{
  "abstract": "Objective To test the feasibility of a smartphone app, BebeApp, that provides evidence-based early childhood development (ECD) guidance in rural Guatemala and pilot procedures for an adequately powered randomised controlled trial.Design We conducted an individually randomised pilot feasibility trial to compare BebeApp to printed ECD guidance.Setting This trial was conducted in Tecpán, Chimaltenango, a semi-rural community that is 95% Kaqchikel Indigenous Maya.Patients First-time primary caregiver-infant (0–28 days) dyads.Interventions BebeApp provides age-dependent, evidence-based caregiver guidance for breastfeeding and complementary feeding, sleep and developmental support.Main outcome measures A mixed-methods evaluation of BebeApp’s implementation and acceptability using the Reach, Effectiveness, Adoption, Implementation, Maintenance framework. App usability, usefulness and satisfaction were assessed via questionnaires, semi-structured interviews and app interaction data.Results 41 infant-caregiver dyads were enrolled with 40 completing the study. Engagement was high with caregivers opening BebeApp a median (IQR) 11 (6–21) times per month. Usability was found to be acceptable but no difference was found between pre-measurements and post-measurements. In interviews, caregivers expressed some initial difficulty using BebeApp but were able to gain confidence with a training session. App usefulness and satisfaction responses were positive. Caregivers often noted that BebeApp was their only source of ECD information outside of their family.Conclusions We found that caregivers in rural Guatemala responded positively to a smartphone ECD app and engaged with it throughout the trial. Given the urgent need for ECD programmes in low- and middle-income settings, smartphone apps may be a method to deliver services directly to caregivers.",
  "authors": [
    {
      "affiliations": [
        "Center for Indigenous Health Research, Maya Health Alliance, Guatemala, Chimaltenango Department, Guatemala"
      ],
      "name": "Scott Tschida"
    },
    {
      "affiliations": [
        "Center for Indigenous Health Research, Maya Health Alliance, Guatemala, Chimaltenango Department, Guatemala"
      ],
      "name": "Eva Leticia Tuiz"
    },
    {
      "affiliations": [
        "Center for Indigenous Health Research, Maya Health Alliance, Guatemala, Chimaltenango Department, Guatemala"
      ],
      "name": "Duglas López"
    },
    {
      "affiliations": [
        "Center for Indigenous Health Research, Maya Health Alliance, Guatemala, Chimaltenango Department, Guatemala"
      ],
      "name": "Meylin Canú"
    },
    {
      "affiliations": [
        "Center for Indigenous Health Research, Maya Health Alliance, Guatemala, Chimaltenango Department, Guatemala"
      ],
      "name": "Vilma Boron"
    },
    {
      "affiliations": [
        "Proyecto Aigle Guatemala, Guatemala City, Guatemala Department, Guatemala"
      ],
      "name": "Javier Zarazúa"
    },
    {
      "affiliations": [
        "Proyecto Aigle Guatemala, Guatemala City, Guatemala Department, Guatemala"
      ],
      "name": "Maria del Pilar Grazioso"
    },
    {
      "affiliations": [
        "Developmental Neuroscience and Neurogenetics Program, Children’s Hospital Los Angeles, The Saban Research Institute, Los Angeles, California, USA",
        "Division of Developmental-Behavioral Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California, USA",
        "Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA"
      ],
      "name": "Beth A Smith"
    },
    {
      "affiliations": [
        "Center for Indigenous Health Research, Maya Health Alliance, Guatemala, Chimaltenango Department, Guatemala",
        "Division of Global Health Equity, Brigham and Women’s Hospital, Boston, Massachusetts, USA",
        "Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA"
      ],
      "name": "Peter Rohloff"
    }
  ],
  "title": "Smartphone-based support for early childhood development in a rural low-resource setting: an individually randomised pilot feasibility trial from Guatemala",
  "uid": "0d42d5e7-4e81-57ce-9b66-8d630c60cdcf"
}