Exploring Adherence to Pelvic Floor Muscle Training in Women Using Mobile Apps: Scoping Review (Preprint)

Harper, Rosie; Sheppard, Sally; Stewart, Carly; Clark, Carol

doi:10.2196/preprints.45947

Cited by 3 publications

(6 citation statements)

References 30 publications

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“…Using this well‐known method of designing interventions in reverse allows the identification of potential facilitatory behaviour change techniques (BCTs) in behavioural interventions. This method has been documented in other studies 10,21 …”

Section: Methodsmentioning

confidence: 85%

“…Behaviour change involves many interrelated factors, of which nudging is only one small part 35 . Similarly, adherence depends on individual self‐efficacy and the number of prescribed exercises completed 21 . More rigorous means of measuring women's behaviour and adherence to PFMT are required to better understand how PFMT digital nudges influence adherence.…”

Section: Resultsmentioning

confidence: 99%

“…This method has been documented in other studies. 10,21 BCTs identified in the images and videos with a RAG rating of one or more were mapped to their core COM components using the COM-BCW. 12 The BCTs were identified by the first author.…”

Section: Data Synthesismentioning

confidence: 99%

“…35 Similarly, adherence depends on individual self-efficacy and the number of prescribed exercises completed. 21 More rigorous means of measuring women's behaviour and adherence to PFMT are required to better understand how PFMT digital nudges influence adherence. PFMT mobile apps on the NHS library provide an alternative means of distributing targeted health messaging at a population level 12 while rigorously recording adherence using in-app algorithms.…”

Section: Behaviour Change Techniques Used In Digital Reminders With T...mentioning

confidence: 99%

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#DryByChristmas: A patient and public involvement study on women's engagement with humorous pelvic floor muscle training digital nudges on social media

Harper,

Sheppard,

Miller

et al. 2024

Health Expectations

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IntroductionPatient and public involvement (PPI) is essential for women's health research. Little is known about how women engage with humorous social media and behavioural health messaging targeting pelvic floor muscle training (PFMT). This PPI aimed to understand how women engage with a humorous social media campaign encouraging PFMT. The study findings will influence the co‐design of a digital intervention to support women's adherence to PFMT.MethodsThe Guidance for Reporting Involvement of Patients and the Public Version 2 short form was used to report the study's findings. The study examined public engagement with a humorous social media campaign encouraging PFMT in women. A healthcare professional and comedian ran the campaign following the national guidelines for engagement in PFMT. Instagram analytics gave insight into the demographics of the public who engaged, how they engaged and the most popular content. The behaviour change techniques (BCTs) used in the digital nudges that generated the highest levels of engagement were analysed using the Capability Opportunity Motivation Behaviour Change Wheel.ResultsThe majority (96%) of the population showing the highest levels of engagement were women aged 35–44 years and were based in the United Kingdom (77%). The Instagram account saw an increase in engagement by 12% over the 3‐month campaign, with 22,032 users seeing digital nudges and 2645 engaging with the digital nudges. The preferred way of engaging was using Likes (9723). The common themes in the digital nudges that generated the highest levels of engagement were BCTs associated with the ‘social influences’ theoretical domain framework that targeted the core behaviour opportunity.ConclusionThe study findings suggest humour may improve women's engagement with online PFMT programmes; however, more rigorous research is required to better understand diverse women's experiences of humorous online PFMT nudges. Future studies may use PFMT mobile apps instead of social media to capture true user engagement and adherence to PFMT more accurately. The insights gained from the study will be taken forward to co‐design a digital behavioural intervention as part of a larger study.Public ContributionMembers of the public were involved in the co‐design of a digital health intervention that will be trialled as part of a larger research study. The public was involved using the social media platform Instagram. Public engagement with a humorous social media campaign to encourage women to engage with pelvic floor exercises was captured using Instagram analytics, for example, the timing of engagement.

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Section: Methodsmentioning

confidence: 85%

Section: Resultsmentioning

confidence: 99%

Section: Data Synthesismentioning

confidence: 99%

Section: Behaviour Change Techniques Used In Digital Reminders With T...mentioning

confidence: 99%

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#DryByChristmas: A patient and public involvement study on women's engagement with humorous pelvic floor muscle training digital nudges on social media

Harper,

Sheppard,

Miller

et al. 2024

Health Expectations

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“…The targeted nudges were designed following Patient and Public Involvement (PPI), a systematic scoping review of literature [23] around interventions used in PFMT mobile apps and qualitative research. The nudges target different stages of the perinatal period and have been divided into the following categories:…”

Section: Interventionmentioning

confidence: 99%

The Pelvic (floor) Reminders (to) Explore Perinatal (women’s) Acceptability (of) Reminders (to) Exercise (PREPARE) study: protocol for a feasibility trial

Harper,

Armstrong,

Sheppard

et al. 2024

Preprint

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Background Pelvic Floor Muscle Dysfunction (PFMD) is a condition that affects up to one in three women at some point in their lifetime and can typically be traced back to the perinatal period. Supervised Pelvic Floor Muscle Training (PFMT) is the gold standard of treatment for symptoms of PFMD however women commonly forget to complete PFMT. ‘Nudges’ are a behavioural intervention that can be targeted to certain populations and can be integrated in existing reminder features in mobile apps. No study has tested this novel digital intervention to encourage perinatal women to complete PFMT. The overall aim of this feasibility trial is to explore adherence to PFMT in those who receive targeted digital nudges and a mobile app compared to those who receive a leaflet. Methods A feasibility study will explore acceptability of digital PFMT nudges amongst perinatal women. Seventy-five women over 26 weeks pregnant will be invited to participate in the study. Women who consent to participating will be randomised to either the intervention or control group. Those in the intervention group will receive a weekly digital PFMT nudge and a PFMT mobile app until they are four months postnatal. Those in the control group will receive a PFMT leaflet. Participants will have three follow-ups at 9, 21 and 31 weeks corresponding to the appropriate gestational and post-natal phase. Both quantitative and qualitative data will be collected. Quantitative data will be collected at each follow up and will include the EQ5D5L, ICIQ-UI SF, EARS, the Broome Pelvic Muscle Self-Efficacy Scale, self-recorded PFMT adherence logs as well as in-app adherence. Qualitative data will be collected through interviews of between five to ten participants at the end of the study. One open-ended question on the acceptability of the intervention at each follow up will be asked. Discussion This feasibility trial will attempt to better understand perinatal women’s acceptability of the novel intervention and study processes provide practical and relevant solutions that can be taken forward in a randomised controlled trial.

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Exploring Adherence to Pelvic Floor Muscle Training in Women Using Mobile Apps: Scoping Review

Harper,

Sheppard,

Stewart

et al. 2023

JMIR Mhealth Uhealth

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Background Pelvic floor dysfunction is a public health issue, with 1 in 3 women experiencing symptoms at some point in their lifetime. The gold standard of treatment for pelvic floor dysfunction is supervised pelvic floor muscle training (PFMT); however, adherence to PFMT in women is poor. Mobile apps are increasingly being used in the National Health Service to enable equity in the distribution of health care and increase accessibility to services. However, it is unclear how PFMT mobile apps influence PFMT adherence in women. Objective We aimed to identify which behavior change techniques (BCTs) have been used in PFMT mobile apps, to distinguish the core “capability, opportunity, and motivation” (COM) behaviors targeted by the BCTs used in PFMT mobile apps, and to compare the levels of PFMT adherence in women between those using PFMT mobile apps and those receiving usual care. Methods We conducted a scoping review of the literature. Published quantitative literature that compared the use of a PFMT mobile app to a control group was included to address the objectives of the study. The electronic bibliographic databases searched included MEDLINE, CINAHL, Scopus, Web of Science, and PEDro, along with CENTRAL. Studies were also identified from reference searching of systematic reviews. Original articles written in English from 2006 onward were included. Nonexperimental quantitative studies, qualitative studies, studies that use male participants, case studies, web-based interventions, and interventions that use vaginal probes were excluded. Narrative synthesis was conducted on eligible articles based on the aims of the study. Results Of the 114 records retrieved from the search, a total of 6 articles met the eligibility and inclusion criteria. The total number of participants in the studies was 471. All PFMT mobile apps used the BCT “prompts and cues.” Opportunity was the core COM behavior targeted by the PFMT mobile apps. Higher levels of adherence to PFMT were observed among women using PFMT mobile apps. Conclusions Digital “prompts and cues” are a BCT commonly used in PFMT mobile apps, and further research is required to practically assess whether a future randomized controlled trial that investigates the effectiveness of digital “prompts and cues” on PFMT adherence in women can be conducted.

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Exploring Adherence to Pelvic Floor Muscle Training in Women Using Mobile Apps: Scoping Review (Preprint)

Cited by 3 publications

References 30 publications

#DryByChristmas: A patient and public involvement study on women's engagement with humorous pelvic floor muscle training digital nudges on social media

#DryByChristmas: A patient and public involvement study on women's engagement with humorous pelvic floor muscle training digital nudges on social media

The Pelvic (floor) Reminders (to) Explore Perinatal (women’s) Acceptability (of) Reminders (to) Exercise (PREPARE) study: protocol for a feasibility trial

Exploring Adherence to Pelvic Floor Muscle Training in Women Using Mobile Apps: Scoping Review

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