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Abstract

Background: The widespread availability of smartphones has created new opportunities for engaging pregnant women and enhancing their self-management abilities to promote maternal and fetal health through mobile interventions. This study focuses on the design and development of a gamification-based mobile health (mHealth) application aimed at providing nutritional support to pregnant women.

Methods: An iterative, user-centered design approach and Agile development method were employed to create the application. The developmental stages included identifying the application’s features, the design and development process, and evaluation. End users assessed usability using the System Usability Scale (SUS), while experts evaluated quality using the Mobile Application Rating Scale (MARS).

Results: Feedback from experts and end users categorized the application’s functionalities into general, specific, and gamification-related functions. Pregnant women rated the application’s usability as acceptable (68.25 ± 10.86), and experts rated its quality as acceptable (mean 3.89 out of 5, SD 0.25).

Conclusions: The positive evaluation results support the use of this application as a tool for managing gestational nutrition and enhancing self-awareness. Future research should investigate its impact on the nutritional status of pregnant women and their infants.

Keywords

digital health mhealth application gamification nutrition support pregnant women

Introduction

Pregnancy is one of the most critical stages in a woman’s life, significantly impacting the health and development of both mother and fetus. Proper nutrition during this period not only supports fetal growth but also helps maintain the mother’s mineral reserves. Research indicates that inadequate nutrition during pregnancy can lead to problems such as obesity, preeclampsia, high blood pressure, and gestational diabetes. Preventing poor nutrition is the best strategy for ensuring health.^1,2

Recent studies reveal that many pregnant women do not follow an adequate diet and there is a need for improvement.³ Having an educational program on pregnancy nutrition, a proper diet plan, and continuous monitoring can positively affect the health of both the mother and fetus.² Furthermore, delivering healthcare services to remote areas and providing continuous monitoring for patients have emerged as significant challenges for health organizations. The COVID-19 pandemic has accelerated the transition from in-person medical visits to remote consultations, making telehealth technologies an ideal solution during this period.^4,5

In response to these challenges, many clinical researchers have turned to technology, developing innovative approaches to enhance access to and the quality of care, particularly during the pandemic.⁶ Numerous studies have shown that women rely significantly on social media and mobile health (mHealth) applications for information and healthcare services during and after pregnancy, both for themselves and their infants.^7,8 Through social media, pregnant women not only seek information online but also actively contribute to knowledge sharing in online forums.⁸

The concept of mHealth, or mobile health, encompasses the use of various technologies such as smartphones, monitoring tools, personal digital assistants, wireless devices, and tablets to enhance patients’ well-being.^9,10 Mobile phones serve as the foundational element for healthcare solutions within the realm of mHealth. These devices can be further empowered through the incorporation of applications, often referred to as apps. These apps are user-friendly software products that do not necessitate special training or expertise for utilization.⁸ mHealth applications offer an ideal platform for individuals to manage their health conditions independently. They are pervasive, possess robust computational capabilities, and are typically carried by users. Additionally, these apps enable real-time access to self-monitoring resources, time-sensitive health information, alerts, reminders, and personalized self-management tools.⁶ Given the significant increase in smartphone access within many communities in recent years, interventions leveraging mobile technology present unique and innovative opportunities to engage pregnant women in enhancing their self-management skills and behaviors for the betterment of their health and the health of their unborn children.^11,12

One of the key challenges in mHealth applications is sustaining user engagement over time. Effective interaction signifies the depth of engagement users have with the application’s features.¹³ Techniques that enhance user interaction are essential for motivating behavior change and encouraging task completion. One such technique is gamification, which integrates game design elements into non-gaming contexts to reshape user interaction and boost motivation.¹⁴ Its primary aim is to solve problems, promote learning, and uncover user motivation.¹³ Gamification has been successfully applied in various fields, including e-commerce, education, and healthcare,^14,15 serving as a link between psychology and technology for business purposes. With their unique capabilities, mHealth applications have the potential to transform patient interaction and behaviors. Consequently, combining game design concepts with mHealth could significantly impact public health,¹⁶ prompting increased interest in using gamification to encourage healthy behaviors.^14,17,18 Developing innovative applications is crucial for supporting the well-being of pregnant women, necessitating effective strategies to promote their consistent use of these tools for improved health outcomes. Thus, this study aims to design and develop a gamification-based mHealth application in Persian, focusing on providing nutritional support to pregnant women. This study contributes to the health informatics field by presenting an innovative gamification-based mHealth application specifically designed for pregnant women, highlighting its potential to enhance nutritional support and self-management, thereby addressing critical gaps in maternal health care delivery and user engagement in digital health solutions.

Methods

Overview of the application, prototype design, and development

This study is part of the Doojan application design and evaluation project, which used an iterative and user-centered design approach and the Agile development method for design and development to ensure that the application is useful for and usable by the end users. The design team comprised experts in medical informatics, midwifery, nutrition, health, and fertility, as well as pregnant women who frequently participated in the design of this application. The stages of application design and development included identifying the features and functions of the application, designing and developing the application, and evaluating the final Doojan application. Written informed consent was obtained from all participants prior to their participation in this study. The study protocol was approved by the Ethics Committee of the *, under ethical code *.

First step: Identifying the features and functions of the application

First, by reviewing documents and similar applications and interviewing pregnant women, a list of features of pregnancy-related applications was drawn up. Then, the functions of Persian applications for pregnancy were examined using this list (the results of this phase of the study are reported elsewhere.¹⁹ Subsequently, a focus group was held with five experts to discuss and review the required functions of the application. The experts included two experts in reproductive health and midwifery, a nutritionist, and two experts in medical informatics. This focus group was conducted in 7 one-hour sessions. In these meetings, they commented and put forward suggestions about the functions of the application and reached a consensus on its functions and features. The focus group meetings were audio-recorded and transcribed verbatim. The interviewer also took notes on individual interviews.

Second step: Designing and developing the application

Using the Agile approach and based on the documentation from the previous stage, a minimum viable product (MVP) was developed in Adobe XD. MVP is a widely used strategy for system testing in the early stages of design. This strategy provides an unbiased understanding with a short build-measure-learn feedback loop and creates a process wherein users are optimally involved in technology development.²⁰ Based on what experts and end users thought, the app’s functions were approved, and the final Persian language application was made for Android phones using the Eclipse programming language.

Third step: Evaluating the application

We asked the users and experts to evaluate the usability and quality of the application, respectively. The System Usability Scale (SUS) was employed to evaluate system usability, and the Mobile Application Rating Scale (MARS) was used to evaluate system quality (see Supplementary Material, Appendix 1).

System usability was evaluated using the Persian version of the SUS by 10 pregnant women who had used this application for at least 1 month. The validity and reliability of the Persian version of this questionnaire have already been investigated by Dianat et al. (internal consistency: α = 0.79, test-retest reliability: ICC = 0.96).²¹ This industry standard is a subjective assessment in 10 questions scored on a five-point Likert scale (1 = strongly disagree, 5 = strongly agree). For each odd question, 1 point is subtracted from the number chosen by the user. For each even question, the score assigned by the user is subtracted from 5. The total score is then multiplied by 2.5 to obtain the total SUS score. SUS scores range from 0 to 100, with a score above 67 qualifying as above average.²²

Five experts specializing in medical informatics, nutrition, maternal health and fertility conducted an assessment of the application’s quality using the Mobile Application Rating Scale (MARS). MARS is a well-established, multidimensional tool for appraising the quality of mHealth applications, widely recognized for its reliability and validated through numerous studies.^23–27 This comprehensive instrument comprises 23 inquiries divided into four objective sub-scales and one subjective sub-scale.

The four objective sub-scales encompass:

1- Engagement, which evaluates factors such as entertainment value, interest, customization, interactivity, and alignment with the target audience.

2- Functionality, encompassing aspects like performance, user-friendliness, navigation, and gesture-based design.

3- Aesthetics, considering factors related to layout, graphics, and visual appeal.

4- Information Quality, which assesses the accuracy of the application’s description, the clarity of its objectives, the quality and quantity of information provided, visual information presentation, credibility, and evidence base.

Additionally, the subjective quality sub-scale consists of four questions aimed at gauging user satisfaction. For each of these aspects, a standardized 5-point Likert scale is employed, ranging from 1 (inadequate) to 5 (excellent).²⁸

The data obtained from evaluating the applications using the MARS and SUS were analyzed using Microsoft Excel. The Likert scale data were summarized as means ± standard deviation (SD). The use of Microsoft Excel for data analysis was due to its accessibility and efficiency in performing the necessary calculations and analyses.

Results

Identifying the features of the application

The results of seven focus group meetings about the functions required for the application led to 10 general functions, 12 specific functions, and 5 categories of gamification elements. These functions were confirmed by five experts who had at least 5 years of work experience in the field of mHealth applications. These suggested functions are presented in Table 1.

Table 1.

Doojan application suggested features.

Row	Functions	Description
General functions
1	Free installation
2	Free features	Ex. free consultants by experts
3	Literature based
4	Privacy settings	Based on their phone number
5	Providing offline information	Ex. articles
6	Text search field
7	Pictures
8	Android based
9	Ease of use
10	Backup	Ability to save information on the server
Specific functions
1	User profile (pregnant mother)	Includes information: Height, weight, age, gestational age, mobility level
2	Get mother’s nutritional information	Daily
3	Calculation of daily calorie requirements	Based on the specifications of each user
4	Expert recommended nutrition plan	Nutrition program based on each user’s profile
5	Calculation of daily calorie intake and display as a graph	Based on the nutritional information of each user
6	Calculation of received nutritional macronutrients (protein, fat, carbohydrate)	Based on the needs of each user
7	Calculation of required nutritional macronutrients (protein, fat, carbohydrates)	Based on the nutritional information of each user
8	Presenting articles related to nutrition	Based on international guidelines
9	Calculation of fluid intake	Water
10	Reminders	Water, medications, appointments, to-do lists
11	Daily intake of mother’s weight	Daily
12	Favorites list	Article and questions

Gamification elements
1	Display graphs and progress stages	- Pregnancy weight
		- Consumed calories
		- Received nutritional macronutrients (carbohydrate, fat and protein)
2	Feedback and rating	- Entry of nutrition and weight information
		- Compliance with the number of calories consumed
		- Compliance with the required macronutrients
3	Interaction with other people and experts (forum)	- In-app interaction with other expectant mothers
3	Interaction with other people and experts (forum)	- In-app interaction with experts
4	Related challenges	- Participating in the challenges related to the regulation of substances needed by the body during pregnancy
5	Setting goals	- Food consumption during pregnancy according to the advice of nutritionists
		- Adjusting calorie intake according to the recommendations of experts
		- Adequate intake of macronutrients needed for fetal growth during pregnancy

Designing and developing the application

Based on the functions established in the previous stage, we designed a minimum viable product (MVP). Once the MVP was created, we conducted testing with two experts and two pregnant women to gather qualitative feedback on their experiences. Participants provided insights on the app’s features, their placement, and various elements within the application pages, which informed revisions to the prototype. Users expressed concerns regarding navigation difficulties and misunderstandings of the nutritional guidelines, leading us to implement significant improvements. These adjustments included simplifying the app’s navigation structure and enhancing customization options for reminder features, enabling users to tailor notifications to their individual preferences.

As testing progressed, we faced challenges, including technical glitches and low engagement with gamification elements. However, these obstacles provided valuable learning opportunities. By improving technical stability and introducing social features that encouraged user interaction, we were able to elevate the overall experience. The result is an intuitive and user-friendly application that empowers pregnant women to manage their nutrition and health more effectively, ensuring they feel supported throughout their journey.

The final application has five main sections: profile, nutritional information, forum, reminders, and favorites. The user can view and edit her information (username, password, name, age, weight, height, level of physical activity, date of birth), as well as her goals and challenges in the profile (Figure 1(a)). Nutritional information has two sections: articles related to nutrition and nutritional information customized for each user. The articles are based on credible scientific sources and are updated (Figure 1(b)). In the nutritional information section, the user can view the recommended diet based on her specifications, enter her consumed foods, and view the history of the inputted data. It is also possible for the user to view a graph of calorie and macronutrient intake (fat, protein, and carbohydrates) (Figure 1(c)). In the forum, users can post and answer other users’ questions. Experts can also answer users’ questions in the forum. Furthermore, in the frequently asked questions (FAQ) section, experts post frequently asked questions and their answers. The application assigns points to users according to their level of participation in conversations and displays the list of users with the highest points at the top of the forum (Figure 1(d)). In the reminders section, users can add reminders for medications, appointments, checkups, etc. (Figure 1(e)). The last section is intended for saving favorite articles and questions (Figure 1(f)).

Figure 1.

Doojan application screens (all names are pseudonyms).

Evaluating the application

Usability evaluation

Ten pregnant women who had used the application for at least 1 month participated in the usability evaluation. Seven women (70%) had less than a bachelor’s degree, while 30% had university education. The mean age of the mothers was 28 years (Table2). There are 10 questions in the SUS. The mean score for each question is 2, indicating neither agree nor disagree (neutral). The mean and SD of the answers to the questions are given in Table 3. For all the participants, the mean total score for the SUS was 68.25 ± 10.86 which, according to Terhorst et al.,²⁶ demonstrates a successful system.

Table 2.

Characteristics of participating mothers in the usability evaluation (N = 10).

Age (mean ± SD)	28 ± 4.59
Employment status	Employed	2
	Not employed	7
	Student	1
Education level	Primary school	3
	Secondary school	3
	High school	1
	University education	3

Table 3.

SUS result.

	Mean score	SD
Q1- I think that I would like to use this app frequently	2.90	0.57
Q2- I found the app unnecessarily complex	2.40	0.84
Q3- I thought the app was easy to use	3.90	0.88
Q4- I think that I would need the support of a technical person to be able to use this app	1.80	0.79
Q5- I found the various functions in this app were well integrated	3.50	0.71
Q6- I thought there was too much inconsistency in this app	2.30	0.82
Q7- I would imagine that most people would learn to use this app very quickly	3.70	1.06
Q8- I found the app very cumbersome to use	2.10	1.20
Q9- I felt very confident using the app	4.20	0.92
Q10- I needed to learn a lot of things before I could get going with this app	2.30	0.82
The overall value of SUS	68.25

Quality evaluation

The quality of the application was evaluated by five experts in medical informatics (two with a PhD), nutrition (one with a PhD), maternal health and fertility (one with a PhD and one with a master’s degree). All the experts were experienced in system evaluation using MARS and had worked with the Doojan application for a week. MARS examines five key quality categories: engagement, functionality, aesthetics, information quality, and a subjective application quality. Among the four main scales of MARS, functionality obtained the highest mean score of 4.10 ± 0.14, followed by engagement (4.04 ± 0.33), information (3.97 ± 0.30), and aesthetics (3.47 ± 0.30). The subjective quality scale obtained a mean score of 4.15 ± 0.58 (Table 4). As for the final mean score of the application’s quality, the mean score of the four main subscales of MARS (without including the subjective quality subscale) was 3.89 ± 0.25.

Table 4.

MARS result.

	Engagement	Functionality	Aesthetics	Information	Subjective quality	Ave^a
Ave	4.04	4.10	3.47	3.97	4.15	3.89
SD	0.33	0.14	0.30	0.41	0.58	0.25

^aThe final average is the result of MARS four main scales (engagement, functionality, aesthetics, information quality).

Discussion

We developed and evaluated a gamification-based application to support gestational nutrition. After extracting and categorizing the functions of the application based on experts’ opinions, an MVP was designed using the Agile approach to ask mothers and experts to confirm the functions of this application, which were then embedded. Using MVP in the early stages of application design is a good way to get early user feedback.²⁰ The final version of the Doojan application was evaluated from the two dimensions of usability (by pregnant women) and quality (by experts). The users evaluated the usability of the application as acceptable; therefore, it can be used as a prototype for gestational nutritional support. The experts also deemed the quality of the application acceptable.

It is crucial to explore the benefits and impacts of maternal nutrition and nutritional education programs that utilize various mHealth interventions across different contexts. Comparative studies have highlighted that face-to-face health education, mobile calls, SMS services, and other mHealth applications have proven effective in enhancing maternal nutrition among diverse female populations worldwide. For instance, research conducted in various countries has demonstrated that nutritional education programs can significantly improve health outcomes, such as increasing hemoglobin levels in pregnant women,²⁹ and reducing anemia among adolescent girls.³⁰ Moreover, the development of mobile applications for midwifery care underscores the promising role of technology in supporting maternal health.³¹ These studies strengthen the justification for the intervention methods chosen in our application design and emphasize the potential impact of the Doojan application on public health outcomes, particularly in improving maternal and child health through enhanced nutritional support. Such comparisons not only highlight the efficacy and innovative aspects of our application but also situate it within the broader landscape of maternal health interventions.

In the application design phase, based on the literature^11,32,33 about maternal support applications and experts’ comments, we categorized functions into two categories of general (10 items) and specific (12 items). The general functions included being free of charge, being based on reliable sources, privacy settings, and providing information offline; the specific functions included suggesting a diet based on the mother’s specifications (pre-pregnancy BMI and weight during pregnancy), the ability to input food intake, calculating calories and macronutrient intake, and access to credible nutrition-related content. Given the importance of using appropriate strategies to motivate behavior change and encourage users to use the application to achieve their goals, gamification-based design has been recommended as a technique to improve user interaction^13,14,16,17 ; in this study, gamification-based design based on five categories of gamification mechanics was considered in the Doojan application. These five categories include graphically displaying the stages of progress, feedback and points, interaction with other users and experts, challenges related to adjusting the substances needed by the body during pregnancy, and setting goals.

We also sought feedback from both users and experts to evaluate the usability and quality of the final application. To assess usability, we had 10 pregnant women, who had been using the application for a minimum of 1 month, complete the SUS. The results indicated that the application is generally acceptable, with a total mean SUS score of 68.25.³⁴ However, these findings also revealed some existing flaws that require identification and rectification. Moreover, experts evaluated the application’s quality using the MARS and assigned it an overall score of 3.89. This score was distributed across four sub-scales: engagement, functionality, aesthetics, and information, all of which collectively indicated that the application possesses an acceptable level of quality.²⁸ Specifically, the experts rated the functionality and engagement aspects of the application as good, with scores exceeding 4. However, the aesthetics sub-scale, which assesses overall visual appeal and stylistic consistency,³⁵ received the lowest score of 3.47, highlighting areas in need of improvement. It’s worth noting that aesthetics is a critical dimension of quality that can differentiate applications in the market and contribute to positive emotional experiences, ultimately enhancing user perception.²⁴

Given the successful integration of all gamification elements and the consensus among specialists, the next steps for the Doojan application involve continuous improvement and potential expansion. Further iterations of the application will be based on comprehensive user feedback gathered during usability testing and through ongoing interaction with end users. This will ensure that the application remains relevant and effective in addressing user needs.

We recognize the potential for wider deployment and plan to adapt Doojan application to different linguistic and cultural contexts. While the core nutritional information and gamification principles are broadly applicable, successful adaptation requires tailoring the app to specific cultural norms, dietary practices, and health beliefs. Future development will focus on content localization (culturally appropriate translation of text and multimedia), dietary customization (adapting dietary plans and recipes to local food availability and guidelines), gamification adaptation (adjusting game mechanics and rewards to cultural preferences), and community engagement (involving local experts to ensure cultural sensitivity). Cultural adaptation is complex and requires ongoing research; future studies will assess Doojan’s effectiveness in diverse contexts and identify best practices for adapting mHealth interventions.

This study had several strengths, including the innovative use of gamification to enhance user engagement and the incorporation of expert feedback throughout the development process. These elements contribute to the application’s potential effectiveness in promoting gestational nutrition. However, the study also had limitations that may have influenced the results. First, while Nielsen’s guidelines³⁶ suggest that five participants per round can identify a significant proportion of usability issues, our sample size of ten participants may still limit the generalizability of our findings to the broader population of pregnant women. Recruitment was challenging due to the sensitive nature of maternal health, resource constraints, and limited incentives. Future research should employ stratified sampling with a larger sample size to ensure representation across diverse demographics. Second, the 1-month follow-up period may not adequately assess long-term usability, engagement, or the impact of Doojan on maternal nutrition behaviors. Extending this evaluation period to several months is essential to assess the sustainability of behavior changes. Third, while the SUS provided a general overview of usability, it lacks the specificity to identify detailed usability issues. Future studies should incorporate additional usability evaluation methods and qualitative data (e.g., in-depth interviews) to provide richer insights into user experiences and identify potential areas for improvement. Finally, we did not assess users’ willingness to adopt the technology, the impact of gamification mechanics, or the application’s usage rate, all critical aspects for understanding the broader implications of the application in real-world settings. Furthermore, we are actively pursuing opportunities to integrate Doojan into existing maternal and child health programs, which would allow for broader implementation and evaluation in real-world settings. Future studies should also focus on how Doojan can be implemented to improving maternal nutrition outcomes, while also assessing its potential impact on child health during the critical first 1000 days.

Conclusion

This study successfully developed and evaluated Doojan, a gamification-based Android application designed to support gestational nutrition using an Agile development approach. User evaluation indicated acceptable usability, while expert assessment confirmed acceptable quality, suggesting the potential of Doojan as a supportive tool for managing nutrition during pregnancy and enhancing awareness of gestational nutritional care. However, limitations including a small sample size, a limited 1-month follow-up, and a lack of assessment regarding adoption willingness warrant cautious interpretation of these findings. Future research should focus on rigorously evaluating Doojan’s effectiveness in improving maternal and infant nutritional outcomes through large-scale, randomized controlled trials with extended follow-up periods. Additionally, studies should explore factors influencing user adoption, engagement with gamification mechanics, and real-world usage rates. Integrating Doojan into existing maternal and child health programs represents a promising avenue for broader dissemination and evaluation, ultimately contributing to improved maternal and child health, particularly within the critical first 1000 days.

Summary points

• Developed a gamification-based mobile health (mHealth) application for pregnant women to enhance nutritional support, capitalizing on the widespread availability of smartphones.

• Employed an iterative, user-centered design approach and the Agile development method throughout the application’s creation.

• Users found the application’s usability acceptable, with an average System Usability Scale (SUS) score of 68.25, while experts rated its quality as acceptable, with a mean Mobile Application Rating Scale (MARS) score of 3.89 out of 5.

• Recommends the application’s use as a supportive tool for managing gestational nutrition and increasing users’ awareness of nutritional care during pregnancy.

• Suggests further research to assess the application’s impact on the nutritional status of pregnant women and their infants.

Supplemental Material

Supplemental Material - Enhancing maternal nutrition: The development of Doojan, a gamified mHealth app for pregnant women

Supplemental Material for Enhancing maternal nutrition: The development of Doojan, a gamified mHealth app for pregnant women by Lida Moghaddam-Banaem, Rezvan Rahimi, Sabereh Ahmadi and Somayeh Hossainpour in Health Informatics Journal

Statements and declarations

Ethical approval

This research has been approved by the ethics committee of the School of Medical Sciences at Tarbiat Modares University under the ethical code IR.MODARES.REC.1400.258. Additionally, this research received approval from the Ethics Committee of the Iran National Science Foundation (INSF) and adhered to the applicable guidelines and regulations throughout the study, ensuring the ethical conduct of all research methods. All participants received comprehensive information about the study and provided their informed consent. The questionnaires used in the study were designed to be anonymous, ensuring the confidentiality of participants’ information.

Footnotes

Author contributions

All authors contributed to the conception and design of the study. RR and SA were responsible for data collection, analysis, and initial manuscript drafting. RR, LM, and SH contributed to data analysis and interpretation, and critically revised the manuscript. All authors have approved the final version of the manuscript for submission.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by the Iran National Science Foundation (INSF) under Project No. 4002586. INSF played no role in the design of the study, data collection, data analysis and interpretation, or the writing of the report, and had no involvement in the decision to submit the paper for publication.

Conflicting interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Data Availability Statement

The datasets generated and/or analyzed during the current study can be obtained upon reasonable request from the corresponding author.*

Declaration of AI-assisted technologies in the writing process

During the revision of this work, the author(s) used OpenAI (ChatGPT) to improve readability and language. After using this tool/service, the author(s) reviewed and edited the content as needed and take(s) full responsibility for the content of the publication. The textual percentage change resulting from the use of ChatGPT is approximately 20%.

Preprints

Enhancing Maternal Nutrition: The Development of Doojan, a Gamified Mhealth App for Pregnant Women ().

Supplemental Material

Supplemental material for this article is available online.

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Supplementary Material

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Enhancing maternal nutrition: The development of Doojan,a gamified mHealth app for pregnant women

Abstract

Keywords

Introduction

Methods

Overview of the application, prototype design, and development

First step: Identifying the features and functions of the application

Second step: Designing and developing the application

Third step: Evaluating the application

Results

Identifying the features of the application

Designing and developing the application

Evaluating the application

Usability evaluation

Quality evaluation

Discussion

Conclusion

Summary points

Supplemental Material

Supplemental Material - Enhancing maternal nutrition: The development of Doojan, a gamified mHealth app for pregnant women

Statements and declarations

Ethical approval

Footnotes

Author contributions

Funding

Conflicting interests

Data Availability Statement

Declaration of AI-assisted technologies in the writing process

Preprints

Supplemental Material

References

Supplementary Material