Mobilizing mHealth for Moms: a Review of Mobile Apps for Tracking Gestational Weight Gain

A Motivational Technology Perspective on the Use of Smart Wrist-Worn Wearables for Postpartum Exercise and Weight Management

Exercise and weight management is crucial in preventing postpartum depression and long-term obesity that carries the risk of chronic illness among postpartum women. Although communication devices, such as a smart wrist-worn wearable (SWW), can help users be more physically active, the extent to which postpartum women might benefit from this technology is unknown. We examined how SWWs promoted exercise and helped postpartum women return to pre-pregnancy weight. We tested a model based on the premise that a motivational device that prompts users to engage with it can establish healthy daily routines. An online survey of 309 postpartum women who were living in the United States and were current users of SWWs revealed that the device encouraged them to spend time completing workout goals. Technological affordances (i.e. customization, navigability, and interactivity) and subsequent user engagement with the device positively predicted total workout hours among postpartum women. We present practical implications for postpartum care programs and smart wearable developers.

The effect of Internet-based nutrition education according to Pender's health promotion model on gestational weight gain: Study protocol for a randomized controlled clinical trial

BACKGROUND

Gestational weight gain (GWG) should be managed appropriately because both inadequate and excessive weight gain have negative health consequences for mother and child. Therefore, we report the study design for investigating the effect of nutrition education based on Pender's health promotion model (HPM) through the smartphone app on GWG.

MATERIALS AND METHODS

This randomized controlled trial (RCT) will be performed on the Internet for intervention by uploading text messages, audio, images, and portable document format (PDF) files via a group in one of the virtual messenger networks with the title "Nutrition education research plan." After random allocation, both control and intervention groups will receive the routine prenatal care including dietary recommendations. The data will be collected using a multipart researcher-made questionnaire containing 33 questions including demographic information and Pender's construct parts. The evaluation is performed with pretest, posttest, and measurement of the obtained weight. Paired and independent samples t-tests and analysis of variance (ANOVA) with repeated measurements will be applied to compare mean scores of constructs of Pender's HPM and gained weights.

RESULTS

The results of this study will clarify whether the present intervention will be effective on the total gestational weight gain and the weight gained in different weeks of pregnancy compared to the control group.

CONCLUSION

The obtained findings of this study might be useful for managing GWG and consequently maternal and neonatal outcomes.

Mobile health apps for pregnant women usability and quality rating scales: a systematic review

OBJECTIVE

This study is to identify the apps used by pregnant women during the technology era and to choose the best app from the point of view of pregnant women and experts.

METHODS

The article is a research article that uses PRISMA flowchart. Given that there are many apps in the field of pregnancy and due to technological advances, the articles of the last 13 years that have been scientifically published in the databases of Google Scholar, PubMed, and Science Direct have been analyzed. The most widely used and, at the same time, the best app is introduced in terms of its high usability in users' attitude. Finally, Apps will be compared in terms of accuracy, precision, and usability of the dimensions of Jacob Nielsen's five principles.

RESULTS

According to the search strategy, 23 articles were identified qualitatively by reviewing both authors. Then, the types of apps were divided into three general categories, pregnant entertainment apps, pregnant information apps, and monitoring apps for mothers' physical health. Finally, 10 apps were selected and the Amila app was introduced as the best due to its high usability (Effectiveness %66.66) and users' satisfaction or women's choice (%98).

CONCLUSION

Using trusted apps to maintain their health and reduce traffic will be very important. Given that this research article was written with the aim of choosing the best app, that not only provides the required information to mothers, but also the ability to interact with doctors and specialists.

Pregnancy mobile app use: A survey of health information practices and quality awareness among pregnant women in Australia

BACKGROUND

Health-related mobile applications (apps) have the potential to improve health knowledge and promote healthy behaviours during pregnancy. Pregnancy apps are popular and extensively used by consumers.

OBJECTIVE

This study investigates the usage patterns, decision-making criteria and concerns regarding the quality and credibility of health-related information within pregnancy mobile applications. The aim of this study is to understand consumer perspectives to potentially contribute to guidelines for apps containing health-related information.

DESIGN

A cross-sectional study, utilising an online questionnaire for data collection.

METHODS

The study surveyed pregnant women in Australia who were recruited via online platforms, including social media and paid Facebook ads. Participants completed a 29-item questionnaire assessing their use of pregnancy apps, sources of health information and perceptions of app quality and safety, with data collected and analysed using the Qualtrics platform and SPSS Statistics.

RESULTS

The survey was survey completed by 427 current-or-recently pregnant individuals, aged 18 or over and located in Australia. Overall, 62.3% were currently pregnant and 37.7% were recently pregnant, within 6 months. Medical practitioners were the primary source of pregnancy-related health information, and pregnancy apps were the third most common source. Pregnancy apps were considered to be a trustworthy source of information by 63.8% of respondents and the majority used apps during pregnancy (94.2%). Of those who used pregnancy apps (n = 325), information being safe and trustworthy was their top priority when selecting an app. However, 35.5% (n = 115) had encountered information in an app they felt was unsafe or conflicted with previous knowledge or advice. Only 4.6% (n = 15) were aware that health-related apps are not screened for accurate information/undergo quality assurance checks before being made available to download. If provided with a guide to evaluate app quality, 74.6% (n = 241) would utilise the tool.

CONCLUSIONS

These findings highlight a need to promote the critical assessment of health information within pregnancy apps and to develop resources to support consumers in doing so.

Digital Self-Monitoring Tools for the Management of Gestational Weight Gain: Protocol for a Systematic Review

BACKGROUND

Gestational weight gain (GWG) exceeding the recommendations of the Institute of Medicine (in the United States) is associated with numerous adverse maternal and infant health outcomes. While many behavioral interventions targeting nutrition and physical activity have been developed to promote GWG within the Institute of Medicine guidelines, engagement and results are variable. Technology-mediated interventions can potentially increase the feasibility, acceptability, and reach of interventions, particularly for pregnant women, for whom integration of interventions into daily life may be critical to retention and adherence. Previous reviews highlight GWG self-monitoring as a common intervention component, and emerging work has begun to integrate digital self-monitoring into technology-mediated interventions. With rapid advances in technology-mediated interventions, a focused synthesis of literature examining the role of digital self-monitoring tools in managing GWG is warranted to guide clinical practice and inform future studies.

OBJECTIVE

The proposed review aims to synthesize the emerging research base evaluating digital GWG self-monitoring interventions, primarily focusing on whether the intervention is effective in managing GWG. Depending on the characteristics of the included research, secondary focus areas will comprise intervention recruitment and retention, feasibility, acceptability, and differences between stand-alone and multicomponent interventions.

METHODS

This protocol was developed following the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) guidelines for systematic review protocols. The proposed review would use a planned and systematic approach to identify, evaluate, and synthesize relevant and recent empirical quantitative studies (reported in English) examining the use of digital weight self-monitoring tools in the context of technology-mediated interventions to manage GWG in pregnant US adults, with at least 2 instances of data collection. Literature eligible for inclusion will have a publication date between January 2010 and July 2020. The Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies will be used to assess the methodological quality of included studies across various domains, and results will be synthesized and summarized per the synthesis without meta-analysis guidelines.

RESULTS

The initial queries of 1150 records have been executed and papers have been screened for inclusion. Data extractions are expected to be finished by December 2023. Results are expected in 2024. The systematic review that will be generated from this protocol will offer evidence for the use of digital self-monitoring tools in the management of GWG.

CONCLUSIONS

The planned, focused synthesis of relevant literature has the potential to inform the use of digital weight self-monitoring tools in the context of future technology-mediated interventions to manage GWG. In addition, the planned review has the potential to contribute as part of a broader movement in research toward empirically supporting the inclusion of specific components within more extensive, multicomponent interventions to balance parsimony and effectiveness.

TRIAL REGISTRATION

PROSPERO CRD42020204820; https://tinyurl.com/ybzt6bvr.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/50145.

A mixed-methods study exploring women's perceptions and recommendations for a pregnancy app with monitoring tools

Digital health tools such as apps are being increasingly used by women to access pregnancy-related information. Conducted during the COVID-19 pandemic, this study investigated: (i) pregnant women's current usage of digital health tools to self-monitor and (ii) their interest in theoretical pregnancy app features (a direct patient-to-healthcare-professional communication tool and a body measurement tool). Using a mixed methods approach, 108 pregnant women were surveyed and 15 currently or recently pregnant women were interviewed online. We found that pregnant women used digital health tools to mainly access pregnancy related information and less so to self-monitor. Most participants were interested and enthusiastic about a patient-to-healthcare-professional communication tool. About half of the survey participants (49%) felt comfortable using a body measurement tool to monitor their body parts and 80% of interview participants were interested in using the body measurement to track leg/ankle swelling. Participants also shared additional pregnancy app features that they thought would be beneficial such as a "Digital Wallet" and a desire for a holistic pregnancy app that allowed for more continuous and personalised care. This study highlights the gaps and needs of pregnant women and should inform all stakeholders designing pregnancy digital healthcare. This study offers a unique insight into the needs of pregnant women during a very particular and unique period in human history.

Pregnancy Apps for Self-Monitoring: Scoping Review of the Most Popular Global Apps Available in Australia

Digital health tools, such as apps, have the potential to promote healthy behaviours, especially self-monitoring, which can facilitate pregnancy management and reduce the risk of associated pregnancy health conditions. While pregnancy apps are popular amongst pregnant women, there is limited information about the overall quality of their content or self-monitoring tools and the number of behaviour change techniques (BCTs) that they include. The aim of this study was thus to assess the quality of pregnancy apps for self-monitoring, and their usage of BCTs. We identified pregnancy apps by web scraping the most popular global apps for self-monitoring in the Apple App Store and Google Play Store available in Australia. The app quality was evaluated using the scorecard approach and the inclusion of BCTs was evaluated using the ABACUS tool. We identified 31 pregnancy apps that met our eligibility criteria. We found that pregnancy apps tended to score the highest in the domains of 'cost and time', 'usability', and 'technical', and lowest on 'clinical' and 'end-user requirements'. Additionally, the majority of apps contained minimal BCTs. Based on our findings, we propose a digital health scorecard visualisation that would break down app quality criteria and present them in a more accessible way to clinicians and pregnant users. We conclude that these findings highlight the shortcomings of available commercial pregnancy apps and the utility of a digital health scorecard visualisation that would empower users to make more informed decisions about which apps are the most appropriate for their needs.

Assessing the Content and Quality of Digital Tools for Managing Gestational Weight Gain: Systematic Search and Evaluation

BACKGROUND

Digital health resources have the potential to assist women in optimizing gestational weight gain (GWG) during pregnancy to improve maternal health outcomes.

OBJECTIVE

In this study, we aimed to evaluate the quality and behavior change potential of publicly available digital tools (websites and apps) that facilitate GWG tracking.

METHODS

Digital tools were identified using key search terms across website search engines and app stores and evaluated using the Mobile App Rating Scale, the App Behavior Change Scale, as well as criteria to evaluate the rigor and safety of GWG information.

RESULTS

Overall, 1085 tools were screened for inclusion (162 websites and 923 apps), and 19 were deemed eligible. The mean Mobile App Rating Scale quality score was 3.31 (SD 0.53) out of 5, ranging from 2.26 to 4.39, and the mean App Behavior Change Scale score was 6 (SD 3.4) out of 21, ranging from 19 to 0. Of the 19 items used to evaluate rigor of GWG advice, most tools (n=11, 57.9%) contained ≤3 items.

CONCLUSIONS

This review emphasizes the substantial limitations in current digital resources promoting the monitoring and optimization of GWG. Most tools were of low quality, had minimal behavior change potential, and were potentially unsafe, with minimal linkage to evidence-based information or partnership with health care.

Helping Individuals Achieve a Healthy Weight Gain During Pregnancy: A Multipronged Approach

Approximately half of pregnant individuals in the United States exceed recommendations for gestational weight gain (GWG). Excessive GWG is associated with negative outcomes for maternal and infant health. In this article, we provide guidance to nurses who counsel patients about GWG. Because of negative bias toward persons with obesity, nurses need to understand their own attitudes toward obesity to provide supportive GWG counseling. The use of words such as weight is preferred to obese, and recommended GWG goals should be consistent with established guidelines. The setting of specific, measurable, attainable, realistic, and trackable behavioral goals can help translate a goal for GWG into practical actions in daily living. Mobile phone apps, if carefully chosen, may help individuals learn about and track GWG.