Acceptability of the Pregnancy, Exercise, and Nutrition Research Study With Smartphone App Support (PEARS) and the Use of Mobile Health in a Mixed Lifestyle Intervention by Pregnant Obese and Overweight Women: Secondary Analysis of a Randomized Controlled Trial

Abstract

Background Dietary interventions can improve pregnancy outcomes among women with increased BMI. Although the interest in mobile health interventions is growing, little is known about the acceptability of smartphone apps to support lifestyle interventions in such a cohort. Objective We aimed to assess the acceptability of the pregnancy, exercise, and nutrition research study with smartphone app support (PEARS) and the use of mobile health in a mixed lifestyle intervention delivered to overweight and obese pregnant women. Methods PEARS was a randomized controlled trial of a low glycemic index dietary intervention with exercise prescription and a smartphone app, which was delivered to pregnant women who were overweight or obese. Acceptability questionnaires were completed by the intervention group at 28 weeks of gestation (n=149) and at postintervention (n=123). Maternal characteristics were recorded (ie, age, ethnicity, BMI, socioeconomic status). Associations between maternal characteristics and acceptability of the intervention and app were analyzed using two-tailed t tests, Mann-Whitney U tests, chi-square test, and logistic regression. One-on-one semistructured interviews were conducted with a subcohort of the intervention participants (n=28) at 34 weeks of gestation, in which the participants shared their experiences of the PEARS intervention. Results The intervention was generally accepted, with respondents agreeing that the diet was easy to follow (98/148, 68.5%), enjoyable (106/148, 74.1%), and affordable (110/148, 76.9%). Qualitative and quantitative results were consistent with each another, both demonstrating that app acceptability was high. The participants agreed that the app was enjoyable (96/120, 80.0%) and easy to use (116/119, 97.5%). Compared to those with tertiary education, those with lower education levels were more likely to enjoy the dietary changes (P=.04). Enjoyment of the app was associated with disadvantaged neighborhood deprivation index (P=.01) and higher BMI (P=.03). Conclusions The PEARS intervention and use of a supportive smartphone app were accepted by pregnant women, particularly by those from vulnerable subgroups of this population. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN) 29316280; https://www.isrctn.com/ISRCTN29316280

A Digital Cancer Ecosystem to Deliver Health and Psychosocial Education as Preventive Intervention

“…The first one, which represented approximately half of the sample, was optimistically engaged, involved light-heartedness toward health, loyalty toward healthcare, and eagerness to adopt eHealth. These results are in line with other studies that also show that participants with low SES can engage in eHealth interventions [ 30 , 31 , 32 , 33 ]. The second attitude, embodied roughly a quarter of the sample, were doubtfully disadvantaged, feeling hesitance toward eHealth adoption.…”

The Barriers and Facilitators of eHealth-Based Lifestyle Intervention Programs for People With a Low Socioeconomic Status: Scoping Review

“…The studies included were randomized controlled trials (RCTs) [ 23 , 30 - 40 ], observational studies [ 41 - 56 ], and design studies [ 57 - 77 ]. Several RCTs and observational studies evaluated eHealth interventions on health outcomes (eg, BMI, blood pressure, and hemoglobin A 1c ) [ 30 , 34 , 35 - 37 , 40 , 43 , 45 , 47 , 48 , 53 , 78 ], nutrition-related behavior outcomes [ 32 , 38 , 39 , 79 , 80 ], physical activity–related outcomes, smoking-related outcomes [ 23 , 31 , 46 , 51 , 81 , 82 ], usage outcomes [ 33 , 49 , 54 ], and reach [ 44 ], as well as feasibility and acceptability outcomes [ 47 , 80 ] ( Multimedia Appendix 3 ). Design studies examined recruitment [ 57 ], usability, feasibility [ 57 - 65 ], development, or acceptability of eHealth interventions [ 58 - 60 , 64 , 65 , 67 , 68 , 70 ].…”

“…In the various stages of the development and evaluation of the intervention (ie, problem definition, development, and implementation for the study) [ 48 , 50 , 59 , 60 , 64 , 66 , 69 , 70 , 84 ], several studies involved stakeholders, which included family members, experts, key informants [ 50 , 61 , 69 , 75 , 84 , 86 ], health professionals, and end users [ 48 , 54 , 64 - 66 , 68 - 70 , 73 , 75 , 83 ]. However, some studies provided little information on the identification of stakeholders and did not clarify the level of involvement of stakeholders and end users [ 37 , 44 , 50 , 56 , 66 , 70 , 78 , 79 , 81 , 83 , 87 ].…”

Child Anthropometrics and Neurodevelopment at 2 and 3 Years of Age Following an Antenatal Lifestyle Intervention in Routine Care—A Secondary Analysis from the Cluster-Randomised GeliS Trial

“…Furthermore, a recent meta-analysis has focused on the use of smartphone-based interventions to promote maternal health behaviours and maternal-foetal health outcomes, and indicated that multimodal interventions that also include another method of communication seem to have the highest effectiveness in reducing GWG [ 49 ]. Regarding smartphone applications (apps), non-time-consuming, concise, and practical information and advice are valued by participants [ 50 ], and apps may help overcome some barriers caused by socioeconomic gaps by being easily accessible to all women [ 50 ]. Overall, the above-mentioned aspects could be interesting approaches for the design of future trials, and might be able to improve child health outcomes by increasing the intervention effect on maternal health and lifestyle during pregnancy.…”