Health Care Professionals’ Attitudes Toward, and Experiences of Using, a Culture-Sensitive Smartphone App for Women with Gestational Diabetes Mellitus: Qualitative Study

Abstract

BackgroundThe increasing prevalence of gestational diabetes mellitus (GDM) among women of different ethnic backgrounds provides new challenges for health care professionals, who often find it difficult to provide information about the management of this disease to such individuals. Mobile health (mHealth) may act as a useful tool for blood sugar control and care process enhancement. However, little is known about health care professionals’ experiences and attitudes toward the use of mHealth for women with GDM.ObjectiveThe aim of this study was to explore how health care professionals perceived the provision of care to pregnant women who managed their GDM using the culture-sensitive Pregnant+ app in a randomized controlled trial.MethodsIndividual interviews with 9 health care professionals providing care for women with GDM were conducted. Braun and Clark’s method of thematic content analysis inspired the analysis. This study included health care professionals who were primarily responsible for providing care to participants with GDM in the Pregnant+ randomized controlled trial at 5 diabetes outpatient clinics in Oslo, Norway.ResultsHealth care professionals perceived mHealth, particularly the Pregnant+ app, as an appropriate tool for the care of women with GDM, who were described as individuals comprising a heterogeneous, motivated group that could be easily approached with health-related information. Some participants reported challenges with respect to provision of advice to women with different food cultures. The advantages of the Pregnant+ app included provision of information that women could access at home, the information provided being perceived as trustworthy by health care professionals, the culture sensitivity of the app, and the convenience for women to register blood sugar levels. Technical problems, particularly those associated with the automatic transfer of blood glucose measurements, were identified as the main barrier to the use of the Pregnant+ app. Strict inclusion criteria and the inclusion of participants who could not speak Norwegian were the main challenges in the recruitment process for the randomized controlled trial.ConclusionsThe findings of this study suggest that mHealth is a useful tool to enhance the care provided by health care professionals to women with GDM. Future mobile apps for the management of GDM should be developed by a trustworthy source and in cooperation with health care professionals. They should also be culture sensitive and should not exhibit technical problems.

Effect of the Pregnant+ smartphone application in women with gestational diabetes mellitus: a randomised controlled trial in Norway

“…The questionnaires were pilot tested among women of different ethnic backgrounds. During the RCT, individual interviews with participants and healthcare providers were conducted to gain knowledge on their experiences with the intervention 31 32…”

Evaluation of a Text Messaging Intervention to Support Self-Management of Diabetes During Pregnancy Among Low-Income, Minority Women: Qualitative Study

“…Thus, an mHealth intervention that reduces these burdens may be particularly impactful and needed in this community. Ultimately, given the limited ability of in-person care to improve health behaviors, the implementation of mHealth interventions such as TDS may significantly enhance the care provided by the health care team [ 53 ]. Furthermore, when designed with both patient and clinician input to offer ongoing support beyond simply tracking glucose results, motivation-focused mHealth programs may be especially successful.…”

Identification of Type 2 Diabetes Management Mobile App Features and Engagement Strategies: Modified Delphi Approach

“…Several health apps suggested contacting HCP without providing specific contact details, access to experts, or just-in-time resources that could provide this type of guidance [ 40 ]. Other apps provided contact details for the diabetes health care team [ 41 , 42 ] or emergency contact lists [ 38 ].…”

“…By clicking on a particular hospital, all information regarding that hospital could be provided; Furthermore, this is particularly advantageous for travelers as they could be connected with nearby health care centers if needed, which is a common concern for travelers with chronic diseases [ 46 ]. For the “database listing local restaurants and stores providing diabetes-friendly food” feature, a study modified a food database to provide symbolic food names and calorie information, including recipes, ingredients, and local food names [ 41 ], which can be added to the diabetes self-management health apps. Another study showed that 11 of 15 available diabetes management health apps on the market focused on tracking carbohydrate intake, while only 3 of 15 had a built-in food database [ 32 ].…”