparing the total IYCF knowledge scores of the teen mothers obtained after a verbal training, and post-BabyThrive app utilization.

Large proportions of the study participants were married (58.9%), and had no income (68.9%). The mean quality rating for the BabyThrive app was 4.3  0.39 out of 5.0. High levels (> 80%) of usability and user satisfaction were documented. Knowledge of exclusive breastfeeding and total knowledge scores were significantly higher in the BabyThrive group than in the verbal training (p < .05) group. The IYCF knowledge scores obtained from both groups showed coherence, with a statistically significant Spearman’s correlation coefficient of 0.50 (p = 0.00).

This research has developed a novel, offline, valid, mobile gaming app. It will be an easy, effective and acceptable method to disseminate critical knowledge on infant and young child feeding to teenage mothers in rural Nigeria.

ClinicalTrials.gov NCT05181293