A Comparison of Functional Features of Chinese and US Mobile Apps for Pregnancy and Postnatal Care: A Systematic App Store Search and Content Analysis

Understanding and Involving the Perspective of Pregnant Women as Users When Designing the Framework of e-Health and Exercise Interventions during Pregnancy: Preliminary Study

Health and exercise technology may promote a healthy lifestyle during pregnancy. The objective of this cross-sectional study was to understand and involve the perspective of pregnant women as users in the design of a framework for future e-health and exercise interventions during pregnancy. Pregnant women replied to a questionnaire aimed at understanding their physical activity patterns, needs, and preferences regarding the use of mobile applications (apps). The main results showed that one-third of the women did not practice any type of exercise during pregnancy. Women preferred to exercise in a gym, outdoors, or at home. The majority already had or were currently using a fitness app, but never used any pregnancy-specific app. Most women agreed that it was important to have a specific app for pregnancy to improve knowledge about recommendations on lifestyle, have direct contact with health and exercise professionals, have social interaction with other mothers, and have guidance on preparation for childbirth and postpartum recovery. Understanding and involving the perspective of pregnant women as users will allow researchers to improve the design of a pregnancy-specific app and future e-health and exercise interventions during pregnancy. These preliminary results will lead to the development of the "active pregnancy app" focused on the promotion of an active and healthy lifestyle during pregnancy and postpartum.

A socio-ecological model of factors influencing physical activity in pregnant women: a systematic review

Physical activity (PA) is safe for most pregnant women, improving both maternal fitness and birth outcomes. Despite evidence of benefits, most pregnant women eliminate or reduce PA during pregnancy. This systematic review aimed to analyze the factors affecting maternal PA during pregnancy with reference to a socio-ecological model. A systematic search of relevant published studies between 2001 and 2022 was conducted through PubMed, Scopus, Web of Science, Academic Search Ultimate, Medline, and SPORTDiscus with full text via the EBSCO platform. A total of 32 studies that met the inclusion criteria were reviewed. The findings revealed that various study designs can lead to different outcomes in terms of what is identified as a PA facilitator or barrier. The factors that positively influenced PA in pregnant women were: higher levels of education, knowledge, and skills, as well as access to mass media. Conversely, lower levels of education, lack of knowledge and skills, low income, pregnancy discomforts, limited time, safety concerns, and societal perceptions of PA in pregnancy acted as barriers. Additionally, family, colleagues/friends, and partners could either support or hinder PA. Factors affecting overall maternal PA were somewhat different from those affecting the moderate-to-vigorous intensity of PA. Pregnant women receive little organizational and policy support. There is an urgent need to provide accessible information and resource systems for pregnant women. Since most pregnant women are motivated to engage in PA and susceptible to family advice, interventions should not be limited only to pregnant women, but should involve a family member, especially partners. There is a need to take global, systemic actions to promote an active lifestyle in pregnancy. Addressing safety concerns related to PA during pregnancy should be a significant part of these promotional activities.

App-Supported Lifestyle Interventions in Pregnancy to Manage Gestational Weight Gain and Prevent Gestational Diabetes: Scoping Review

BACKGROUND

Excessive gestational weight gain (GWG) and gestational diabetes mellitus (GDM) are common pregnancy complications that have been shown to be preventable through the use of lifestyle interventions. However, a significant gap exists between research on pregnancy lifestyle interventions and translation into clinical practice. App-supported interventions might aid in overcoming previous implementation barriers. The current status in this emerging research area is unknown.

OBJECTIVE

This scoping review aims to provide a comprehensive overview of planned, ongoing, and completed studies on eHealth and mobile health (mHealth) app-supported lifestyle interventions in pregnancy to manage GWG and prevent GDM. The review assesses the scope of the literature in the field; describes the population, intervention, control, outcomes, and study design (PICOS) characteristics of included studies as well as the findings on GWG and GDM outcomes; and examines app functionalities.

METHODS

The scoping review was conducted according to a preregistered protocol and followed established frameworks. Four electronic databases and 2 clinical trial registers were systematically searched. All randomized and quasi-randomized controlled trials (RCTs) of app-supported lifestyle interventions in pregnancy and related qualitative and quantitative research across the different study phases were considered for inclusion. Eligible studies and reports of studies were included until June 2022. Extracted data were compiled in descriptive analyses and reported in narrative, tabular, and graphical formats.

RESULTS

This review included 97 reports from 43 lifestyle intervention studies. The number of published reports has steadily increased in recent years; of the 97 included reports, 38 (39%) were trial register entries. Of the 39 identified RCTs, 10 efficacy or effectiveness trials and 8 pilot trials had published results on GWG (18/39, 46%); of these 18 trials, 7 (39%) trials observed significant intervention effects on GWG outcomes. Of all 39 RCTs, 5 (13%) efficacy or effectiveness trials reported GDM results, but none observed significant intervention effects on GDM. The RCTs included in the review were heterogeneous in terms of their PICOS characteristics. Most of the RCTs were conducted in high-income countries, included women with overweight or obesity and from all BMI categories, delivered multicomponent interventions, delivered interventions during pregnancy only, and focused on diet and physical activity. The apps used in the studies were mostly mHealth apps that included features for self-monitoring, feedback, goal setting, prompts, and educational content. Self-monitoring was often supported by wearable activity monitors and Bluetooth-connected weight scales.

CONCLUSIONS

Research in this field is nascent, and the effectiveness and implementability of app-supported interventions have yet to be determined. The complexity and heterogeneity of intervention approaches pose challenges in identifying the most beneficial app features and intervention components and call for consistent and comprehensive intervention and outcome reporting.

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.

Quality of Mobile Apps for Child Development Support: Search in App Stores and Content Analysis

BACKGROUND

Following increases in smartphone access, more parents seek parenting advice through internet sources, including blogs, web-based forums, or mobile apps. However, identifying quality apps (ones that respond to the diverse experiences of families) for guidance on child development can be challenging.

OBJECTIVE

This review of mobile health apps aimed to document the landscape, design, and content of apps in the United States available to parents as they promote their child's developmental health.

METHODS

To understand the availability and quality of apps for early childhood health promotion, we completed a content analysis of apps in 2 major app stores (Google Play and Apple App stores).

RESULTS

We found that most apps do not provide tailored experiences to parents, including cultural considerations, and instead promote generic guidance that may be useful to parents in some contexts. We discuss the need for an evaluative framework to assess apps aimed to support parents on child development topics.

CONCLUSIONS

Future work is needed on how to support designers in this area, specifically related to avoiding potential burdens on users and providing culturally informed and equity-driven experiences.

Pregnancy Activity Levels and Impediments in the Era of COVID-19 Based on the Health Belief Model: A Cross-Sectional Study

Physical activity (PA) and exercise benefit both the mother and the fetus. Many pregnant women avoid or severely limit PA, leading to complications before and after delivery. This study elucidated the precise effect of each moderator variable on prenatal physical activity (PPA) by examining demographic factors, the PPA-related health belief level (HBL), and the current PPA level. The health belief model (HBM) in conjunction with the international prenatal physical activity questionnaire was used. The HBL in pregnant parous women (PPW) (3.42) was significantly higher than that in nonpregnant nulliparous women (NNW) (3.06). The PPA level in pregnant nulliparous women (PNW) (5.67 metabolic equivalent-hours per week (MET-h/week)) was lower than in the PPW (6.01 MET-h/week). All HBM dimensions (except for perceived barriers) were positively correlated with exercise expenditure in both PNW and PPW. According to the regression tree, participants in PNW aged ≤ 23 years with annual household incomes > CNY 100,001−150,000 had the highest energy expenditure (10.75 MET-h/week), whereas participants in PPW with a perceived benefit score of >4 had the highest energy expenditure (10 MET-h/week). The results demonstrated that the HBL in all groups was acceptable, whereas the PPA level was lower than the recommended PA level. In both PPW and PNW, the HBL was most strongly correlated with exercise expenditure. There is an urgent need to organize public-interest courses to alleviate household expenditure, raise the HBL about PPA in pregnant and NNW, and ensure personal health in the context of COVID-19.