Promoting Healthy Development in Early Childhood: A Proposal of a

Mobile Application

Joana Tavares

, Rita Santos

and Oksana Tymoshchuk

DigiMedia, Department of Communication and Art, University of Aveiro,

Santiago University Campus, 3810-193 Aveiro, Portugal

Keywords: e-Health, Early Childhood, Healthy Development, User-Centered Design, Mobile App.

Abstract: Developing digital solutions to support parents of children in early childhood is crucial for enhancing

parenting practices and promoting child development. In the context of an intervention project that advocates

the child's emotional, social, cognitive and cultural development and stable growth from prenatal life until the

first three years of life, a multidisciplinary team collaborated to propose a mobile application supporting

parents in promoting their children's healthy development during this period. The study followed a

development research methodology, including a literature review, comparative analysis of existing apps,

prototype development, and evaluation. This approach, combined with user-centred design, helped to identify

critical features and design principles for an effective parental support app. The resulting app proposal

foresees personalized resources, from different categories, a digital diary, suggestions of activities to be

carried out with the child and recommendations of events. Evaluation results showed that an app based on

this proposal can be an important resource for parents and foster positive parenting behaviours, benefiting

parents and children. This research contributes to the growing field of digital health solutions for early

childhood development, presenting a promising tool to enhance parental support and child well-being.

1 INTRODUCTION

It is crucial to prioritize promoting healthy behaviors

at all life stages, giving every child the best start in

life, through, among other things, health literacy

(Diário da República, 2021), and also to foster "better

cooperation between or integration of services for

families and children, particularly with health and

social services, and schools, at national, regional and

local level" (Council of the European Union, 2019,

p.9). Recognizing this need for a new perspective on

early childhood, the Águeda Health Centre conceived

the Cres(SER) (Growing up) project in 2017.

Supported by the Regional Health Administration of

the Centre, this project promotes children's

emotional, social, cognitive, and cultural

development from prenatal to the first three years. It

involves a multidisciplinary team of education,

psychology, and primary health care professionals.

https://orcid.org/0009-0008-6346-4642

https://orcid.org/0000-0001-9741-6210

https://orcid.org/0000-0001-8054-8014

Aiming to improve the access to information and

convenience for parents through digital health

solutions, effectively overcoming barriers to

healthcare access and use, the Cres(SER) project aims

to widen its intervention by providing a mobile

application to support parents in fostering healthy

child development during the first years of life.

Historically, parents obtained health information

from friends, family, and doctors. However, recent

studies on health information-seeking behaviour

suggest that this situation is changing (Benoit et al.,

2021; DeWitt et al., 2022). With the expansion of

mobile device usage, the information supply has

become more widespread and accessible. Many

healthcare apps are focused on pregnancy and early

childhood, offering many features and goals.

However, these apps face several problems.

According to Virani et al. (2019), factors such as a

lack of personalization, unattractive design, absence

of interactive features, poor functioning, and

276

Tavares, J., Santos, R. and Tymoshchuk, O.

Promoting Healthy Development in Early Childhood: A Proposal of a Mobile Application.

DOI: 10.5220/0013292700003938

Paper published under CC license (CC BY-NC-ND 4.0)

In Proceedings of the 11th International Conference on Information and Communication Technologies for Ageing Well and e-Health (ICT4AWE 2025), pages 276-283

ISBN: 978-989-758-743-6; ISSN: 2184-4984

unreliable information reduce parents' involvement

and lead to app abandonment. According to their

research, apps that are aesthetically pleasing, user-

friendly, functional, engage users and provide reliable

information are considered high quality (Virani et al.,

2019).

In this context, this research was developed to

inform the characteristics, features, and services of an

app that can support parents in creating a favourable

environment for children's healthy and stimulating

development and present a proposal for Cres(Ser) app

to support early childhood development. A literature

review was conducted to understand how digital

solutions can help parents and identify aspects that

should be considered in designing a mobile app for

healthy development in early childhood. Then, a

benchmarking of mobile apps in early childhood was

also carried out. Finally, a proposal for an app capable

of supporting parents in creating a favourable

environment for children's healthy and stimulating

development was developed using a user-centred

design approach. Creating an empowering app

requires understanding users' needs and collaborating

with professionals and end-users. Thus, the

development of the proposal was accompanied by

several moments of discussion and evaluation from

users and other stakeholders.

2 UNDERSTAND PARENTS’

NEEDS

Parents are the first line of defence in recognizing and

managing their children's behavioural health needs

and promoting their well-being (Grodberg et al.,

2022). According to research on Evaluations of

Social Interventions (Terzian & Mbwana, 2009),

greater parental involvement in a child's mental and

behavioural health care can triple the chances of

positive outcomes.

People increasingly use smartphones and the

Internet to search for health information, such as to

understand the cause of a particular illness, access

ways to assess the severity of symptoms and get

prepared before consulting a doctor (Benoit et al.,

2021).

Maternal healthcare during pregnancy and

parenting support are examples of areas in which

there’s a growing proliferation of apps, with

considerable diversity in visual style, functionalities,

and objectives (Bailey et al., 2022). Several

researchers emphasize the need to harness digital

technologies for early childhood development,

ensuring all families can benefit from the same digital

possibilities for their children's well-being

(Hatzigianni et al., 2023). Mobile apps are generally

offered free of charge and can circumvent the

difficulties associated with conventional treatments,

such as financial burdens, access restrictions, and

social stigma. These digital tools emerge as viable

and accessible alternatives, removing traditional

barriers often preventing access to appropriate

treatment and care (Neary & Schueller, 2018).

Parents appreciate the convenience of

technological solutions, which provide round-the-

clock assistance, when more traditional parental

support services are unavailable. These solutions

empower parents, offering scalability and possibility

of community collaboration (Darling et al., 2020).

These solutions help parents feel more confident in

assessing their children's health, significantly

changing health-seeking behaviour (Benoit et al.,

2021).

3 CONSIDERATIONS WHEN

DESIGNING AN APP TO

SUPPORT PARENTS

In ‘5 Design principles for e-health’, it’s stated that e-

health services and products often prioritize

technology over user needs. This shows that

designers must solve and understand problems,

considering the user's needs, limitations, living

context, and associated issues (Amaral, 2019). To

meet this challenge, it is essential to adopt approaches

such as User Centred Design (UCD), which focuses

on creating solutions based on end users' needs and

feedback, and Participatory Design (PD), which

actively involves users in the design process. These

approaches ensure the resulting system is user-

friendly, engaging, adaptable, accessible, and

valuable.

As mentioned in the Good Communication

Practices Guide of the National Health Plan (2022), it

is essential to consider communication as a strategic

tool for the success of health strategies (Duarte Melo

et al., 2022). This guide highlights, for example, the

importance of the communication tone, which reflects

the organization's identity and values. This tone

should be consistent across all channels, providing a

coherent attitude, while adapting to different

circumstances - be it more informative, empathetic,

emotive, or formal.

Other research also recommends that a solution

presents a hierarchy that prioritizes information,

Promoting Healthy Development in Early Childhood: A Proposal of a Mobile Application

277

guaranteeing complete but gradual access, i.e., having

access to everything but not having it all at once

(Amaral, 2019). Even so, the system is intuitive

enough to allow the user to perform basic operations,

without introducing unnecessary or complex

terminology.

Credibility and trust are also essential when

developing health-related products and services.

Based on numerous studies, Sousa (2017) defined

five interface dimensions relevant to increasing those

elements:

Visual Dimension. It is essential for communicating

and understanding interfaces, going beyond

aesthetics. It must fulfil functions that positively

influence interaction and the credibility perceived by

the user. The author discusses some basic elements of

visual communication, such as point, line, shape,

direction, tone, colour, texture, scale, dimension,

movement and typography, as essential components

of the visual dimension.

Information Architecture. Information architecture

organizes, structures, and names content to make it

easier for users to find, understand, and carry out

tasks.

Interaction: Interaction design on digital platforms

seeks to create functionalities that facilitate

interaction between users and systems. Garrett (2011)

defines three objectives for improving usability and

effectiveness: creating meaningful paths, ensuring

clear communication between navigation and

interaction elements, and establishing a clear

relationship between information and actions.

Social Presence. The social presence dimension

represents presence, connection and communication

between individuals and organizations mediated by

the interface. Individual variables, such as

willingness to suspend disbelief, familiarity, means of

communication, gender and seeking sensations of

humour, affect social presence.

User Experience. The user experience goes beyond

utility, encompassing affection, sensation and

meaning in the user's life. It is interesting to many

professionals and relates to all the other dimensions

of the Interface, assuming its most emotional

component.

By considering these dimensions, holistic

experiences that solve problems effectively can be

created, engaging users, promoting trust, and

establishing meaningful connections.

The scarcity of comprehensive design

guidelines specific to the area of this study represents

a significant challenge, affecting the quality and

effectiveness of these solutions.  This often results in

products with usability problems, inadequate

professional involvement, and a poor understanding

of the healthcare context (Stevenson & Oscarsson,

2021). Also, most apps fail to provide personalized

experiences for parents, including specific cultural

considerations. Instead, they provide generic

information that may only be relevant in certain

contexts for parents (DeWitt et al., 2022).

4 BENCHMARKING

In a previous study, a first survey was carried out

about apps related to early childhood to understand

the current market landscape. Using keywords such

as "baby development” and "parenting", we identified

278 apps from Google Play and 401 from the App

Store. We applied the following inclusive criteria: 1)

user rating of at least 4 (scale: 1-5), according to

previous evaluations of the application; 2) rating

≥100; and 3) available free version. Apps dedicated

to only one of the following needs were excluded:

feeding/breastfeeding/sleep monitoring, parental

control as well as apps focused only on pregnancy,

apps showing growth metrics, photo albums, games,

and apps unavailable in English or Portuguese. Ten

apps were identified (Cunha et al., 2023). This was

followed by an analysis of their features using

subscales A to D of the Mobile App Rating Scale

(MARS) (Stoyanov et al., 2015).

Based on this previous analysis, we further

analysed the five apps that had the highest scores:

Kinedu - Baby Development; Baby Daybook -

Tracker, Schedule; Baby + | Your Baby Tracker;

BabyCenter - My pregnancy and my baby today; and

Prodigy baby - parenting app. This benchmarking

aimed to analyse the functionalities and visual aspects

of these apps identified from a previous focus group

with parents of children developed by the team and

from the literature review. 

The comparative analysis of these apps

considered the following aspects (see Figure 1 on

Annex 1):

• Visual content (videos);

• Customized information;

• Tips on various stages of development;

• Page for the community;

• Page for entering milestones;

• Notifications/alerts;

• Sharing content to other sites/networks;

• Gamified approach;

• Free application plan;

• Fremium application plan.

ICT4AWE 2025 - 11th International Conference on Information and Communication Technologies for Ageing Well and e-Health

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The results show diversity in the criteria included

by the apps. This creates a vast market that can meet

some specific needs. However, no app combines all

the relevant functionalities identified by the research

team as promoting healthy early childhood

development. 

Overall, the app with the best result was Prodigy

Baby, which lacked only two aspects analysed - tips

on various stages of development and a free plan, and

the app with the worst performance was Baby

Daybook, which is just a tracker, so it lacks multiple

features. The most recurrent aspects of this analysis

were the possibility of entering milestones, entering

notifications or alerts, and sharing content with other

networks. These three aspects are related to memory

and recollections, whether remembering an activity or

some memorable moments. On the other hand, the

least recurrent aspects were the screens dedicated to

the community, the gamified approach, and the

availability of free apps.

5 METHODS

The study followed a development research approach

(De Villiers, 2005). This purpose-oriented approach

seeks to address real-world problems, promoting

innovative solutions and establishing fundamental

principles to guide future actions and decisions. It was

outlined in two distinct phases: Phase 1 - study and

analysis of the problem previously described and

Phase 2 - development and evaluation of the

proposal. These phases were further subdivided into

stages (see Figure 2 on Annex 1) that were identified

considering the UCD methodology, thus, considered

iterative development and evaluations. Health and

education professionals provided important inputs

while potential users participated in the final

evaluation, checking that the proposal could suit their

needs.

Phase 2. Proposal Development

The primary project target includes families with

children up to 3 years old. Stakeholders such as health

and education professionals were also considered, as

their involvement is crucial for effective

implementation of the Cres(SER) project. 

The phase 2 began with developing a medium-

fidelity prototype, guided by principles established

from the study's first-phase conclusions.

The first validation moment was conducted in a

focus group with health and education professionals

with knowledge and experience in the field to assess

how logical and efficient the information organisation

was. In addition, the adequacy of the names of the

information categories was discussed to ensure a

more intuitive and effective user experience. 

The transition from the mid-fi prototype to the hi-

fi prototype marked a significant milestone.

Throughout this process, once again, the principles

from Phase 1 acted as essential pillars to guide the

decisions to refine and improve the prototype and

visual identity was also incorporated. An interview

with professionals who have collaborated in the past

with the Cres(SER) project validated the hi-fi

prototype and confirmed the appropriateness of the

changes.

In the final research stage, the prototype was

subjected to usability tests to assess its effectiveness

and identify areas for improvement with parents of

children up to three years old (app users).

We used non-probabilistic convenience sampling

to select participants who could make relevant

contribution. Águeda Health Centre of Portugal

helped recruit participants and provided venues.

Participants were asked to read and sign the informed

consent form and respond to characterization

questions. They were also asked to think aloud during

the tests, and notes were taken using an observation

grid.

Based on the results of these tests, final

adjustments were made to the prototype. This

iterative process ensured the prototype met quality

standards and satisfied user expectations.

6 RESULTS

6.1 Focus Group

Following developing a medium-fidelity prototype,

we validated it with experts in a focus group (FG)

context.

In February 2024, we conducted an FG

comprising 12 participants - health professionals and

education professionals - linked to parenting projects.

Due to their frequent interactions with various

parenting situations, these participants offered a

comprehensive understanding of the needs,

challenges, and dilemmas that parents often face at

various stages of parenting. Thanks to their constant

immersion in the field and the PD approach,

professionals provided valuable information on the

quality of communication between the app and users

and the effectiveness of the strategies adopted for

sharing information.

Promoting Healthy Development in Early Childhood: A Proposal of a Mobile Application

279

The FG's objectives were: 1) Understand how

health and education professionals receive and

perceive the app; 2) Assess whether the app's

functionalities are the most relevant; 3) Explore ways

to promote engagement with the app. This focus

group allowed us to gather valuable insights and

feedback from professionals in the field. Their

expertise helped us validate our design choices,

identify potential areas for improvement, and ensure

that the app's functionalities aligned with the needs of

both parents and professionals. The discussions

during this session provided information that guided

our subsequent design iterations and feature

refinements.

The main changes have been the categories of

interest, which have been moved from the Register to

the Homepage. The idea is for all areas to be of equal

interest to parents and are presented on the homepage.

To make it easier to search for content, a search bar

has also been added to filter content by text or video

(Figure 1).

Figure 1: First change regarding the FG.

Next, the Milestones screen has been modified

and renamed Activities, containing only

recommended activities that encourage parents to get

involved with their children. These activities are

categorised by age group and type (physical,

cognitive, linguistic, social, emotional, and cultural),

offering a complete guide for parents looking to

stimulate their children's development; the

Community screen, that no longer exists, leaving only

the Playdates section (now called Events). In the

participants' opinion, the Forum section could cause

confusion among parents expecting answers to their

questions from professionals. Instead, it was decided

to focus on creating Cres(SER) Project events for

parents. To make it easier to find events, a search bar

was added with the possibility of filtering events into

two categories: closest to you and most recent;

finally, given the unanimity over the replacement of

the word baby, it was changed to child throughout the

application (see Figure 3 on Annex 1).

6.2 Semi-Structured Group Interview

In April 2024, the research team conducted a semi-

structured interview with two health professionals

who had collaborated with the Cres(SER) project in

the past. While we had an initial script, it was

intended that there would be flexibility to introduce

new topics if necessary. The contribution of these

professionals was vital to understanding their

expectations and needs about the app under study.

This session enabled us to validate the high-

fidelity prototype of the Cres(SER) app. The health

professionals provided valuable feedback on the user

interface, functionality, and overall user experience.

Their insights helped us identify areas for

improvement and confirmed that the app aligned well

with the goals of the Cres(SER) project. For example,

we changed the names of some important categories

and page titles and personalized the sign-up page to

include more positive parenting.

Based on the feedback received, we refined the

prototype. These included adjusting the layout of

specific screens to improve information hierarchy,

enhancing the navigation flow, and adding features

that the health professionals deemed essential for

adequate parental support. The iterative process of

prototyping and validation proved crucial in ensuring

that the final product would meet the needs of both

parents and health professionals.

The main changes have been a variety of new

avatar options have been introduced in user

registration. These options were carefully chosen

based on previous discussions, with the aim of

promoting more positive parenting. To further

personalise the user experience, the possibility of

choosing a photo from the user's personal gallery has

also been added (Figure 2).

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Figure 2: First change regarding the Interview.

Finally, the titles of the Progress and Your

Progress pages have been changed to Evolution and

Your Achievements, respectively (see Figure 4 on

Annex 1).

6.3 Usability Tests and Final Proposal

In May 2024, the research team conducted usability

tests with seven parents of children up to three. These

tests provided crucial insights into the app's usability

and user experience, allowing valuable feedback for

future improvements. The objectives of the tests were

to 1) Evaluate the effectiveness of the prototype in

meeting the needs and expectations of the participants

and 2) Identify specific areas of the prototype that

require improvement or adjustment.

Seven participants took part in these tests, all of

them female. One participant had a 3rd cycle degree

(7th to 9th grade), two had a secondary degree (10th

to 12th grade), one had a bachelor's degree, and the

remaining three mentioned having completed a

master's degree. Notably, only one participant had

experience with similar apps, and that experience

came from an app from a children's center also in

Águeda.

Two participants had some difficulty carrying out

the tasks, although the remaining five performed the

tests easily. At the end of the tests, participants were

asked to respond to the System Usability Scale (SUS)

to calculate a score for the prototype app. Considering

the method established for calculating the SUS scale

score (Barros, 2022), the prototype obtained an

average score of 82 (excellent). This result indicates

that the prototype has high usability, allowing users

to complete their tasks and reach their goals simply

and clearly, bringing user satisfaction. This result

indicates that the prototype is effective in its high

usability, allowing users to complete their tasks and

reach their goals simple and clearly, bringing user

satisfaction.

The first change made after the usability tests was

the bar with the categories of interest, both on the

Homepage and on the ‘Your achievements’ screen.

Here, we wanted to improve the sense of continuity,

so that users know that there are more categories of

interest than those that appear on the screen by

default. To this end, the thickness and saturation of

the line accompanying the categories have been

increased, emphasising the lack of margin on the

right-hand side of the screen. We also increased the

font weight of selected categories from regular to

medium, along with the thickness of their indicator

lines. We increased the spacing between categories so

that the last category appears partially cut off by

default, indicating additional content without

requiring scrolling (Figure 3).

Figure 3: First change regarding the Tests.

Another key finding involved navigation to the

'Your events' screen. Since four out of seven

Promoting Healthy Development in Early Childhood: A Proposal of a Mobile Application

281

participants naturally navigated to the Events screen,

we added a calendar icon in the top-right corner

linking to personal events. We maintained the

existing Profile link as well, since some participants

logically looked there to access personal information

(see Figure 5 on Annex 1).

After incorporating modifications based on the

usability test results, we finalized the graphic

proposal for the Cres(SER) app. This final version

incorporates several features, including: the

possibility of creating multiple profiles for different

children; access to information on different categories

of interest within healthy development; access to a

personal digital diary, as well as activities that

promote not only healthy development but also the

connection between parents and children; access to a

list of events that promote healthy development;

notifications; and a profile, with access to features

such as your achievements, saves, events, archive,

and settings (see Figure 4 here and Figure 6 on Annex

1).

Figure 4: One of the main features of the final proposal

(Milestones).

Finally, a design system was created for the

Cres(SER) app (see Figure 7 on Annex 1), a set of

components and guidelines that guarantee the visual

consistency of apps, saving time in reproducing

visual elements and patterns (Bergman, 2024).

This stage allowed us to create a comprehensive

and user-friendly design for the Cres(SER) app. By

establishing a cohesive design system, we ensured

that all visual elements and interactions within the

app would be consistent, intuitive, and aligned with

the project's goals.

7 CONCLUSIONS

This study explored the importance that digital

technologies can play, proposing a mobile app to

support parents in promoting healthy development in

early childhood. 

By incorporating key features such as milestone

tracking, timely notifications, and personalized

content, alongside crucial design elements that

enhance usability and engagement, the app stands

poised to make a significant impact. Additionally,

features and design elements such as alignment, scale

and contrast, hierarchy, reliable content, ease of use,

and personalization were considered as crucial to a

solution's credibility, effectiveness, and usability. 

Given that the proposal emerged directly from an

initiative by the Águeda Health Centre, this not only

validates the usefulness of the work carried out but

also creates a significant opportunity for the efforts

and insights to be applied practically and

continuously. Also, the use of UCD and PD proved to

be very relevant making it possible to understand the

user's needs and involve them in the design process.

This research demonstrates an ongoing

commitment to improving future generations' living

conditions. The Cres(SER) app has the potential to

make a difference in supporting families during the

first years of children's lives.

Although the research was conducted in a specific

geographical context, it could be applied to different

regions and contexts, benefiting a wider population,

with adjustments for diverse cultural and social

needs. Expanding the test participants beyond the

Águeda region would be valuable for future work.

In conclusion, this research underscores the

critical importance of supporting healthy

development in early childhood through digital

technologies. The proposed Cres(SER) mobile app,

developed through rigorous research and iterative

design processes, offers a promising solution to

empower parents in fostering their children's growth

and well-being.

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