AMAR - Aplicativo de Monitoramento, Acompanhamento e Rastreio do desenvolvimento infantil: um estudo de desenvolvimento e validade do conteúdo

Abstract

Introduction: Based on the Sustainable Development Goals described by the World Health Organization (WHO), ensuring the suitable child development in all countries became as indispensable once approximately 219 million of child, less than five years old and originated from low/middle-income countries (i.e. Brazil), fail to achieve their maximum development potential. In this context, the use of mobile health (mHealth) tools arrives as a remarkable approach to overcome and help that goal. Nonetheless, mHealth tools targeted to surveillance and monitor child development does not exist, making difficult the successful of health professionals in contributing to WHO goals. Objectives: In order to solve the aforementioned problem, two aims were designed: (i) to identify, from a bibliography search following a scoping review article construction, the types of mHealth technologies used to improve the child development surveillance in low/middle-income countries and, their achieved goals and; (ii) to develop a software to enhance the child surveillance development by families and health professionals and, to evaluate, preliminarily, its contend validation. Methodology: Frameword York and PRISMA recommendations were used to achieve the first aim. The search strategy was performed in PubMed, Scopus, Embase and Bireme databases using “telemedicine” and “child development” and “low- and middle-income countries” as keywords. The studies were selected using Rayyan®️ software. Following the design methodology of participative interaction, composed by four steps were used to achieve the second aim. The steps are describe as (1) identification of users’ needs; (2) layout design; (3) construction of a functional prototype and; (4) evaluation. The step 4, the validity contend was tested by health professionals experts in child development. Families of children, users of public health care, also tested the developed software. Results: Eight studies, published between 2016 and 2020, originated from Peru, Kenia, South Africa, Thailand and China. These studies showed 6 different mHealth tools aiming to facilitate the child development surveillance; however, it was not possible to evaluate the effect post use of neither of those. In addition, it was observed that these developed mHealth tools were well accepted by the families, which reported that the use of the cell phone is practicable, leading the home visits standardized and the health recommendations to children’ parents more focused. Based on the aspects observed, a web and a mobile app was suggested AMAR – Aplicativo de Avaliação e Rastreio do Desenvolvimento Infantil (Child Development Assessment and Screening Application). Both systems (web and mobile) were developed using a front end with responsive design and the back and wrote in JavaScript. PostgreSQL version 12.5 was used for data storage and management. In addition, in order to allow the app system communication, an Application Programming Interface, using Django Rest Framework version 3.12.4. Moreover, the developed app showed contend validity index higher than 80% in all questions. Conclusion: mHealth showed themselves as usable tools in the child surveillance development in low/middle-income countries, but furthers studies need to be conducted to evaluate the effect post implementation of that in the child health and development. In the same direction, the AMAR application contend was considered suitable by families and health professionals to monitoring the child development and grown. Finally, the study herein presented open new directions for children health care and prompting further investigation regarding the benefit of screening for changes in child development by health professionals with the help of families.