Implementation Fidelity of a Smartphone Application for Population-Based General Movement Assessment: The Early Moves...

To describe the infant and maternal characteristics of the Early Moves cohort and to assess representativeness to the general population, and to evaluate the implementation fidelity of an application-based collection of General Movement Assessment (GMA) videos at writhing and fidgety age.

Prospective observational study. Mothers who had recently delivered or were enrolled to deliver at maternity hospitals in Perth, Western Australia, were recruited from November 2019 to December 2023. Sociodemographic and infant clinical characteristics were extracted from hospital records. Parents were invited to record GMA videos using the Baby Moves smartphone application, which were assessed for scorability by certified GM assessors.

A total of 3002 infants (mean gestation, 38.9 ± 1.7 weeks; 46.6% female) were recruited. Infants were representative of the local population with respect to key infant risk factors, although mothers were more likely to be Caucasian and reside in higher socioeconomic suburbs compared with the broader Perth metropolitan birth population. Overall adherence was 76%, with 2272 families returning at least 1 scorable GMA video, with the majority (>69%) requiring personalized reminders to upload. Risk factors for nonengagement were infant prematurity, special care nursery stay, low maternal age, low socioeconomic status, minority ethnicity, and single caregiver mothers.

Inclusive recruitment strategies and broad inclusion criteria supported participation from diverse sociodemographic groups and infants representative of the local population on key medical risk factors. Parent-recorded GMA can be implemented in a large population-based cohort, though application-based notifications alone may be insufficient to facilitate engagement. Population-based applications should ensure targeted implementation strategies to support priority families.